T4 levels

[AlexaAmbidextra]

Went to my GP to request check on thyroid because of weight gain that unusually, I’m finding difficult to shift, lethargy, tiredness, finger nails crumbling, rough hair, overall joint pains and muscle weakness. Result has come back as plasma free T4 - 8.2. Normal, no further action.

Ok, so I’m 65 and have nursed my terminally ill dad for 6 months earlier this year, but was really hoping these symptoms were due to hypothyroidism. Is it possible to have an under active thyroid despite this result?

Hi, if you go to health unlocked you'll find all the info you need. You are hypothyroid it's just the NHS doesn't treat until your TSH gets to 10. In other countries diagnosis and treatment starts at a TSH of 3. I think that the NICE guidelines do say that treatment can be considered at a TSH level of 5 but most GP's take no notice of that. Anyway, you'll get all the help and info you need at health unlocked. Good luck!

You can't tell anything with just a T4 result. You need TSH and T3 tested too, at a minimum.

Oops, sorry, I read that your TSH was 8.2 - ignore my post!

Without the lab range it's impossible to comment and it's strange they didnt test your TSH as they usually test that first, or did they? If so, can you post the result? (including the range - it will be on the printout, which you are entitled to). As another poster said, even those two don't show the full picture and FT3, antibodies etc would be better but the NHS won't do it.

They would have tested tsh first I'm
Sure, is it definitely t4 or was it tsh?

Ask for a print out.

Apologies. I’ve just had another look at my results via my surgery’s online system and there is a TSH result way down the page which I initially missed as it was nowhere near the T4 result.

So, the T4 is 8.2 pmol/L. Range 6.3 - 14
TSH 19.58 mu/L. Range 0.3 - 5.6

That’s definitely the lot. No T3.

Wow that's completely out of range.

Google the nice guidelines and go back in waving them/ see a different Gp.

I don't give a shit that the t4 is a little in range the tsh is showing full blown hypothyroidism.

Thank you. I haven’t actually spoken to GP yet as accessed these results online. Have a GP appt tomorrow to discuss.

Something definitely going on that merits further investigation if they still say they won't treat but iirc this is potentially sub clinical and your symptoms do match hypothyroidism. Do you know if you have a goitre?

That TSH is terribly high.

You need to phone them and ask them to look again!

Based on those levels you should be started on levothyroxine at your appointment tomorrow.

They haven’t said they won’t treat as I haven’t actually spoken to a GP yet. These results have just appeared on my online patient record following a blood test last week. I requested this as I had a number of symptoms that made me suspect I was hypothyroid. Hopefully I’ll come away from my appt tomorrow with a prescription for thyroxine. Thank you for all your comments.

Ah I see - surprised they haven't called you and just written out the prescription. But hope it goes well.

Thank you.

Mine was around that when I first started thyroxine it takes a few weeks to kick in. Hope it helps. I don’t know what the answer is for the dry hair I haven’t found one yet!

Definitely hypothyroid TSH will need to come down to less than 2 and FT4 go up to over 10.

Given your age, they will probably start you on 25mcgs of thyroxine which will knock out your own thyroid function and make you feel worse. Don't give up. Get tested again after six weeks and ask for an increase and keep doing this until you feel better.

Lots of support on the ThyroidUK forum.

Well ffs! What a waste of time. GP says ‘compensated underactive thyroid’ because although I have an elevated TSH, my T4 is within range. Therefore, further blood test in a month to test TSH again plus thyroid antibodies. I feel so disappointed as I’m desperate to feel better. ☹️

Absolutely get a second opinion. This is madness.

That's obscene. NICE guidelines say a TSH of 10+ and a normal T4 should be treated with levothyroxine (please someone correct me if I've read that wrong)

Can you see another GP?

Violet. Thanks for that. You’re absolutely correct about the NICE guidelines. I’ll go back armed with that info.

See another GP asap and complain about the other dickhead. You shouldn't have to be relying on unqualified (mostly) members of a forum, your GP should know this.

Can you afford to pay about £70 for a private test? I did the thriva one. Showed hypothyroidism with antibodies. I took it to the GP who put me on levo and just ordered an NHS test for the records.

Brambly. Yes, I may well do that.