Baffled by blood results, please help me work out what on earth is going on!

Hi everyone, if any of you read my lasts posts I had a climbing TSH and my GP had just agreed to try me on 25mcg of Levothyroxine. I did a private blood test BEFORE I started taking any thyroxine so that I knew what my most recent levels were. I had expected them to be the same as in March if not a slightly higher TSH.

I can't seem to attach my results as a PDF so I'll outline them here. 

January 2016

TSH 2.9 (0.27-4.2)

March 2016

TSH 4.4 (0.27-4.2)

May 2016

TSH 2.12 (0.27-4.2)

Free T4 22.84 (12-22)

Free T3 6.09 (3.1-6.8)

I didn't have the T4 or T3 tested in the January or March tests. The doctor's notes on the most recent private blood results say this is indicative of borderline Hyperthyroidism, which hasn't yet affected my TSH levels.

I am very confused as this wasn't what I was expecting and would really appreciate anyone's input as to what they think might be happening, what on earth to investigate next or if in fact there really is nothing wrong with me at all. 

Thank you x

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  • Ask GP to test thyroid antibodies. If you have them it may be that they are attacking your thyroid gland now and then, i.e. sending out too many antibodies and then too little but they eventually make you hypothyroid.

    Also GP should test B12, Vit D, iron, ferritin and folate as well as antibodies. We are usually deficient and if so we can also suffer from clinical symptoms.

    If you were hyper I think your TSH would be much lower:-

    thyroiduk.org.uk/tuk/testin...

  • The FT4 is a little over but I've always understood that that is ok as long as the FT3 is within range and it is

  • Thanks for your replies. Shaws, I had my TPO antibodies checked in March and they came out negative at 14 (<34), is it unlikely that they would have changed since then?

  • Ofelia,

     That's the problem with NHS only testing TSH, they've missed the high FT4 and misdiagnosed hypothyroidism.  You certainly don't need Levothyroxine while FT4 is over range and FT3 near the top of range.

    _______________________________________________________________________________

    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.

  • I know, I asked both times for them to test t3 and t4 but the lab refused.

    Do you have any suggestions what to do next? Are there are potential reasons why the TSH is fluctuating and I feel so awful? I wondered, is it possible that supplementing iron has solved the problem and I will feel better if I just continue that? Sorry for all the questions, I'm just at as loss as to why and what next x

  • Ofelia_1,

    Often it is Hashimoto's antibodies which cause fluctuations in thyroid levels and TSH but your antibodies are low and negative for Hashimoto's.

    Testing at different times of day will cause variance in TSH results.  TSHfluctuates throughout the day and night and is highest early in the morning and lowest at night.  It surprises me that your TSH is >2 when your FT4 is over range and FT3 top of range.  I would give your GP a copy of your private results to put on your medical file.  GP should insist lab tests TSH and FT4 next time you are tested.

    _____________________________________________________________________

    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.

  • They need to check BOTH sets of antibodies 

    TPO Ab and TG Ab

    You can get negative result on one (low) and positive (high) result on the other.......or high on both obviously 

    Can get tested privately if NHS won't do it.

  • Are the TG antibodies indicative of Hashimotos as well? I'm dreading going back to the GP to be honest, it's not going to be a pleasant experience!

  • Print this off to take in with you from the NHS recommended support website

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

  • I would also add that one negatvie antibody test does not completely rule out Hashi's, because antibodies fluctuate.

    The NHS, in it's wisdom, does not consider it necessary to test for TgAB. Goodness knows what their reasoning is on this, because if TgAB are high, you have Hashi's, and TgAB can be high when TPOab are low.

    Secretly, I believe that if they did both sets of antibodies, they would have to diagnose a lot more people with Hashi's, and that's not what they want to do!

  • T3 is the active thyroid hormone which regulates the metabolism and therefore the symptoms. With a free T3 near the top of the range you should not have any hypothyroid symptoms.

    One possible cause of your continuing symptoms is thyroid hormone resistance, also known as impaired sensitivity to thyroid hormone. The high TSH is also common with this condition.

    This is a genetic condition so if there are others in your family with fibromyalgia, chronic fatigue, depression or thyroid issues this would support this possibility.

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