Thyroid UK
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Borderline for hypothyroidism?

Borderline for hypothyroidism?


I'm new to the forum. I've been tested twice for hypothyroidism, and I've attached my results. I'm borderline for FT4, but on the upper end of normal for TSH level. I've been told to come back again in 8 weeks.

The thing is, I have essentially every symptom and it's so frustrating because it's affecting my life quality so much. I'm 19, and I haven't had a period in 5 months. I have had a severe eating disorder between the ages of 11 and 16. I still have a lot of difficulties surrounding eating and my weight; I'm a healthy weight, but I constantly have to watch my weight, yo-yo in weight so often, and I'm so jealous of my friends being able to eat whatever they want and not have to worry about it. I'm cold all the time, tired all the time, my face is puffy and bloated, my heart rate is so slow (about 52 at rest) and I get palpitations, my hair is so thin and falls out easily. I'm 19, I'm supposed to feel energetic but I just feel so lethargic.

I just don't know what to do. I have a history of hypothyroidism in my family, and I feel like I've tolerated and come to accept the side affects for so long. I feel like a time waster going back to the doctor and requesting TT4 and FT3 levels to be tested too. I dislike the idea of being a "know more than the doctor, but I insist blah blah" kind of patient, and I know people have much more severe health problems and members here must have much more severe levels of thyroid issues.

I read somewhere that TSH reaches it's peak in the middle of the night and declines after. My previous two tests have both been first thing in the morning, about 8am. Would this significantly impact on results, or is it only a minor fluctuation?

Essentially I'm asking, if T4 and TSH levels come back the same after my next test, will I be denied treatment because TSH is within the normal range? Should I ask for TT4 and FT3 levels to be tested too? And finally, do doctors take into account personal symptoms and experiences when determining an individuals "normal" levels?

6 Replies

Welcome to the forum, Woolie123.

Your GP is following protocol to retest in 2-3 months after the first abnormal result, in this case your FT4 being below range. I imagine your TSH is high in range because FT4 is low. FT4 can be low and TSH high due to a non-thyroidal illness like a virus or infection and this is why you've been asked to go back in a few weeks.

The fluctuations in TSH are shown in the link below. Arrange the blood test as early as possible in the morning when TSH is highest and fast (water only) as eating and drinking lowers TSH. If FT4 remains below range your GP should prescribe Levothyroxine.

Total T4 (TT4) is rarely done in the UK as FT4 is a more accurate test. FT3 is usually not done unless TSH is suppressed <0.1.

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Absolutely no point in asking for TT4, it doesn't give you any useful information. The most important number is the FT3, but the NHS rarely tests for that.

But, you could ask for antibodies to be tested if your next test shows similar results.


If you can help yourself, or your family can financially support it, then you can order your own tests from Blue Horizons.

It is important to get all the thyroid hormones done at once, so if you wait the 8 weeks then yes do ask for TSh, freet3 , freet4, TPO, TgAb at your next apt. And suggest vitd, ferretin, B12 also.

In the meantime you could do some research with your who is affected? By what? What do they do to help it? Have they been able to find energy again? How did they react to any meds? Have they had a helpful doctor?

Sometimes the thyroid problem comes first, and then because of low thyroid hormone levels, you are more prone to ED behaviours. And other times the psychology and circumstances cause ED which sets the ground for the thyroid disorder.

EDs are incredibly common and I hope you dont feel alone in that. Most women and girls, even if they dont get a full blown ED, can have disordered eating or unkind thoughts about themselves.

Its a shame that you have to hang on in there, and we will hang on in there with you :)

I know its easy to get despondent about energy and weight and how we feel about ourselves, but becasue you have now discovered this, you will find a way, and your weight will stabalise and you will feel happy and energised.

EDs do ravage so it could take some time, a lot of investigation and patience, but your life is yours. so i hope you can find ways to really enjoy yourself, relax and spend time with peopl you love, even if you are tired. You know how it is, we have to pick a movie over a hike sometimes!

Some doctors take in to account symptoms but you really have to make them listen. Believe it or not, its quite easy to know more than your doc about this, and if you are prepared and calm, and try to approach them more as a partner in health, than the enemy, you made succeed.

Some doctors just suck, they are stressed and agressive and make you feel pants.

But occassionally one listens to your rational view on the matter and agrees to the tests.

Take care and keep posting as you need help. xx




Eating Disorders


Cheers xx

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