TSH only tested although request was also for T4 and TPO

Following advice from my first Endo appointment where I've been diagnosed with Hashimoto's, the consultant suggested as there's a genetic link, that any sisters should be tested too. Only one of my three sisters GP's agreed to testing TSH, T4 and TPO. Readings were requested but it appears there is only a reading for serum TSH level 4.18 mu/L (0.35 -5.50). Observations "THYROID PEROXIDASE ABS" will be filed as 43Gd.00 Thyroid PEROXIDASE antibody level. Thyroid antibodies N/A with normal TFTs.

Any ideas what the above means please?

11 Replies

  • Gill-56, it looks like the lab declined to test antibodies because TSH is in normal range. Your sister's TSH is high in range. Advise her that her next thyroid test should be early morning and fasting (water only), as TSH is highest early and before food and drink.


    I am not a medical professional and this information is not intended to be a substitute for medical guidance from your own doctor. Please check with your personal physician before applying any of these suggestions.

  • Your endo is 100% correct other family members must be tested especially children

    With a tsh of 4.18 and thyroid antibodies your sister is hypothyroid

    The other GPs are wrong to refuse testing

    My husband was also warned when he developed Hashis

    One daughter now has Hashimotos as do 3 of her 4 children the 4th one is aspergers

    Other daughter is ok but her daughter is both Coeliac and Hashimotos all of them were severely hypothyroid with a TSH of 2.9

    His nephew has hashimotos

    The genetic link is therefore rampaging through

  • It doesn't say my sister has antibodies since It appears they only tested TSH. Was trying to decipher if that was true.

  • Hmmmm

    I read it as Tpo antibodies were 38

    Maybe i am wrong but as said by others your sister TSH is high in range

    Sure she will have antibodies and symptoms too

  • It's confusing I know as if a box is ticked surely the blood should be taken and a result given. All we can see on her prints regarding TPO is "THYROID PEROXIDASE ABS" will be filed as 43Gd.00 Thyroid PEROXIDASE antibody level. Thyroid antibodies N/A with normal TFTs.

  • Its all down to path labs behaving like accountants without using brains as to patients health

    NhS wastes money hand over fist yet is mean minded when it comes to nessecary tests

    Phone the path labs and directly ask them why they ignore a doctors request and an endos request that relatives are tested for Hashimotos and Central Hypothyroid wheh they are only testing TSH which simply can never ever be an accurate test

  • As Hashimotos is the most common of thyroid issues throughout the world - I fail to see why Labs refuse to test for them. It must be to do with costs. Having raised anti-bodies does not always cause the TSH to rise - so how can these scientists be SO short-sighted. Or is there complete misunderstanding in the medical profession due to the fact they think patients do not need to know as treatment is the same. They should hang their heads in shame.

    Perhaps when preventative medicine becomes the norm - they will think again :-)

    When I was diagnosed here in Crete - my anti-bodies were HIGH - however all the other TFT's were mid range ! Treatment began immediately.

    Is it possible to have private testing done through one of the labs suggested by Thyroid UK ? It can be done at home.....


  • I worked in an NHS hospital lab many years ago and there's no way we would have declined to do tests that were requested by a doctor as we were not qualified to make a clinical decision. I can only assume this has changed in order to save money. Often the GP would only request a Thyroid Function Test, which would mean test TSH and then only test T4 if the TSH was out of range, but if T4 and T3 were requested specifically then they would be tested, after all how can a Biochemist who has never met the patient and has no access to patient records make an assessment of what tests are required. It's a shame that patient health is being compromised for what appears to be cost cutting reasons.

    I wonder if your consultant would write a letter for your sisters, perhaps that would persuade their GPs to take action.

  • Thank you all for your responses and good advice.

    Clutter, my sister did fast before the test and was early morning. Does that still fit with your observations?

  • I'm also wondering why they have ranges for readings which I assume are unrealistic?

  • Quite. There have been a number of pieces of research, largely I think in the States, which have taken a large sample of people and excluded those with thyroid nodules, antibodies etc, and the top of the TSH among those people was about 4.2, from memory. I've never had the time to read the actual pieces of research, but clearly there is a flaw somewhere, since people who come on here with a TSH that high are feeling really bad.

    Anyway, that's why some hospitals set the TSH range for sub clinical hypo at about there. Your sister is close to that range. Can she afford to do a private blood test with antibocies herself? Does she have symptoms? Bet she has Hashis. Of course she does.

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