Any thoughts on my latest blood results?

[Emstar1892]

Hello, so my latest results are as follows:

TSH: 2.53 (0.27-4.20)

Free T4: 10.3 (12.0-22.0)

Free T3: 3.1 (3.1-6.8)

Three weeks ago they were:

TSH: 2.29 (0.27-4.20)

Free T4: 12.9 (12.0-22.0)

Free T3: 3.4 (3.1-6.8)

I did some research online and some websites seem to state that a low T4 with an "in range" TSH is not a thyroid problem but an adrenal/cortisol/pituitary problem. The thing is I have all the hypo symptoms too, like a low pulse, low temperature, brain fog, dry skin, scaly skin, thin hair, very frequent periods, etc. Do you have any thoughts? Thanks in advance.

[Clutter]

Emstar1892, low-normal TSH with low FT4 and low FT3 indicates secondary hypothyroidism due to pituitary dysfunction or, more rarely, tertiary hypothyroidism due to hypothalmus dysfunction .

Your FT4 is below range and FT3 is bottom of range while TSH remains low-normal so your GP should consider secondary hypothyroidism (hypopituitarism).

Treatment is Levothyroxine to replace low thyroid hormone but hypopituitarism should be investigated in endocrinology in case sex and growth hormones are also deficient.

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

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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.

[Emstar1892 in reply to Clutter]

Thanks! Although are you sure 2.51 TSH is low? I thought the ideal value was around 1!

[Clutter in reply to Emstar1892]

Emstar1892, TSH 0.5-1.7 is euthyroid. 2.51 is low-normal in range 0.27-4.2. Patients on Levothyroxine will usually be comfortable with TSH just above or below 1.0 with FT4 in the upper range.

In primary hypothyroidism TSH is usually high with low-in-range FT4 and FT3. One would expect much higher TSH than 2.51 when FT4 is below range which is why I suggested you may have secondary hypothyroidism. If secondary hypothyroidism is diagnosed TSH is valueless and FT4 and FT3 levels should guide dosing.

_______________________________________________________________________________

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.

[Emstar1892 in reply to Clutter]

Thanks so much I'm going to my gp Saturday to show him the results, and am praying for a referral to an endocrinologist! I feel like I can't go on...I will, but it's a struggle! Aah. Sigh. Thanks again

[Clutter in reply to Emstar1892]

Emstar1892, secondary hypothyroidism should be managed in endocrinology as hypopituitarism can cause sex and growth hormone deficiencies too. Your GP can start you on Levothyroxine for low thyroid while you are awaiting referral. Refer your GP to the NICE link I posted above.

[Emstar1892 in reply to Clutter]

Hey clutter, no luck sadly. My gp looked at the result and said "that's just subclinical hypothyroidism, since the tsh is normal we don't need to treat anything, and it might just resolve itself"

[Clutter in reply to Emstar1892]

Emstar82, your GP is wrong. Subclinical hypothyroidism is TSH 4.20 - 10, with FT4 in normal range. Your FT4 is below range. Ask for a second opinion from a senior GP at your practice.

[Angel_of_the_North]

I'd say secondary/central hypo as your TSH is OK-ish, but your FT4 and FT3 are rock bottom - you'd expect much higher TSH with those levels (they are worse than mine!). Although my TSH is lower, too.

[Emstar1892 in reply to Angel_of_the_North]

Yes I was very surprised at the tsh! I can't even describe how unwell I feel. On the train to work the last few days I've honestly doubted whether I've had the strength to get off at my stop. I'm also getting horrible irregular heartbeats and migraines now. Oh and to boot, my vision has gone and I cry at the drop of a hat for no reason. It's hell. And im only 23! I hope you are better now x