Thyroid results

[topsi]

Hi could someone look at my thyroid results please, they are all within 'normal' limits but some are on the low side. Many thanks

total thyroxine (T4) 84 (59-154)
TSH 2.87 (0.27-4.2)
free thyroxine 14.2 (12.0-22.0)
free T3 5.4 (3.1-6.8)

Also checked anti bodies but they are well within normal ranges.
Just want to find a reason for me feeling so down and tired all the time.

To answer my own question, after further investigation, my TSH is on the high side and may indicate hypothyroidism.
In the USA endocrinologists want to put the top level is TSH to 2.5 meaning I would be classed as high (hypo)
I am going to my GP asap to badger him/her for thyroxine.
It is a scam in this country with reference ranges being all over the place!
For someone being treated with thyroxine they want you levels to be under 2 it doesn't make sense to me at all.
I hope this is the answer to me feeling like shit for the last 5 years or even longer!

Hi ya, I'm not a doctor or medically trained in anyway but I do have thyroid problems myself and so does my OH and yr readings are absolutely fine. have you had an iron count done at all? Are you possibly anaemic? Or a bit depressed? :)

Begging to differ - that FT4 is only two points off the bottom of the range - should be in the top third ie above about 18.

TSH is too high - should be around 1.

If you start reading up on this you will see that a normal, or slightly raised TSH plus a low in range FT4 may be indicative of secondary hypothyroidism.

If you don't have antibodies, which most people with underactive thyroid do, then you need to look for a cause other than auto immune disease.

At this point you need to look at things like Vitamin B12 and folate, Vitamin D, ferritin, to see if any of these are low in range.

If I were in your shoes, and three years ago I was, I would get your GP to do as many blood tests as you can blag out of him and learn as much as you can about these conditions.

D

thank you so much rockin, so what is secondary hypo thyroid, as in caused by something else?
The Americal Association of Clinical Endocrinologists state that in the future the higher level of TSH may be lowered to 2.5 making me over!
I cant get down the GP's fast enough, as usual no appointments for 2 weeks!!
Thanks for your advice, could it be secondary to adrenal function?

I think, you'd need to check this, but I think if it's secondary the root cause is a lack of pituitary function rather than antibodies attacking the thyroid directly.

D

Secondary hypothyroidism occurs when the pituitary gland is malfunctioning rather than the thyroid gland. I think it is quite unusual and is caused by damage to the pituitary gland. I'm not sure you can say with certainty that you have secondary hypothyroidism just by looking at blood results. I saw my Endo yesterday for my latest bloods which were:

FT4 14.4
TSH 4.1
FT3 4.2

He asked if I had been missing taking my levo because my TSH was high. I take my tablets religiously in the morning and avoid consuming anything that might interfere with their uptake. I actually feel very well indeed at the moment, lots of energy and so didn't want to increase my levo dose.

The Endo said that if I did start to feel symptomatic we could up it as I wished. He was clear that he would treat me on symptoms rather than blood results and I think you need to talk to your GP about doing the same for you. If you feel you would benefit from more levo then ask for it and if your GP refuses then seek a second opinion.

Thanks Scott I was actually thinking if it was best just to seek out an expert and go straight to them. It seems such a mine field.

As expected GP wouldn't treat! Clinical guidelines etc etc. Sent me for repeat blood tests as wouldn't trust my private results, I could have just printed them out in order to try and get treatment?!
Wouldn't treat sub clinical hypothyroidism.
Not interested in new guidelines in USA, we are not in America!
Thinks I am stressed.
What do i do now, can anyone recommend a private endo that may take me seriously please?

The NHS is very sniffy about private results, but I was able to use them as a lever to get treated. I sent a copy of the private results, and the company?s quality assurance document to the endo who had told me there was nothing hormonally wrong with me and discharged me with a diagnosis of CFS and a sleep disorder and basically asked him what he was going to do now, as the private lab had assessed me as hypothyroid. He referred me to his Head of Department who picked up the various things that were wrong with me and treated them.

What?s included in the repeat blood tests?

