Help with Thyroid test results please!

[cakedup]

I know normal ranges for UK are different to other parts of the world but I have no idea what I'm looking at here! Results:

Serum TSH level 2.31 mU/L 0.30 4.20mU/L
Serum free T4 level 10 pmol/L 12.00 - 22.00pmol/L

About a year ago, after testing, my GP automatically prescribed me some thyroid meds (can't remember what they were). I hadn't had any discussion with the GP about this so surprised the meds were in the chemist ready for me to take with no consultation. However, when I made an appointment (different GP, same practice) he told me there was no need for me to take anything as I was border line and it didn't warrant medication. This was backed up by another GP.

I am also trying to find out what test results mean! Have posted separately but will watch with interest.

I would post your concerns over on healthunlocked.com on their thyroid uk community page- lots of knowledgeable people over there

Thanks InSpaceNooneCanHearYouScream I'll give that a go if I don't get any responses here. I know there are mumsnetters who know their shit when it comes to thyroid ranges but not sure where they're hiding!

So, you're not taking any thyroid medication, is that right?

You should be referred to an endocrinologist for much further and more detailed investigations (beyond the GP's scope). I am married to a GP and I hesitate saying this BUT thyroid issues are complex and you really do require a consultant's view.
Low TSH and low T4 can indicate a pituitary problem.

Push for a referral to endocrinology, not only for further testing but an endocrinologist needs to be reviewing your medication every 6 months, not your GP. Push hard, OP.

Have you had blood tests for FSH, GH or prolactin OP?
Your GP should absolutely be testing those in response to your low free T4 and low TSH.

Nice one Vanguard, that's what I was working round to.

That is correct timeistight I am not taking any medication for thyroid. Two GPs told me there was no need as I was borderline.

Thanks for that TheVanguardSix . It would be great if I could get a referral but I'm guessing even an endocrinologist would adhere to UK guidelines which have been criticised as being too lax? And I feel I need to know a bit more in order to push. And no...I can't see anything on my results referring to FSH, GH or prolactin. Had lots of other things tested but not those. I wonder why?

Does anyone know if my thyroid levels would get treated outside of UK?

I'm not sure this would be considered a pituitary problem. Your TSH is a bit higher than you'd want it to be and to me that suggests your thyroid is struggling.

I would test your antibody levels. If you look at Blue Horizon they do a home test if you can't get your GP to test you.

If your antibody levels are high this would confirm a thyroid problem and rule out the pituitary.

I had a t4 the same as yours and a below range t3 when I was diagnosed with central hypothyroidism. A TRH test at the hospital will confirm this. But my TSH was below 1.

It would also be interesting to see what your T3 is doing. If that is also below range it would possibly give you enough to argue you should be medicated.

You shouldn't need to see an endocrinologist if you have a standard underactive thyroid.

Gosh this all seems so complicated. Why didn't the gp request bloods for antibodies and FSH etc.? I just wish the gp could help me with this.

Well I do know you'd possibly be treated in the uk if you pushed for it and wanted to conceive - tends to need to be below 2.5 pre conception and is in nice guidelines. T4 seems low.

Borderline with symptoms can be treated but is usually classed as 4.5 but your t4 is low.

Symptoms?

One thing that can cause a flagging thyroid and raised tsh is low iodine and low iron. You also need selenium.

A study on vegans who weren't taking supplements found similar results.

Do you have plenty of dairy and white fish?

You could try taking a decent multi vit with the rda for iodine in, look at ferritin levels and boost those and see if it helps in any way.

Protocol for antibody tests seems odd or non existent these days but you could push gp to double check.

Shouldn't really need an endo referral but you're allowed to request one and this sometimes makes a gp do more tests and cross check things in prep for the appointment.

Actually I'd push for endo referral. You'd probably need to if querying the pre conception levels of 2.5. I'd be really questioning why one gp prescribed and later ones didn't.