Thyroid UK

Guidance on blood tests

Hi there

Looking for a wee bit of guidance......

I am a 51 year old female with some symptons of under active-thyroid:


unexplained rash

"floaters" in eye

weight gain!!!

sore joints particuarly sore thumbs

brain fog

stopping mid-sentence unable to find my train of thought

but my blood tests do appear to be normal

TSH - 2.01 - (0.2 - 4.5)

Free T4 - 13 - (9 - 21)

Is it safe to say I do not have an under active thryroid and as my doctor suggested is probably due to the menopause and aged related hormones?

Your help would be much appreciated.


9 Replies

Your T4 is a little on the low side. It is possible something else is the cause. Have you had any other blood tests done? Might be worth having a whole bunch done, such as B12, Ferritin, Folate etc checked.


Thanks for your reply.

the doctor did take a number of thests for liver/kidney/overy/red and white cell counts etc., but not B12, Serum Folae or Ferritin.

I was also tested for celiac and apparently that is also normal

Amti-tTG Iga (DS2) - (0.1 - 5.0) 1.3

Looking at my full results I have had various blood tests over the years - (I have never had a print out before)

TYPE 22/12/08 15/07/09 31/05/10 15/07/11 27/06/13

TSH (0.2-4.5) 0.94 0.93 0.34 1.69 2.01

Free T4 (9-21) 13 14 16 11 13

I wonder if this is a normal pattern and what, if anything would be the cause of my increased TSH do you think there is anything likely to interfere with the levels at the time of blood tests - like a cold or an unexplained rash on thighs and stomach at the time of the tests (I would have thought it would have made them lower and not higher though!)

Do you think it is worthwhile asking for B12/Serum Folae and Ferritin? and do you think I would be able to ask for a T3 test or doe the current results not merit that test?

I have private health care through work and I checked and they would cover the T3 blood tests and any others if the Doctor asked for the referral, but my question/worry is based on this set of results would the Doctor be willing to write that referral or does it come over as if I am neurotic!

When I pushed the Doctor for what would be wrong with me she asked about my general mood - which I said was fine (apart from being ill) and she talked at length about getting older (51) and this is what happens with the menopause! As well as many Thyroid symptons I also have celiac symptoms bloating/loose stools etc., being the main ones, together with the other similar symptoms of thyroid.

She agreed to send me for a USS pelvis and after that a colonoscopy to check my overies and my bowel.

I believe she thinks she is covering all bases, but wonder if the other blood tests would be a better "next" step rather than the scans etc.,

One thing I did notice is she didn't check nails/my pulse/my unexplained rash/my blood pressure/my thyroid gland......nothing, just looked at the results - I found that very disheartening! - at the very least should she not have passed comment on the unexplained rash or is that also a sign of being a menaposal 51 year old!

Any steer would be welcome........



Looking at your results there is a general trend of uneven T4 results all quite low in their range and a rising TSH. T4 optimal results should be in the top 3/4 of the range. The rising TSH indicates that the thyroid is being "encouraged" to produce more T4, but does not manage to produce enough for your needs so you are starting to have symptoms.

The T3 test should be very useful, and also have TPO antibodies test, I think, as you have symptoms and might well require treatment to stop thing developing further.

Read up on every aspect of hypothyroidism on the Thyroid UK main site, it is a mine of information:

and also get Dr A Toft's "Understanding thyroid disorders" , BMA publication, £5 from chemist/Amazon, this has pointers Pages 44, 46, 81, you can pursue in greater depth.

Push for the needed referral, do not worry about being thought "neurotic" or whatever, ask yourself, are you allowing yourself to suffer just because of what you think she might think of you? She is well paid, by you/us, to look after your health, you have symptoms and the good fortune to have private health care available, go for it.


Many, many thanks nostoneunturned

I actually have Dr A Toft's book and will certainly read up on the pages you mention

I will hand a note to my GP today asking for the referral for private T3 and TPO anatibodies blood tests and await to hear from the private hospital - do you think I should also ask for the Ferritin/folate/B12 also?

It just so happens, there is a Dr A Toft practicing at the BUPA Murrayfield (my local private hospital) who I presume is the same! - I thought if after the new set of blood tests I might ask for a referral to him!

Many thanks again



Hi there

I have understanding thyroid disorders on Kindle and for some reason can't get page numbers - do you know which chapter or the chapter number? -

thanks that would be helpful



Same Dr Toft who wrote the book and whose advice re T4/T3 rescued me years ago!

Remarkably there are no chapter numbers in my paperback edition, but maybe this will help: PP 44 and 46 are in the chapter entitled Underactive thyroid, and oops! gave wrong page number, not P 81, should be P 88 in the chapter entitled Thyroid blood tests. In my edition there is also a red panel at the bottom of P 88 saying

"Thyroid blood tests should not be interpreted in isolation and correct medical care will also depend on careful assessment of symptoms and clinical examination."

Ferritin, folate and B12 plus Vit D are all linked in to thyroid matters, it would be good to get them done also, think info on the optimal levels is on the main site, roughly in top 1/4 of range.

The earlier in the day blood for testing is drawn then the higher the TSH will be owing to circadian rhythms, high TSH encourages diagnosis of hypothyroidism, among other diagnostic items.

Check out the hypo symptoms on main site as above, you might see that many things you have just learned to live with could well be on the list.


Thank you nostoneunturned.....I am reading the pages as we speak. I have handed in my letter to the doctors this morning requesting a referral for the additional blood tests so once they are done I will post.

Your help and encouragement is truly appreciated.



Hi 2101. No need to add further to good suggestions already given - but to answer your Q about testing ferritin etc - yes! Have them done too - get as much info as possible. I also often see on here people recommend testing for vit D. Good luck!


Hi there LizaShara - thanks for your support and I will get all the tests I can - will hopefully post some good news once tests are done!



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