I think in the end your GP has a duty to work with you to get you better and if he can?t (or won?t) do it, then he should refer you on. That is a lottery in itself, but the various thyroid patients? organisations have lists of doctors (NHS and private) who take perhaps a more balanced view than others.

D

Hi Rockin for full blood count, liver tests???, repeat TSH, glucose.
Trying to get a list of doctors but doesn't seem that easy, I don't want to pay a fortune to end up seeing someone with the same point of view.
Thyroid UK have a list but you have to send of a form and a cheque to receive their info pack, how old fashioned is that?
Our local private endo would charge £220 for a consult! There is a hormone Dr in Harley St who may help but again she is ££!

Thyroid uk can just email you out a list of gp's for free - have you asked on their 'health unlocked' website

I can also recommend 'understanding your thyroid' by anthony toft as a book to take to your gp to discuss further

Has anyone ever checked your neck for nodules etc? Maybe try to get a scan too

I don't know much about secondary hypo so can't really advise, but keep going back to the gp for further investigations

Thyroid uk can just email you out a list of gp's for free - have you asked on their 'health unlocked' website

I can also recommend 'understanding your thyroid' by anthony toft as a book to take to your gp to discuss further

Has anyone ever checked your neck for nodules etc? Maybe try to get a scan too

I don't know much about secondary hypo so can't really advise, but keep going back to the gp for further investigations

those thyroid blood results are normal! The GP can't treat something that isn't wrong or he will make you hyperthyroid!

They wouldn't be 'normal' if I was in USA!

They are only normal to someone who can't read a bell chart properly

Did you hear of dr skinner and dr peatfield? One is a private gp but you need a referral from your gp, the other is a natuopath but used to be a gp. It will cost you though

How about a new test after spring (tsh is lowest in spring - doesn't affect t4 though, despite the holy grail of the miraculous tsh test) and first thing am when tsh is higher? Might get you into 'subclinical' and then treated if you show refs from toft

You're not ttc are you? There is evidence now for treating at your current levels

They are only normal to someone who can't read a bell chart properly

Did you hear of dr skinner and dr peatfield? One is a private gp but you need a referral from your gp, the other is a natuopath but used to be a gp. It will cost you though

How about a new test after spring (tsh is lowest in spring - doesn't affect t4 though, despite the holy grail of the miraculous tsh test) and first thing am when tsh is higher? Might get you into 'subclinical' and then treated if you show refs from toft

You're not ttc are you? There is evidence now for treating at your current levels

they are normal but can be repeated in a month in case TSH is on its way up.

if you are already diagnosed with previously abnormal TFTs then that is slightly different and levels are used to judge levothyroxine replacement.. not the same as making initial diagnosis

here
A bit complicated but says that lab 'normal' range should be lowered to 2.5 and treatment should start at TSH 3.0.

reference ranges vary between labs and need to be read in context.. no "scam"

sorry treat at 5.0

Lol at re-doing tests in a month
My mum is now at 5 but their range goes to 5.5. She can get hers re-done in a year! No idea what t4 is cos they didn't bother doing it. Sigh.
I can't persuade her to do the private tests, even if I pay, as she is of the old school 'trust the gp' mould

Anyhow, we can debate the tsh all day, but imo if you have symptoms and tsh is above that of 95 percent of euthyroid popn, I just don't understand why they don't trial levo

Lol at re-doing tests in a month
My mum is now at 5 but their range goes to 5.5. She can get hers re-done in a year! No idea what t4 is cos they didn't bother doing it. Sigh.
I can't persuade her to do the private tests, even if I pay, as she is of the old school 'trust the gp' mould

Anyhow, we can debate the tsh all day, but imo if you have symptoms and tsh is above that of 95 percent of euthyroid popn, I just don't understand why they don't trial levo

There are docs out there who will treat you based on symptoms. You just have to find one. If the treatment does send you hyperthyroid then in my view it is easily rectified and not the end of the world. It is better to have tried and failed than to have left you feeling like dross because the GP can't think outside the box.

Is there another GP in your practice that you could go to?