Thyroid UK
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Hypothyroidism/TSH/Free T4 (newbie)

Do you have to have both an abnormal TSH level and abnormal free T4 before doctors offer you Levothyroxine?

Reason I ask is my TSH level was above range at 13.⅔ miu/L - Ref.Range (0 .20 - 4.00) and my

Free T4 was 12.0 pmol/L (10.0-20.0), which I believe is within range, if my understanding is correct? (I still have a lot to learn) in March 2013

Not one single doctor has bothered to explain to me, as yet, since I was diagnosed in Nov 2013, what hypothyroidism is, so I was both happy and relieved to find this site, thank you!!!!

I was only offered Levothyroxine, in November 2013, however, my rheumatologist had the above results back in March 2013 and now I'm wondering why I wasn't offered Levothyroxine then?

Would be so grateful for any advice xx

3 Replies

The reason doctors don't explain about hypothyroidism is that I doubt they actually know what the purpose is of the thyroid gland. They are also completely unaware of the clinical symptoms which the doctors before the 60's knew full well through their medical training.

Doctors appear nowadays to have only a cursory knowledge of the thyroid gland and follow the guidelines, i.e. to diagnose by the TSH alone and, if you are lucky, and reach 10 you would be medicated, except that we can go to the doctors with so many different complaints before being diagnosed that we might be diagnosed as hypochondriacs rather than hypothyroid.

So, that's why it's good to have sites like this when we are struggling and nothing is forthcoming from doctors to help us. We can get well but sometimes it is a very hard climb. We have to read and learn ourselves lots of stuff to be more knowledgeable and I think many on this site have educated themselves.

The fact that your TSH was above 10 and you remained undiagnosed just tells you how knowledgeable the doctor is and also rheumatology if the info wasn't passed to your GP.

1 like

ajb, an initial high TSH can sometimes be due to non-thyroidal illness and it is usual to retest 6 weeks later and commence treatment if TSH is still high. TSH >10 should be treated even when FT4 is within normal range which yours was.

Hypothyroidism means your thyroid is not producing sufficient hormones and is underactive. The pituitary gland detects low levels of circulating hormone and produces TSH to stimulate the thyroid gland to produce more. If it can't then Levothyroxine is prescribed to replace the low hormone and TSH should fall as hormone is replaced and absorbed. Most people are comfortable with TSH just above or below 1.0 and with FT4 towards or in the top 75% of range.


Thanks for your reply xx


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