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After showing symptoms of an underactive Thyroid for years but blood results from the my GP showing me in the 'normal' range I have paid to have a private more comprehensive test done.

I have today received the following results with the following note from the testing clinics doctor

TSH - 1.280 (range 0.270 - 4.200 mU/L)

Free T4 - 11.95 (range 12 - 22 pmol/L)

Free T3 - 3.9 (range 3.1 - 6.8 pmol/L)

"The combination of normal Thyroid Stimulating Hormone level, borderline low Free T4 and normal Free T3 levels is unusual unless you are taking T3 form of thyroxine - is this the case? If so, it might be a good idea to discuss your ongoing thyroid medication dose requirement with your usual doctor. If not, and you were unaware of any thyroid problem, the low T4 level might indicate a developing hypothyroid (underactive thyroid) state"

Apologies but this is all very new to me. Can someone tell me what this means (results and doctors note) so I know exactly what to say to the doctor when I next see them?

5 Replies

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  • Welcome to the forum, Sherbetkitty.

    The doctor's note on your results is suggesting you are either taking Liothyronine (T3) thyroid medication or becoming hypothyroid.

    In primary hypothyroidism TSH normally rises when the pituitary gland detects low circulating thyroid hormone in order to stimulate the thyroid gland to produce more T4 (storage hormone) for conversion to thyroid hormone (T3). Your results are unusual in that TSH is in low-normal range but FT4 is below range which is secondary or central hypothyroidism, often due to pituitary dysfunction, or tertiary hypothyroidism if due to hypothalmic dysfunction. In secondary and tertiary hypothyroidism the thyroid gland is usually healthy but not receiving stimulus to produce T4 and T3 and Levothyroxine is necessary to prevent overt hypothyroidism.

    Show your results to your GP and ask for secondary/central hypothyroidism to be considered. If pituitary or hypothalmic dysfunction is suspected referral should be made to an endocrinologist for further investigation.

    thyroiduk.org.uk/tuk/about_...

    patient.co.uk/doctor/hypopi...

    cks.nice.org.uk/hypothyroid...

  • I went to see the doctor who referred me to my local Hospital and I finally saw an Endo this afternoon.

    Well what a waste of time that was. Apparently according to the consultant I cannot have secondary/central/tertiary hypothyroidism as....

    1. My test results are normal, the T4 is more than likely below range due to "fluctuations/calibrations in lab ranges" (??)

    2. Symptoms for Secondary Hypothyroidism are weight loss NOT weight gain or failure to lose weight.

    2. Females who still menstruate don't have a problem with their pituitary gland.

    I am being given a further Thyroid Function test to 'confirm' that all is OK and tests for sleep apnea are being persued (as I have a fat neck). No offer of testing vitamin, folate or ferritin levels were made.

    I have managed to obtain previous test results and ranges from my local hospital and I would appreciate your thoughts

    21/02/2013

    TSH - 1.64 mU/L (0.34 - 5.60)

    Free T4 - 10.2 pmol/L (7.8 - 17.0)

    No T3 tested

    18/06/2014

    TSH - 1.41 mU/L (0.34 - 5.60)

    Free T4 - 8.9 mU/L (7.8 - 17.0)

    No T3 tested

    Plus the Blue Horizon test results at the start of this post.

    I didn't even get the chance to explain that in 2005 I was involved in a serious car accident. My car rolled several times, could have caused Pituitary trauma maybe? But didn't get the chance to ask the question.

    Where do I go from here?

  • Sherbetkitty, Wait for the results of the repeat thyroid test. Your previous results indicate FT4 low and dropping. Lab error is a possibility for your BH FT4 result but unlikely.

    As for his comments about weight, he appears to be confused. Most hypothyroid patients whether primary or secondary gain weight and most hyperthyroid patients lose weight but there are exceptions to both.

    Menstruation doesn't protect against pituitary dysfunction. He's talking out of his rear end.

  • Thank you Clutter

    I was so cross that everything I have read/learnt and digested was being dismissed by someone who wouldn't even give me chance to explain myself.

    I will go for the blood test and post back with the results. I did ask the Endo when is the best time to draw blood and was it a fasting test as all previous have been early/fasting but she daid I could go at anytime, it didn't matter.

  • I have received a follow up appointment with my Endo... 16th May 2016.

    Would feel less insulted if she had just signed me off completely.

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