Blood results

[katiebrighton]

Ok, just got my print out. My t4 is normal range 10.6. My tsh is 8.96mu/L. At my appointment my gp said that my levels weren't too bad, but they are going to ultrasound my thyroid because it's pretty swollen. I don't really know what any of this means. Can anyone enlighten me please?

[Clutter]

Katiebrighton, 'Normal' is a broad range. Do you have the range for FT4 (figures in brackets after your results) as it helps to see where in range the result is. TSH 8.96 is high. Has your GP tested thyroid peroxidase and thyroglobulin antibodies to rule out or confirm autoimmune thyroid disease (Hashimoto's)?

In the presence of positive antibodies most GPs diagnose subclinical hypothyroidism when TSH is >5. If antibodies are negative some wait until the patient is overtly hypothyroid with TSH>10.

Thyroid can swell when TSH flogs it to produce more hormone. Treatment now would probably reduce the swelling.

An ultrasound scan will measure the size of the thyroid gland and any nodules, and will also show the condition of the gland. A smooth texture generally denotes the gland is healthy but a coarsened lumpy texture shows the gland is failing, often due to autoimmune thyroid disease. The scan isn't uncomfortable or painful and usually takes a few minutes.

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

[katiebrighton in reply to Clutter]

Thank you so much! My serum free t4 is 10.6 pmol/L with the normal range stated as 9-19.

On the print out there are a list of other tests HbA1c amongst other.

[Clutter in reply to katiebrighton]

Katie, FT4 is almost at the bottom of range. HbA1C is a diabetes test. See whether thyroid peroxidase (TPO) or thyroglobulin (Tg) are on the list.

[katiebrighton in reply to Clutter]

Ah! Ok. No, they're not there. What does it mean that my t4 is low within the range? My gp was fairly dismissive, said hypothyroidism is very common. Tbh I feel fine... I get a bit cold but I've got plenty of energy. I'm keen that my thyroid doesn't swell any more.

Thank you for all your help.

[Clutter in reply to katiebrighton]

Katie, Diabetes is very common but it isn't dismissed by GPs and nor should hypothyroidism be dismissed. Long term untreated hypothyroidism can can have significant adverse health impacts.

Low FT4 usually means T3, which is the active hormone, is low and, it is low T3 which causes hypothyroid symptoms. I'm surprised you have energy with your results. It would be a good idea if your GP treated you now to prevent FT4 dropping below range by which time you will probably have accrued other symptoms which may take some time to resolve.

[katiebrighton in reply to Clutter]

Sorry, I didn't explain very well. I have started on levothyroxine at a lowish dose. I am also surprised at my results, because I've lost 40 lbs this year, and my fitness levels are better than they've been for years. I only went to the doctor because my thyroid was swollen. Otherwise I'm feeling good; my running has improved this year, and I regularly walk 8 miles or more at the weekends.

[Clutter in reply to katiebrighton]

Katie, when did you start Levothyroxine and what dose?

[katiebrighton in reply to Clutter]

I started 2 weeks ago, the day after these bloods were taken. I take 50 mcg a day.

[Clutter in reply to katiebrighton]

Katie, it takes 7/8 days for Levothyroxine to be absorbed so it will only just have started working and it will take up to six weeks to feel the full impact of the dose. The swelling should be reducing then.

You should have a follow up thyroid blood test to check levels 6-8 weeks after starting Levothyroxine as your dose will probably need adjusting. Leave 24 hours between last dose and blood draw.