TSH Levels - hypothyroidism?

[ElleC90]

Hi all. I recently visited the GP for bloods and requested a copy of them. My TSH levels are 7.6 and T4 is 9.4, Dr has stated I need tested again in 3 months however I feel rotten. Symptoms are irregular periods (v light and either come every 3 weeks or not at all, they used to be v heavy and v sore). I am always tired, could sleep 12 hours a night and still nap in the daytime! I also have a small lump in my neck which is more on the right side, this was checked in 2021 and GP said it wasn't my thyroid!!

I initially went to GP this time due to the issue with my periods as this isn't normal at all for me. I'm definitely not pregnant but am not using hormonal birth control ATM.

Am I wrong to think something more should be done at this stage or is it normal for them to wait 3 months to retest with results like mine? My mum has hypothyroidism and is on levothyroxine also.

Many thanks x

Sorry meant to add I also have hairloss also x

Bump x

Does sound like low thyroid symptoms but I think some doctors only start treatment if TSH is greater than 10

This is from the NHS

Reference range: Note new reference range for FT4 from 10/05/24: TSH: 0.38 -5.33 mU/L, Free T4 8.0 – 18.0 pmol/L, Free T3: 3.8 – 6.0 pmol/L.

So I think you have somewhat raised TSH and ok T4 in the doctors opinion. Were you hoping to start treatment t?

Yes definitely your results suggest hypothyroidism. TSH is best around 1.0-1.5, you are way over that and no wonder you feel at death's door (I did with a TSH of 4.95). You need to be prescribed Levothyroxine asap. Unfortunately it is far too common for people to be left feeling unwell before they get treatment.

Is there another GP you can see? Mention that your mother has hypothyrodism and is medicated for it. It does run in families.

Thanks all. I am probably most concerned about my periods, I'm only 33 and although more children aren't on the cards for me (DS's are 13 and 8) I definitely don't want the option taken away from me if that makes sense? The tiredness is killing me, I feel as though I'm running on empty and could sleep all the time. Exercise knocks me out for days after and I'd just like to feel a wee bit normal 😊

Also the GP didn't bother calling after these results and when I requested bloods due to my period issues they sent me straight to the practice nurse. GP sent a letter stating I need re-tested in 3 months, so far haven't actually spoken to a GP about it at all which is handy 🥴

”Normal” TSH is up to around 5 I believe per NICE (though many people say this is too high, and some other countries say normal is up to 3 or 3.5). Anyway 7.6 ought to be treated IMO. What’s the rationale for waiting and retesting? In case it’s a blip?

My blood results say 'TSH moderately elevated. Suggest repeat testing in 3 to 6 months time to exclude or confirm developing hypothyroidism'. Is it worth me calling to try and have a conversation with the GP? Suppose I'm a bit wary they will just fob me off tbh

I've recently had a blood test , I went to see the doctor about my leg that constantly aches and is now happening in my arm so I wanted to make sure it wasn't a blood clot . I was called numerous times on the day the blood tests came back (I was at work so didn't see the phone calls until I had finished ) a text and an answerphone message . I was immediately prescribed folic acid . My magnesium, liver , kidneys and thyroid are all 'borderline'. The doctor requested to see me again and I have to retest in 6-8 weeks but has already talked to me about starting thyroxine if the levels are the same . My levels were not as high as yours. Although I try to avoid the doctors and I haven't been for a very long time apart from my usual asthma checks with the nurse, they've been absolutely brilliant. Did your doctors do a full blood test ? I would try and get a face to face appointment, if no luck, are there another doctors close by or could you go private for a second opinion? I'm so sorry you are feeling rubbish , 3 months is a long time when you feel poorly !

The NICE recommendation is to treat the symptoms. You also have elevated levels (above the standard 'range') and a family history. You should go back to the GP with the NICE recommendations and ask for medication.

They will likely start you on a teeny dose and retest every 3 months until your results are OPTIMAL, not just in range, so around 1-2ish.

I'm on 100mg a day and that bone-weary tiredness has finally lifted.

