Help With TSH And Free T4 Results

[Fil72]

Hi,
A client of mine ( I am newly graduated NT in the UK) came to me with gut issues, (gastritis etc, a lot of fruit she couldnt tolerate) and i have put her on a gut healing programme, eliminating grains to start with.

HEr blood results came back and her Serum TSH is 1 and her Free T4 is 15.4.

I read that low tsh and normal free T4 is indicative of subclinical hyporthyrodism. But reading Ray Peat 1 and below is good? I am not sure how to interpet this?

Also, in the same test she had raised potassium levels. (5.2). range is 3.5 - 5.

Help-advice would be much appreciated. Thanks,

 

[marsaday]

Being a nutiitionist means you must become familiar with the thyroid workings. It really is the base from which good health comes.

The higher TSH is the worse thyroid health is. So 1 and under is the place to be. BUT the TSH on its own is a poor measurement of thyroid health. You need to see the FT4 and Ft3 numbers. Her Ft4 at 15 is very typical and normal. She will struggle getting the FT3 in the UK, unless she goes to blue horizon blood testing which is the best place for private tests in my opinion. If Ft3 is low, this indicates she has a conversion issue and is more common in women because of higher oestrogen levels.

So all looks ok with thyroid, but an Ft3 would be useful. Potassium is only just over range. Is she eating a lot of potassium rich foods ? Was sodium also normalish ?

High potassium is caused by a kidney problem, i am sure you are aware.

 

[Fil72]

Thanks for replying!

Being a nutiitionist means you must become familiar with the thyroid workings. It really is the base from which good health comes.

Totally agree. I have read a lot about how to improve a sluggish thyroid but still learning how to read blood tests and knowing how to interpret the ranges ranges. Disovering Peat has changed the way I think about health for sure. Compared to nutrition college.

The higher TSH is the worse thyroid health is. So 1 and under is the place to be. BUT the TSH on its own is a poor measurement of thyroid health. You need to see the FT4 and Ft3 numbers. Her Ft4 at 15 is very typical and normal. She will struggle getting the FT3 in the UK, unless she goes to blue horizon blood testing which is the best place for private tests in my opinion. If Ft3 is low, this indicates she has a conversion issue and is more common in women because of higher oestrogen levels
So all looks ok with thyroid, but an Ft3 would be useful. Potassium is only just over range. Is she eating a lot of potassium rich foods ? Was sodium also normalish ? Sodium was 141 (range 135-145)

High potassium is caused by a kidney problem, i am sure you are aware - Yes I have a client with very severe itching, hives and histamine issues and when she went to the GP for a blood test she came out with a reduced kidney function. (of which itching can be a symptom of) But looking at her blood test her potassium levels are within range (4.9 ?) compared to client above which is 5.2.

Wondering if high potassium levels can be linked to her gut issues. I have read that you can get chronic gastritis from having kidney issues. She is doing a gut healing program now which should hopefully help her with her reactions to so many different foods (especially fruit)

 

[Fil72]

realised that my post didnt come out correctly above , not sure how to fix it. Please press on expand to read my comments...thanks,

 

[papaya]

Being a nutiitionist means you must become familiar with the thyroid workings. It really is the base from which good health comes.

The higher TSH is the worse thyroid health is. So 1 and under is the place to be. BUT the TSH on its own is a poor measurement of thyroid health. You need to see the FT4 and Ft3 numbers. Her Ft4 at 15 is very typical and normal. She will struggle getting the FT3 in the UK, unless she goes to blue horizon blood testing which is the best place for private tests in my opinion. If Ft3 is low, this indicates she has a conversion issue and is more common in women because of higher oestrogen levels.

So all looks ok with thyroid, but an Ft3 would be useful. Potassium is only just over range. Is she eating a lot of potassium rich foods ? Was sodium also normalish ?

High potassium is caused by a kidney problem, i am sure you are aware.

what does a very low tsh & a very low ft4 mean? i take thiroyd, should i add some t4?

 

[marsaday]

Low TSH means the brain thinks you have plenty of thyroid in the system, but if you have low FT4 figures then you actually don't.

This can mean a brain signalling fault and this is called HypoPit. Have a read here:

Hypopituitarism - Wikipedia

I am not saying this is the cause, but it wants to be looked into. Do you have any other data which shows what your signalling hormones are doing. e.g., FSH is the signal to make more sperm. If this is low and sperm count is low then again it indicates an issue. If LH is low and testosterone is low again the same issue.

 

[papaya]

Low TSH means the brain thinks you have plenty of thyroid in the system, but if you have low FT4 figures then you actually don't.

This can mean a brain signalling fault and this is called HypoPit. Have a read here:

Hypopituitarism - Wikipedia

I am not saying this is the cause, but it wants to be looked into. Do you have any other data which shows what your signalling hormones are doing. e.g., FSH is the signal to make more sperm. If this is low and sperm count is low then again it indicates an issue. If LH is low and testosterone is low again the same issue.

hmm, that's interesting, thank you so much. at the time of the test i was taking 2g thiroyd under the tongue & i was taking iodine. i wonder if taking it sublingually somehow tricks the brain. i now take 1g(still sublingual) & stopped the iodine, & as of tonight i plan on adding bsp t4. by the way, i'm a girl . i'm thinking i should maybe just order cynoplus.

