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Thyroid UK
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Normal TSH but low T4


Hope someone can give me some advice after receiving some blood results back today of TSH 1.01 (normal range 0.27 - 4.2) and T4 free 12.3 (normal range 12.0 - 22.0)

To give you some background - 2 years ago I went to the G.P with symptoms of hypothyroidism. She did blood tests, said they were normal and put me on anti depressants even though I wasn't sure I needed them.

My symptoms, (constipation, fatigue, dry skin, feeling cold etc ) continued so I visited a naturopath who asked to look at the blood results. He told me that only the TSH had been done. In the meantime I had been back to the GP with the same symptoms as originally and she told me to eat more fibre!

After seeing the naturopath I asked the GP to do a T4 test and she refused. So last week I paid for one and the results were as above.

Does this indicate secondary/tertiary hypothyroidism? I should add the symptoms haven't gone anywhere.

I have a 3 year old and a 5 year old and I am wondering if a problem could have been triggered by the birth of my second child. I didn't notice the tiredness straight away after having her obviously because after having a baby you are tired for several months anyway!

I have an appointment to see the doctor (a different one) next week. Any advice?

Thanks in advance,


6 Replies

Did you lose a lot of blood with the birth of either child? Blood loss can cause pituitary dysfunction. If your pituitary isn't working well, your TSH will be lower than it should be therefore producing a lower level of T4.

The bottom line is that your T4 is much lower than it should be. It's barely within the reference range which does suggest something is wrong. You would expect your TSH to be higher with such a low T4 which leads me to suspect secondary hypothyroidism. This is even more likely if you have experienced heavy blood loss.

I'm afraid I can't really advise what to ask your doctor but you might want to ask for a referral given that your blood results, although normal, are not exactly typical.

I hope you get somewhere with this.

Carolyn x


Hi Carolyn,

Thank you very much for your reply. As far as I am aware I didn't lose a lot of blood during either birth, at least no one told me I did. I did seem to lose quite a lot of blood in the days following the birth of my eldest but I'm not sure what is a 'normal' amount so its hard to say.

I went to the GP this morning with my blood results indicating the normal TSH but low T4. Initially he was dismissive and said the T4 was normal (12.3 with normal range of 12-22). I had to push and say that they were only just normal and asked about secondary hypothyroidism.

Once I had mentioned this he agreed to do further blood tests and test for FSH too. (I mentioned my cycles were getting lengthier and I hadn't been able to conceive after trying for a year - but had put both these things down to age - I'm 39)

It seems I will have to be a little pushy to get to the bottom of this! My blood tests are next week so will let you know!

Again, I appreciate your time in responding.



Hi Claire just wondered if you got anywhere with this? I have very similar results and also experienced problems with my periods, but Drs telling me can't be my thyroid as results are all within range.


No I didn't! But I've had more tests since (through an online company) and now my T4 is even lower, at 11. I also have low B12, a count of 234 but again the GP says I don't need treatment as I'm within the reference range (just) . This is despite my hair falling out quite badly and having dizzy spells that are bad enough to leave me unable to drive/work at times. I've given up with docs to be honest and ordered some B12 jabs to do myself. Drastic but it seems from looking on here several people do it and I feel I've been left no choice. Good luck!


You need to go to a good Functional/Integrative medicine doctor that has experience in treating Thyroid issues and a lot of them do.

You will never get anywhere with "mainstream" medicine on your Thyroid issue because "mainstream" docs, aside from their HUGE egos, THEY DO NOT LISTEN to their patients at all as if we are so stupid that we don't have the intelligence to know that we're sick and they are very content doing NOTHING. They depend on patients following along like a herd of sheep, not questioning anything to feed their egos and shut you up so they can move on to the next patient.

Reading up on the condition and what Functional medicine doctors are doing is the best way to "arm yourself"/"empower yourself" so you will to be able to stand up for yourself in getting treatment. "Mainstream" docs don't like that but Functional medicine docs are very much open to that if you go do a decent one.

I myself had "normal" Thyroid values (my T3 and T4 were very barely "in range" and TSH was 3.18) but I had MANY of the typical Hypothyroid symptoms, including fatigue so bad is would literally take me 6 to 8 hours to do an hour and a half workout. Been an athlete my whole life and it was quickly slipping away because of the symptoms, so I refused to leave my workout room until I finished my workouts.

At that point I was only going to a Naturopath and I literally told her that most of my symptoms are consistent with Thyroid (my mother also has it so there's a family history) and my T4 and T3 can't go any lower without being out of range. I then said a lot of Functional medicine and Naturopath doctors out there will do a "trial" of Thyroid medication in a situation such as mine and that I wanted to do a trial to see if it would help my symptoms (if I started to feel worse then I would stop the medication(s))...and I told her if she wouldn't do it, then I would find someone who would.

So she agreed and I got improvement in the fatigue, but not complete improvement and still had the other symptoms. That was 5 or 6 years ago. Today my T4 is still barely normal and my T3 has tested low a few months ago. TSH is 1.7.

It is only now that I just started going to a Functional medicine doctor who one of her specialties is "hidden" Thyroid conditions. I only just started the new treatment literally today which we will tweak every 2 weeks as needed, so I obviously don't know yet if this will help my situation any further. She trained with an Endocrinologist who "thought out of the box" and was passionate on helping people with "hidden" Thyroid problems. He unfortunately died last April but the testimonials from patients in his obituary are incredible in number and content, so I decided to call her because she was trained by him, and treats her patients using the same protocol he used.

Don't know if you are familiar with Functional medicine doctors or not but if not...they are not Naturopath doctors but regular MDs who practice medicine differently than "mainstream". They actually listen to you, spend more time with you, and "think out of the box" but they typically don't take insurance but if you have out-of-network coverage with your insurance, that will obviously help.

I have had to fire many doctors and a few "discharged" me because I absolutely refuse to live chronically sick (because that is what today's medical establishment expects you to do...shut up and "live with it" instead of trying to figure out what is wrong) and am basically demanding to find out what is physically wrong. I used to be extremely healthy but things quickly changed.

From what I have seen, the widespread use of antidepressants etc in A LOT of people, is a red flag as to the "mainstream" medical establishment's lack of desire AND incompetence to diagnose and actually treat patients who are physically sick....so they give you a pill to shut you up.

For me, I refuse to take any antidepressants because I tell any Dr. who tries to push them on me..."fix the physical problem that's making me sick".

Please seek the help of a Functional medicine doctor if you can. You should be heard and be able to live a healthier life.


Hi my tsh is 1.01 and t4free is 1.1 I have been having symptoms of thyroid problems too but my doc said my levels are normal.


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