Thyroxine tablets- TSH4 and T4 results.

CranberryIce said:

Evening all,

My current TSH4 is 0.1
and T4 is 25

10 weeks ago my
TSH4 was 11.4
and my T4 was 14- so my Thyroxine dose was increased from 100 to 125mg daily.

My GP has asked me to decrease my dose back to 100mg. As he said that a TSH4 of 0.1 is abnormal? And T4 of 25 is way to high.

Does anyone know what the “normal ranges are”.

I am under the care of a fertility clinic and they won’t allow me to have any treatment unless I have a TSH4 of less than 2.5.

I am assuming the GP wants me to decrease my Thyroxine dose to 100mg to reduce my T4- will that mean my TSH4 will rise? As I need to keep that as low as possible.

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Hi CranberryIce - Do you have your lab's assay ranges for your tests? The ranges are usually displayed on the print out, or on the website, if you have access to your records. The "normal" ranges can vary a little, lab to lab.

In essence though, my lab's ranges are as follows:

Thyroid Function
Serum TSH level 0.3 – 5
Free T4 10 to 25
Free T3 3.5 - 6.5
Serum Parathyroid 1.95 - 8.49

As I understand things, we would like our TSH to be under 1.0 and the FT4 towards the top of the range - both of yours are certainly that!

Is your 100mcgr increased to 125mcgr 10 weeks ago, and was it your first titration? When I have been negotiating titrations with my own GP, it's a bit of an arm wrestling match. Her preference is to titrate in 12.5mcgr doses, so please don't get hung up, in your mind, on the whole 25mcgr. When I am on an "intermediate" dose, rather than half a tiny tablet, I just toggle the doses on alternate days. That is considered a safe practise, bearing in mind T4 doesn't work on a dose by dose basis.

Personally, I am in the process of attempting to find my sweet spot for thyroid hormones. When I started trying to make sense of it all, I found https://healthunlocked.com/thyroiduk . I have learned masses from them, in to my view, they are the DCUK of the Thyroid world! In your shoes, I'd sort myself out an account over there.

I'm happy to help where I can, but having personal experience of neither T1 nor pregnancy, I'm probably on a par with a chocolate teapot!

Good luck with it all.

To my understand TSH (Thyroid Stimulating Hormone - syas what it does on the tin) is secreted from the pituitary gland to stimulate the thyroid gland to get going. The higher the TSH number the harder it's having to try to get the thyroid going. The T4 and T3 (and the other sub set) levels indicate how the thyroid is actually performing, so a low TSH means the pituitary isn't having to work hard to get the thyroid going. The higher FT4 shows there's plenty going on in the thyroid, but only when the T3 comes into the mix do we start to see the near whole picture as the T4 has to convert to T3.

Has your T3 ever been tested to your knowledge? Along with that, have your thyroid antibodies been tested?

Just like diabetes, it seems like a simple thing, but heck, the devil's in the detail!

CranberryIce said:

This makes so much sense! I wish I knew this before.

As far as I know I have never had my T3 or thyroid antibodies tested (is there a name for that test?). Is it something docs will do easily? I have an appointment with my GP on Saturday to discuss this in detail and will request a T3 test, as they want to retest my TSH4 and T4 in 3 weeks time.

I was diagnosed with and under-active thyroid within the same week of being told I was type 1. The consultant literally said it’s nothing to worry about just take this tablet daily. When you have just been told you have to take multiple injections daily for life... the one tablet (which I know affects me in so many ways) was the least of my worries.

Sadly, because it has never been an issue - or has been stable I have never worried about it. My situation now has forced me to pay more attention to it. (Feel silly now thinking about it!). But hoping it wont take toooo long to get my head around it.

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CranberrryIce, I can completely understand your view of your thyroid issues, when you had to wrestle your T1 into submission at the same time. I was fortunate enough to be meds-free, forever, before my Levothyroxine, so you can probably appreciate I approached it with some reluctance and some enthusiasm, because I didn't want to be taking meds, but was buoyed by the prospect of my unpleasant symptoms would go away, or at least ease.

For me to understand things I tend to try to visualise things, and my explanation to you was pretty much how I got the hang of it.

Moving on to you though: On the NHS, they are very reluctant indeed to test FT3, and bearing in mind you are T1, I would be astonished, due to the commonality of auto-immune thyroid disorders amongst T1s if your antibodies hadn't been tested at some stage. Do you have access online to your test results? If you do, you would be able to track back on what had been done.

Moving back to the FT3 testing, whilst your TSH (and T4) are in range it can be a real battle to have FT3 tested at all. My initial thyroid panels were requested by an Endo, along with 20-odd other tests. He was,.......... erm,.......... trying to work out what was giving me some bonkers weird symptoms - and failed.

Anyway, you may find yourself with better access to the detailed testing, due to your close monitoring in your pre-conception stage.

The tests can be done relatively cost-effectively, by places like MediChecks, and on Health Unlocked there are quite often discount codes on Thyroid Thursdays (I kid you not!). In your shoes, I'd try to have the NHS do them, as then you'll have consistent lab assays and be able to track your trends, but Medichecks, Blue Horizon and others are all out there, more than happy to test whatever you want, within reason.

https://www.medichecks.com/thyroid-function-tests/thyroid-check-plus

I'm so glad you had a look in Health Unlocked, because I really did find them very helpful, even when I was asking very simple, and some rather left field questions. I'm glad you're finding them useful too.

Let me know if I can help you further, but otherwise, all the best with your big adventure to expand your family. Exciting times!

CranberryIce said:

My surgery don’t offer online results yet. The only time I get a paper copy of any results is when I see my (usually useless) nurse at my GP surgery. Will ask for any results at my appointment.

You have been a great help, thank you <3

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CranberryIce, If you are in England, it is my understanding, surgeries were all supposed to be offering online access since 2016, but of course, if yours aren't, they aren't, but the CCG should be informed. You might find something useful to you from a few clicks on here: https://www.nhs.uk/using-the-nhs/nhs-services/gps/gp-online-services/

It's honestly so much easier and more pleasant to be able to self-service, than all those calls and all that grovelling for our own results.

Sometimes it's just so frustrating!