Please help- thyroid results- normal TSH low free T3 and free T4

[mk366]

So I've had all the hypothyroid symptoms for quite some time....

Tiredness, can't lose weight no matter what (basically cut out most food groups and don't drink alcohol), I exercise to no avail, cold hands and feet, slow metabolism, feel the cold easily, thin hair that doesn't grow.

Over the years blood test after blood test come back 'normal' and it was only when my GP told me to research online about Fibromyalgia that I realised my symptoms fitted so perfectly with hypothyroid and that maybe my normal blood tests were because my TSH was normal. So I pushed and pushed for them to test my free T3 and T4 and with reluctance they referred me and I paid to have it done privately- they wouldn't do it on the NHS- I could tell my GP just had written it off.

So I got my results back today and my free T4 is:

10.9 (12-22)

and my free T3 is 2.7 (3.1-7)

My GP just said, we will retest you in 2 months and I was like, I have all these symptoms and I've paid for a blood test to check and my levels are clearly low you just say we will retest. I know she is not with me on this as she didn't support the idea of me asking for further investigation and now my results prove there is a problem it's like she doesn't want to see it and she kept saying - I don't think there is a problem because your TSH is normal.

Argh, anyone got any advice of what to do? See a different GP?

[jimh111]

What was your most recent TSH figure? Did they not do a TSH assay as part of this private test? The TSH, fT3, fT4 taken together can be informative.

[mk366]

Oh the TSH is like 1.75 which is right in the middle of the normal range

[Hennerton]

I feel so angry on your behalf, dealing with this hopeless doc. My advice would be definitely find another one. I vehemently hate the TSH test, which is making misery for so many hypo people. I do hope you find a doc with a brain and get started on medication soon. xx

[jimh111]

Normally if the fT4 drops the TSH increases and this can have some effect on fT3, increasing it. Thus the body protects itself to some extent. Your normal TSH with low fT3 and low fT4 suggests you may have 'secondary hypothyroidism'. Usually this would initially present as a low TSH but I don't see any reason why it should always do. There is the theoretical possibility that you just happen to have these levels of hormone (the reference intervals just show where 95% of the population lie), BUT you have lots of symptoms.

You should ask your GP for a referral to an endocrinilogist, be polite but firm, take someone along if you need support. An endocrinologist can carry out futher tests and confirm the diagnosis. A trial of thyroxine would probably confirm you are hypothyroid but I think in your case it would be better to find the underlying problem.

[Chippysue]

MK366, research fibromyalgia! yes you can and you will see that it is a symptom, not a diagnosis!

Thyroid antibodies need to be tested for the full picture. My TSH was normal but after reading on a thyroid forum I asked to have my thyroid antibodies tested and hey presto they were off the scale which confirmed that I had autoimmune hypothyroidism - then Hashimotos as I have a goitre with nodules.

It makes me so cross, what is the point in them having ranges and then they ignore the fact that your thyroid is in your boots! I am surprised that you can get out of bed to get to the doctor's surgery!

Other blood tests that are useful are your B12 which is very often low with thyroid disease. Again, the range is too wide, ideally your B12 would be at the higher end of the range. If below range then you need regular B12 injections. Also vitamin D as many of us are deficient - taking vitamin D3 is then advisable.

Then your ferritin and folate need to be at optimum levels too. Also sex hormones.

Deficiencies in any of the above can lead to symptoms similar to hypothyroid symptoms.

Your Doctor is told to just go by your TSH and this doesn't always go up. Your Free T3 and Free T4 are telling anyone that you are hypothyroid.

Please keep us posted.

Sue

thyroiduk.org

[Ansteynomad]

No wonder you feel unwell! You simply do not have enough thyroid hormones in your body!

TSH ‘normal’ but FT4 and Ft3 below range smacks of secondary hypothyroidism to me. I think your GP should be working of the FT4 and FT3 figures and NOT off the TSH

Please tell your GP politely but firmly that you would like a referral to an endo of your choice.

[mk366]

Thank you so much everyone It's so great to have the support on here and be able to talk about it to people who have been through similar things. I went back (I am persistent!) and managed to get a prescription for thyroxine but i'm going to try and see another GP in my surgery tomorrow and ask for referral/second opinion. I think it's just the fact I have all the symptoms and my levels are low. Like if I felt fine in myself but my levels showed up like that it might not be an issue...and vice-versa if I feel like this but my levels are normal I have to accept something else is going on. I've wasted probably around 2 or 3 years of my life on this and kept getting told I was normal and getting prescribed antidepressants and now it feels like finally something is showing but my GP doesn't seem to want to work with me on it. I've moved around a lot (as a student) so I've never had any consistency and have never thought to follow up on the Thyroid thing since I've always been told thats fine but now I realise my TSH would have only ever been checked.

It makes me feel so good that you appreciate how awful I must feel considering my levels because I do- and I've done absolutely everything in my lifestyle to feel healthy- I exercise a lot, I don't eat any grains, sugar, caffeine, artificial sweeteners, dairy etc and I don't drink alcohol. I eat mostly vegetables and meat/fish and drink tons of water and herbal teas and yet I still feel tired and don't lose any weight at all. I think if I hadn't been managing this for so long I would so easily have gained a lot of weight and felt worse.

Thanks again

[jimh111]

Your low fT3, fT4 with in interval TSH is unusual, a referral would be helpful because if your pituitary is underperforming you may be low on other pituitary hormones. The thyroxine will probably help with most symptoms but now is a good time for a specialist to check everything out before you start taking thyroxine. Did you ever have a whiplash type injury? This can lead to pituitary problems sometimes.

[CTKERRI]

WHY do you suggest Ferritin levels? I have recently been diagnosed with low free T3, low free T4, low TSH and really HIGH Ferritin... other hormones are "wonky" as well and seeking answers...

[ShinyB]

Hi, I'm in the same boat! It's taken me till I'm 50 to discover the thyroid link because my TSH always came back in the normal range, but I've had hypothyroid symptoms since my teens, including severe constipation, depression, low energy, high cholesterol, diagnosed with M.E. blah blah. When I finally managed to see an endocrinologist, she was most put out when I mentioned the pituitary to her and kept telling me it was my Chronic Fatigue and depression diagnoses that were causing my problems. Arggh!

It was researching cholesterol that led me to the FT3 link. I got a full thyroid profile done privately, and my FT3 was under range, with my FT4 low in range, and a perfectly normal TSH.

Good luck and keep in touch with how you get on!

[ShinyB in reply to ShinyB]

ha, I've just spotted how old your post was, so you might not be reading the forum now! If you are, I would love to hear how you have got on

[Ginny52 in reply to ShinyB]

Old post again- are you still around?