Help Interpreting Thyroid Bloods

[StarTravels]

Hello

I've been having problems with constipation and tiredness for some time. My B12 and Vitamin D were low but in the normal range, so I've been taking supplements. The doctor checked my TSH and it was 2.1.

I decided to have a private blood test of my thyroid and the results are as follows:

TSH 1.4
Free T4 11 (range 12-22)
Free T3 3.8 (range 3.1-6.8)

Does anyone know what this means? I seem to have low Free T4 and although the Free T3 is within range, it is at the lower end. Is this indicating a problem with the pituitary gland (tumor?!)

I think I need to reiterate what my GP said to me:

"We're not very good at handling thyroid conditions" (we being gps).

In terms of tests ime now they sort of rattle off a load anticipating what a consultant might ask for so try not to read too much into it.

I do think the antibody test will be helpful. Was there another Tsh result?

I also think there will / should be a mammoth review of the guidelines regarding all these magic numbers. I can't get my head round why, if you have repeated miscarriages and Tsh is over 2.5, this might indicate an issue (I only know one person who was then treated but her Tsh was due to medication for bipolar). Incidentally they let hers hover between 3 and 4 with terrible exhaustion until she had the miscarriage, but it was only at her insistence that an endo consultant was consulted and he over ruled everyone and said she must start thyroxine in order to conceive.

If I really wanted to get on my soap box I'd say treatment of people with thyroid issues (mainly women) sometimes borders on misogyny.

I really hope you get somewhere soon OP.

So, thyroid antibodies came back negative. What does that mean? Not my thyroid even though FT4 is below range. Had two tests now and both were below normal range.

my GP adamant there is no need to test T3. I went to a private endo a few years ago, who tested the lot, and decided to give me Liothyronine for my T3.

He also said that unfortunately most GPs will look at results and say "you're in the normal range" so no need to adjust meds but actually some people work better at one end of the other of the range.

He said most GPs just don't have the knowledge or time to deal with this.

I have had an ongoing battle to get Liothyronine prescribed by the GP on the NHS - it is prohibitively expensive as a private prescription. For now, they haven't stopped, but only because they said they would refer to me an NHS endo and nothing has happened in 18 months, and I am not chasing as I know he will say NHS doesn't prescribe T3.

All that said, am currently feeling totally leaden & exhausted so am having the whole lot tested next week.

Tempo, I did know of someone who is on t3 through NHS consultant a while back. And one more recently (a volunteer at British thyroid foundation).

Sorry you're feeling rubbish

Op, I'm really not sure but please do keep seeking answers. Just because one person discounts things does not mean there isn't an issue. Something is amis.

Tempo, can you afford to pay for a private test of your FT3 so you can take that to your NHS GP to confirm your need for the prescription? You can get finger prick tests from home which are cheaper.

Have you been diagnosed as having thyroid disease? What are your FT4 levels like? I've read FT4 is more important for hypo patients than FT3 (which is more important for diagnosing hyper) FT3 fluctuates throughout the day and FT4 does not. Plus FT3 is the last to be affected.

Can you ask for NDT? This will have some T3 in it and the NHS will prescribe on a "named patient basis" if you have thyroid disease.

Clarella, I've got an endo appointment on the 16th but I can tell the GP thinks it's a waste of time. My cortisol levels came back as "cannot rule out adrenal insufficiency" so that's as clear as mud! However it is all looking like potentially central hypothyroidism as mrstweedie said. So I'm going to ask them to investigate down that route and see if I can get an TRH test to see if my pituitary is working properly! Will let you know how I get on! Thanks for all your help.

Hi everyone,

I just wanted to update you on my progress since we last spoke. In the end I saw an endocrinologist privately who gave me a TRH Stimulation Test. My results came back as blunted, pointing to a problem with the pituitary, most likely secondary hypothyroidism, so I am now on thyroxine.

Thank you everyone for your help in getting me to a diagnosis. I couldn't have done it without all your pointers! And I've learnt an awful lot about TRH/TSH/Thyroids etc; I almost gave up, but I'm so glad I didn't!

Brilliant - well done Star. I hope you're GP has aknowledged this?

Star, did you self refer to the endo? Good news for you.

Mrsmorton, I managed to get an NHS referral from my NHS GP through sheer persistence and tears in an appointment, but when I tried to book it online I was told there were no appointments and they would get back to me, so I then saw a private GP who referred me to the same endo privately and I saw him within the week.

Nope Clarella, but didn't really expect they would!