Thanks so much all. Will call the GP next week to have a chat about symptoms and medication 😊

If you are as symptomatic as you are you should ask for a trial of treatment. Your TSH is above range and T4 at the bottom of the range. Although the top of the TSH range is 5 in most healthy people it is nearer the bottom of the range it is not an even distribution across the range. My TSH was 12.7 when I was diagnosed and I had lots of symptoms by then ,excessive tiredness, dry skin, hair thinning you can also lose the outer part of your eyebrows.

graph attached

Try again

Thanks again all. Spoke to GP today and she said they will only test me again in 12 weeks. She said that if they tested everyone for their thyroid function, 3/4 of the population would have an elevated TSH at some point 😅 I have to wait until December to be re-tested. I did tell her my symptoms, that my mum has hypothyroidism and about the lump at the front of my neck. She said she doesn't think the lump is linked to my thyroid because my TSH would be much higher if it was. Just a waiting game now I suppose x

Some GP’s are very reluctant to start treatment , but a TSH of 7.6 is out of range and in some countries the upper level for TSH is much lower than in the UK at around 2.5-3. Hopefully your TSH level will be even higher next time you are tested and the GP will get on with prescribing for you. Your TSH level is highest in the morning so try and get an appt next time first thing in the morning

It definitely sounds like your thyroid is low to me. Is your hair and skin dry too? Are you putting on any weight or constipated? These are all symptoms of an under active thyroid. As others have said a TSH of over 5 needs to be watched and at 7.5 and T4 of 9 I would have thought to start Levothyroxine of 25mg to start with. You'll probably need more but GP's make to get tested after 12 weeks then if still low will increase by another 25mg. My DH had TSH of 11.2 and T4 of 7.9 and started on 25mg then after 12 weeks and blood tested again put on 50mg then retested after another 12 weeks then moved up to 75mg then retested after 4 months then given 100mg. All this time he felt tired and exhausted, constipated and put on weight. He feels better on 100mg. It may be congenital if your Mum has it. I will warn you now menopause sends it haywire. I take Levothyroxine ever since my youngest DC was born at 34. I took 100mg every day for years. Then going through menopause I felt ill again exhausted. GP tested tsh and it was 17. T4 was only 7.5 and I got moved up to 150mg. Bloods tested again but tsh still 12. I got moved up to 200gm. My GP told me my thyroid wasn't making any Thyroxine at all. I'm still on 200mg now. I feel better but still tired but not sure if that is just me getting older.

Yes, my scalp is dry as of the past few months (never been an issue before) and I've put on half a stone - not doing anything different in terms of eating/exercise all is still the same as a year or 2 ago. I've always been constipated if I'm honest, had issues since I was a teenager and diagnosed with IBS at about 14. Dr said my thyroid was last tested in Jan 2023 (I had gone to docs about tiredness and just general feeling of 'meh') and she said my TSH was 4.8 then, so "totally normal". She will test for antibodies at my next app so that's a start at least. Fingers crossed if my levels are still high I can get some levothyroxine 🤞 x

So basically your TSH has been rising over the past 18 months (and will have been rising before that), as a TSH of 4.8 isn't what most of us with hypothyroidism would call 'normal'. The rise will start long before symptoms set in, your pituitary (that produces TSH or Thyroid Stimulating Hormone) is prodding your thyroid to produce more active hormone, as your production is falling short. So over the past 18 months it's gone from 4.8 to 7.6 and your pituitary is now yelling ever louder for that thyroid hormone. Meanwhile your body is saying 'stop yelling at me, I just want to sleep'.

Getting those antibodies done is very important, make sure it's both TPO and TG as often only TPO antibodies are tested, and there are some folks with autoimmunity who only have raised TG antibodies, but normal TPO Ab levels.

Hi all, thought I'd come back with a little update. Had bloods re-tested 18th November, TSH is now 8.7 and T4 slightly higher at 10.4. I also had antibodies tested which show high antibodies, so autoimmune (doc says they don't use Hashimoto's to describe it anymore 🤔). Had a chat with GP today and after quoting NICE guidelines on treating subclinical hypothyroidism (!) He agreed to start on 50mcg of levothyroxine. Also have folic acid as my folate is low. Feeling hopeful I will eventually feel better and know what it feels like to be a normal energetic person 😅 thanks for all help above its much appreciated x

Hi @ElleC90 i realise this is an old post but wondering how you got on with your thyroxine. I am currently awaiting IVF, and have just been prescribed 25mcg for tsh of 6.9. I’m a little frustrated at such a low starting dose as I need to get it under 2.5 and my GP was reluctant to even prescribe anything. Was 50mcg a good dose for you? (I also have high antibodies and feel this may be the cause for my infertility)