Thyroid UK

Blood test results help please

Hello my husband has just got the results of some private blood tests some are still to come but those that are back don't look that great to me? My husband is 63 and takes no medication he is extremely tired and has low mood. This is a state that is a deterioration over past few years which also reflects his deterioration in his tsh! I don't understand what it means when his tsh keeps reducing to the extent that it is now outside the bottom range? Thank you for your help. Here are his results

tSH 0.26 ml/ul(0.27-4.20)

ft4 15.14pmol/l(12-22.0)

ft3 4.50pmol/l (3.10-6.80)

B12266 pool/l (141-489)

Ferritin 95 ug/l (30-400)

Lipoprotein a 765,100 (0-300,00)

Thank you Helen

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Hi Barnsley, it is strange to see such a low TSH with mediocre FT4, 3 levels. I've used this article to answer lots of questions and this paragraph may help regarding low TSH:

Serum levels of thyroid hormones

(see serum thyroid hormones graph)

Due to the differences in the pituitary’s response to physiological stress, depression, dieting, aging and inflammation as discussed, most individuals with diminished tissue levels of thyroid will have a normal TSH (1-63). Doctors are taught that if active thyroid (T3) levels drop, the TSH will increase. Thus, endocrinologists and other doctors tell patients that an elevated TSH is the most useful marker for diminished T3 levels and that a normal TSH indicates that their thyroid status is “fine”. The TSH is, however, merely a marker of pituitary levels of T3 and not of T3 levels in any other part of the body. Only under ideal conditions of total health do pituitary T3 levels correlate with T3 levels in the rest of the body, making the TSH a poor indicator of the body’s overall thyroid status. The relationship between TSH and tissue T3 is lost in the presence of physiologic or emotional stress (1-32), depression (33-38), insulin resistance and diabetes (28,39), aging (30,40-49)(see thyroid hormones and aging graph), calorie deprivation (dieting)(50-57), inflammation (5-8,22), PMS (58,59), chronic fatigue syndrome and fibromyalgia (60,61), obesity (112,113,114) and numerous other conditions (1-63). In the presence of such conditions, the TSH is a poor marker of active thyroid levels and thyroid status of an individual, and a normal TSH cannot be used as a reliable indictor that a person is euthyroid (normal thyroid) in the overwhelming majority of patients.

Value of Serum T4

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With a TSH that low, I would normally expect T4 and T3 to be near the top of the range or even over the top. This doesn't appear to be the case which suggests to me that something else is awry. It would probably be a good idea to get a pituitary test to see if there is anything going on there. It may be that his body is purposely slowing his metabolism by reducing thyroid function (through reducing TSH) because of some underlying illness. There can be many reasons for this including low B12 or low or high cortisol.

His B12 is lower than optimal, even though it is within range. He may benefit from supplements.

His high lipoprotein a could be due to his lowered thyroid function. It could also be related to diabetes or kidney problems so these should be tested for too. I would have hoped these tests were done and are in the remaining ones you are waiting for.

It would be helpful to see the rest of the results when they come through. They may tell us something we can't see in these results.

Sorry I couldn't be more help but I hope you get to the bottom of things soon.

Carolyn x

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