 

[marsaday]

Iodine can mess with the TSH signal, so maybe have a retest in a few weeks. The iodine will not interfere as much then. I know it increases TSH in high dose, not sure if it also can lower it, but it maybe an iodine issue. Again something to look into.

Taking thyroid meds sublingually will not trick the brain. It is a good way to take meds and is commonly used by many.

Sorry. So look into the female signalling hormones to see if these are low.

 

[sweetpeat]

what does a very low tsh & a very low ft4 mean? i take thiroyd, should i add some t4?

I think it's typical to have low TSH and low t4 lab results when taking NDT (like Thiroyd or Armour). I experienced this myself. I think it's due to the amount of t3 that you're getting from the NDT. In my case, I ended up switching to mainly t4 because I didn't feel good on the amount I was getting from NDT. I needed more t4 and less t3 than NDT provides.

How are you feeling on your current regimen? If you feel fine, then maybe not worry about the lab numbers. But if not, then maybe think of changing things up. Cynoplus has the same ratio of t3 and t4 as NDT, so I don't know if that would improve things. You may need a higher level of t4.

 

[papaya]

I think it's typical to have low TSH and low t4 lab results when taking NDT (like Thiroyd or Armour). I experienced this myself. I think it's due to the amount of t3 that you're getting from the NDT. In my case, I ended up switching to mainly t4 because I didn't feel good on the amount I was getting from NDT. I needed more t4 and less t3 than NDT provides.

How are you feeling on your current regimen? If you feel fine, then maybe not worry about the lab numbers. But if not, then maybe think of changing things up. Cynoplus has the same ratio of t3 and t4 as NDT, so I don't know if that would improve things. You may need a higher level of t4.

thank you so much! i'm not feeling great, but not terrible. i'm planning on adding t4 tonight. should i maybe cut my thiroyd dost to 1/2 grain & the rest t4? how many mcg of t4 would you suggest i take? i currently take 1g thiryd & sometimes(rarely) i'll add an extra 1/2g. how much t4 do you take & what brand?

 

[sweetpeat]

thank you so much! i'm not feeling great, but not terrible. i'm planning on adding t4 tonight. should i maybe cut my thiroyd dost to 1/2 grain & the rest t4? how many mcg of t4 would you suggest i take? i currently take 1g thiryd & sometimes(rarely) i'll add an extra 1/2g. how much t4 do you take & what brand?

I think 25mcg t4 is a typical trial starting dose. Hold that dose for 2 weeks or so and then assess the situation. Lowering your Thiroyd dose as you suggest isn't a bad idea since you say your TSH is very low. Honestly though, it's a lot of trial and error. At least it has been for me. I've found marsaday's posts very helpful as he is also taking mostly t4.

I'm currently taking 150mcg t4 and 2mcg t3, and I get both from Mexico. I'm basically on full replacement; my t4 levels are below the reference range when not taking thyroid. It's taken 2 years for me to reach this level because I was a bit afraid of taking mainly t4 based on the recommendations of the forum. I made very small increases, sometimes as small as 6mcg at a time, and carefully monitored my basal temps. I also got regular lab work, and still do. I've recently started adding in a bit more t3. So even at this point I'm tweaking things, but increasing my t4 dose has overall been a positive experience. But as I said, I was very deficient of t4. Everyone's different and there is no one size fits all dosing. I hope you find what works best for you!

 

[tara]

I read that low tsh and normal free T4 is indicative of subclinical hyporthyrodism. But reading Ray Peat 1 and below is good? I am not sure how to interpet this?

In conjunction with other signs, including monitoring body temps.

 

[papaya]

I think 25mcg t4 is a typical trial starting dose. Hold that dose for 2 weeks or so and then assess the situation. Lowering your Thiroyd dose as you suggest isn't a bad idea since you say your TSH is very low. Honestly though, it's a lot of trial and error. At least it has been for me. I've found marsaday's posts very helpful as he is also taking mostly t4.

I'm currently taking 150mcg t4 and 2mcg t3, and I get both from Mexico. I'm basically on full replacement; my t4 levels are below the reference range when not taking thyroid. It's taken 2 years for me to reach this level because I was a bit afraid of taking mainly t4 based on the recommendations of the forum. I made very small increases, sometimes as small as 6mcg at a time, and carefully monitored my basal temps. I also got regular lab work, and still do. I've recently started adding in a bit more t3. So even at this point I'm tweaking things, but increasing my t4 dose has overall been a positive experience. But as I said, I was very deficient of t4. Everyone's different and there is no one size fits all dosing. I hope you find what works best for you!

thank you so much. what t4 only do you get from mexico? what's so strange is that i have normal ft3 level. i really think this must be coming from taking my thiroyd sublingually & the t4 not being digested. i'm now reading through gbolduev's posts & wondering if i should just try getting off thyroid again???

 

[sweetpeat]

The product I take is called Eutirox. I think it's a generic Synthroid.

If you're only taking 1 grain Thiroyd, it would not take long to wean off and see how you feel. Why did you originally start taking it though?