Thyroid test numbers - don't seem to align with symptoms?

[Trina00]

Please can anyone help me make sense of these numbers, and next steps?

Nov 16 Went to GP with many typical underactive thyroid symptoms.
Diagnosed with goitre
Serum TSH 0.45, range 0.4-4.9

GP said levothyroxine wasn't appropriate but did give me a short course.

Feb 17 Serum TSH 0.33, range 0.4-4.9. Came off the levothyroxine.

Blood showed low Vitamin D (30.1) so was put on a course of Vitamin D.

Dec 18 I go back to GP (different surgery), same symptoms - perpetually cold, flaky nails, thinning hair, constantly tired etc.

Serum TSH 0.47, range 0.1-4.0 (note, different range than before)
Serum free T4 13.7, range 9.5-22

Blood test also picked up low serum folate so I was put on a course of tablets.

As well as the continuing symptoms I have worked out I have put on 30kg over the past six years, with no change in diet. I'm just wondering what my next steps should be. Bizarrely it seems as though I have the symptoms of an underactive thread but the blood levels of an overactive one?

I'd be grateful for any advice! Many thanks.

Hopeful bump

Ask to get this moved to the autoimmune disease board.

Thanks for the tip @Todaythiscouldbe I have asked MNHQ to move it.

I have similar.
I get insomnia with hypothyroidism.
Im surprised they treated you with thyroxine with such low numbers.
I got taken off today as mine was 1.6.

I know what you mean though im cold anyway with the thyroxine.
But my tsh without thyroxine was over 3 and i was even colder.
I only went on it for fertility.
I think sometimes the symtoms may seem like thyroid but it's not. (Im just naturally cold).
Also i put on aeight on thyroxine even though my tsh was in range.
I think it made me hungrier

Basically, the problem is TSH is bollocks on its own. Did you get free T4 and free T3 done at the same time as the earlier tests? Would be useful to see how they’ve changed. The T4 you listed certainly isn’t optimal - it should be in the top 1/4 of the range to make you feel better ideally.

The other problem is that thyroid symptoms are so vague and varied, that it could be something else (or several things) causing the same symptoms. Have you had iron, B12 etc tested?

Thyroids are very strange and it's sometimes hard to know what's going on. I think if you have a goitre and tsh is normal its because the tsh is desperately stimulating the thyroid which is growing to accommodate the extra need for t4 and t3. The t4 is on the low side. T 3 would be helpful but they often don't test that. It's possible you could swing into hypo or calm down. You could ask to be referred to an endocrinologist for longer term advice especially as you have symptoms. Most gps only know the basics (a Gp himself told me.)

Have you had antibodies tested?

Always get tests done in the early morning as tsh can be higher then, which may swing how your condition is viewed. Probably not high enough in your case but it's a good rule of thumb for consistency.

Are you by any chance taking any multi vits with biotin in them? Biotin can affect test assays and so results occasionally, it depends on the lab so best to avoid for a few days/ week before hand.

(Sorry I missed you were actually taken off yours keep. I'm a bit off with flu jab. I'd keep an eye on it though.)

Hi, a few days late to this thread. Have you put the decimal point in the right place on your TSH results?
Just this weekend mine came back as 4.88 and T4 of around 14. She told me that I wouldn’t normally get treated for those levels but I have enough symptoms “we treat the patient not the numbers” and has put me on a low dose of levothyroxine for 8 weeks. Then she’ll test again and also test for thyroid antibodies. I’ve also been given Vit D as my levels were a touch low.
I’m now coming to terms with the fact that I have to wait half an hour for my morning coffee 😭

HealthUnlocked.com is a great website for thyroid questions

You have a great Gp thinkl. Tsh should be below 2.5 for conception; I'm astounded they don't just have that as a rule of thumb!

You can take it at night if it's easier.

Coffee is probably stronger than tea but I'll admit to often having less then 30 mins. Consistency is the key.

Wash the thyroxine down with a big glass of water.

Always get tests done as early in the morning as you can, don't take the thyroxine the morning or evening before.

Health unlocked is good, "seasidesusie" is helpful.

You may need to have your levels monitored over this year.

The British thyroid foundation is great.

Health unlocked is good, "seasidesusie" is helpful

Yes, and greygoose I think it is too, amazing knowledge

Yes and grey.

I take mine at night. Mine was TSH 7 and T4 11 and they have given me 50 of levo and now said levels "fine"
I feel crap still, exhausted, cold, hair loss and struggling to lose 0.5lb a week on 1200 cals despite being 5ft 10 and counting every calorie

@NeurotrashWarrior it’s a lottery at my surgery but today I won it!