Blood Results

Heya,

I'm by no means an expert, just been at it a while now myself. Lol. So what I'll do is give you a general overview as it's been explained to me, so you will hopefully see how it all relates to everything else.

Simply, there's a communication loop between the thyroid and the pituitary in your brain. When the pituitary thinks the T4 is too low in your blood, it releases TSH - thyroid stimulating hormone - to wake up the thyroid and make it produce more T4. When there's enough in the blood, the TSH decreases because more doesn't need to be made.

Now, TSH isn't the friend of someone with thyroid cancer because it wakes up thyroid cells and makes them active, which also makes them multiply to keep the thyroid healthy. As thyroid cancer is still basically thyroid cells, TSH being too high can make the cancer spread or come back.

So people with thyroid cancer are generally kept at the top end of the normal range, or even sometimes into the hyperthyroid range. Because going back to that loop I mentioned above - the higher the T4, the lower the TSH, and vice versa.

So usually, for at least the first year, most oncologists aim to get the TSH to about 0.1. After that, sometimes even before, then it's a very individual thing about how suppressed they want you to be, and it depends on your type of thyroid cancer, spread, if it had invaded anything, and other factors. So one thing to always find out is where they want you suppressed to - and that would need to be a question to ask of the consultant, not the GP.

The other thing is that it takes a while for a dose change to level out in your system. So after a hemi, TT, or dose change - you should wait 6 - 8 weeks before having a blood test to see what difference that dose change has made. Any earlier than that, and you'll get an incorrect reading and could end up changing your dose again unnecessarily. But you definitely should have the blood test, as small dose changes can have big impacts on your readings.

I don't know how long you've been on your pills, or how long since a dose change, but if it has been 6 - 8 weeks or more, I'd be tempted to call your specialist nurse or consultant to ask about that TSH reading and to find out what they want it to be - as they may want to increase your dose a little.

Do shout if some/all of that made no sense or if you've any questions about it.

Lass

Xx

Hi Lass

That explanation helps loads thank you. So basically T4 should be high so that TSH stays low. What’s T3 then?

I had my hemi in September, completion in October. Had bloods done end of November. Just had my RAI couple weeks ago. Those blood results were from November tests.

I had 4cm Papillary cancerous tumour on right side, nothing found in other side and no sign of spread anywhere else. Reason I got RAI was due to aggressive nature of some of the cells as they had spread to some of the veins in that side of the thyroid. So belts and braces! 

I did ask consultant before I had RAI how my GP would know what levels I need to be at and he said because he’s made them aware. I think I’m due to go back and see consultant in NY, don’t have an appointment yet.

When I saw him before RAI in December he said it would be unlikely they would review my thyroxine dose any time soon as it was too soon after surgery. 

With my TSH being at the level it’s at, is the T4 high enough. I’m trying to work out if I’m hypo at the moment as having some of the symptoms.

Thanks,

xx

T3 is the active form, it is converted from T4 by enzimes called deiodinases that are found in your liver, brain, intestines, muscles etc. If your TSH is suppressed you are more likely to be slightly hyper rather than hypo. Some symptoms might over lap though as both experience fatigue, dry skin etc. Anyway don't be afraid to ask to your doctor about it 

Hi EJane,

That’s what I wanted to know, is my TSH suppressed? I know how to read the bloods now but don’t know the ranges and what is classed as high and low for each?

Thanks,

xx

TSH of 0.26 is suppressed relative to the 'normal' range for people with thyroids but your docs may well want you to go a little lower, depending on how long it is since you were diagnosed and what your individual circumstances may be. For many people the target is around 0.1 for the first few years. Those with particularly low risk may be allowed to go a bit higher and at the 5 year mark, most docs will relax the target towards the 'lower end of normal' (so around 0.5 or 1 ish

Hi Barbaral

I was diagnosed in September this year. I’ll definitely ask at my next appointment what their target is.

I’ve gained over a stone since I had my completion surgery in October so I’m surprised that I’m more on the hyper side than hypo.

Have a Merry Christmas!!

xx

People always tend to suppose that being hyper - naturally or artificially as we tend to be - means the weight is going to drop off. Unfortunately it's not true. Being hyper can mean you're just hungry ALL the time. Always best to get the blood tests done as you just can't 'guess' whether you're under or over medicated because a lot of the symptoms are the same.

Hi All, 

I had my bloods done again a few weeks ago and this was the results:

TSH-0.2

3T4-18.2

They are saying no action required but I thought I was supposed to more suppressed than that especially since there was uptake in my hip on the scan after RAI.

I am feeling absolutely drained and napping after work everyday and then still having a full sleep at night. Should I be asking the doctor to test me for something else as I've been convinced I must be Hypo but this obviously isn't the case. I'm also feeling so irritated and snappy all the time!

Any advice greatly appreciated.

Thanks

Your blood tests (above) don't indicate a problem but it might be worth asking for Vit D and Vit B12 (I think that's the one) as quite a lot of people find they are low on those and they can make a big difference

Thanks Barbaral

Got the full letter through today but need a medical degree to decipher the results! Any help appreciated, letter below. It also mentions follicular which has never been mentioned to me before. Please excuse my mums poor photography skills, it took her 4 attempts to send me this haha

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