My TSH and Free T4 blood results - can anyone interpret them please?

Hi all, I finally plucked up the courage to ask for a printout of my blood results - the receptionist could not have been more helpful!! I'd expected to be grilled as to why I wanted them, or have to pay a big fee...

There are only 2 results:

Serum TSH level = 1.3 miu/L (0.2 - 4.0)

Serum free T4 level = 12.5 pmol/L (10.0 - 20.0)

I think I have the symptoms of hypothyroidism, my maternal gran had a big goitre, my mum had Hashimoto's and I know there's a familial link, but the consultant said that my thyroid was normal according to the test results.

BUT it is diagnosed (by scan) as an enlarged multi-nodular goitre which I find confusing - got a giant ticking off for questioning the consultant re this :-(

Can anyone translate them for me? thank you in anticipation :-)

21 Replies

  • Those results are only part of only the first ingredient of feeling well:

  • thank you eljii!!!

    that's a neat little bundle of info!

    Just remembered - I did also have my Vit D level checked:

    Serum Total 25-hydroxy Vitamin D level = 37nmol/L (75.0 - 250.0). I was prescribed some tablets for this, but haven't noticed any difference.

  • Ragstar You're Vit D is very low. It's recommended to be 100-150nmol/L. What were you prescribed? Is it just D3 or does it also have calcium? What dose?

    You also need K2-MK7 and magnesium when taking D3 as they are both co-factors but your GP won't have told you this as he probably doesn't know.

  • Hi SeasideSusie,

    I was given 6 Colecalciferol 20,000 capsules - 2 per month.

    I took the last dose last week - would it still be beneficial to take K2-MK7 and magnesium after the event as it is?

    Also should it be re-tested to see the levels now? it wasn't mentioned by the doc.

  • Ragstar 2 per month, seriously? Per Month? So 40,000iu D3 per month or 10,000iu per week.

    Was it Fultium-D3 20,000iu? The patient information leaflet recommends for adults

    "- Treatment of vitamin D deficiency: 40,000 IU/week (2 capsules) for 7 weeks, followed by maintenance therapy (equivalent to 1,400-2,000 IU/day, such as 2-3 capsules per month, may be required. Follow-up 25(OH)D measurements should be made approximately three to four months after initiating maintenance therapy to confirm that the target level has been achieved)"

    2 per week for deficiency, not per month.

    With your level of 37, members would normally suggest 5,000iu daily for 2-3 months, retest to check your level, then 5,000iu on alternate days as a maintenance dose.

    You need your level retesting now. If your GP won't do it (they don't like spending the money) then do it privately with a fingerprick blood spot test through City Assays for £28

    A maintenance dose will probably now be needed indefinitely along with K2-MK7 and magnesium. Come back with your new test result and suggestions can be made for a supplement and dose.

  • blimey!!! they got that wrong then. There was no brand name on the drug packaging and no leaflet. Just 6 tablets in a plain white box.

    How do I go about telling the doc that they've got it wrong? AND that they need to prescribe the K2-MK7? I'm not very brave and still smarting from the terrible bedside manner of the thyroid consultant.

    Should I just expect them to be shirty. I'm starting to feel like a hypochondriac! even tho Ive only visited the docs twice in the past 8yrs - both for 'tired all the time' etc. I feel like they've just written me off as a bored housewife :-(

  • Ragstar To be honest, doctors really know very little. Just do it yourself with the help of members here. You wont get K2 prescribed, you have to buy it yourself.

    This is the D3 I like It's very reasonably priced, contains only two ingredients and is a small, easy to swallow softgel.

    K2-MK7 isn't so reasonably priced but you'll find some on Amazon. You can also get D3/K2 combo.

  • thank you SeasideSusie, I suppose it's only the same as having to pay a prescription fee, and this way I'll be getting the real deal. thank you for your recommendations. :-)

  • That is an average dose of approx 1300 iU per day. This is not an adequate dose for raising vitamin D levels in someone who is hypothyroid and can't absorb nutrients very well.

    You really need a dose of 5000 iU - 6000 iU per day.

    Vitamin D3 can easily be bought from Amazon, and in comparison to many supplements is relatively cheap. You can buy enough for an entire year for about £10 - £12. Although I have to say, taking a high dose for a whole year without testing probably isn't the best idea in the world.

    Supplement for 3 - 4 months and then re-test. Once you have got to an optimal level (100 nmol/L or possibly higher, it depends on the person) you should reduce to a maintenance dose - either a lower dose every day or stick to the same dose as before and reduce the days of the week you take it.

    Vitamin D can be re-tested with a finger-prick test

    With vitamin D supplementing you need to take magnesium and vitamin K2 as mentioned by SeasideSusie .

    Edit : Wow, I'm an embarrassingly slow typist... SeasideSusie beat me to it 10 minutes ago!

  • aw thank you for taking the time Humanbean! great info re what to take and in what quantity. So that dose was dramatically too small!

    Will I notice a significant difference at optimum level? I do hope so, I feel like an old crock.

  • Well, I can only tell you how it helped me. I started with a level of low 50s and got it up to about 100. Lots of my muscle and joint aches and pains disappeared and I can walk much more smoothly than I used to.

    I now maintain my levels with a dose of 2000 iU per day. I have stopped taking it for a few weeks when I've run out and my aches and pains start coming back in a big way. So I stick to my maintenance dose.

  • heck! I didn't realise that low levels cause aches and pains - now that would be a very nice thing to lose. Thank you for that personal recommendation - did you also alter your diet? I've started to make myself eat oily fish, but I can't really say it's made much difference to anything.

  • I eat gluten-free. Other than that my diet is fairly relaxed (actually too relaxed - I eat too much sugar). My diet is not one to copy (apart from the gluten-free). :D

    I couldn't eat oily fish even if you promised to pay me for eating it. I can't/won't eat fish with bones either. I am not a fish lover.

    I do eat generous quantities of good fats and oils. My personal definition of good fats and oils are ones that people somewhere in the world would have recognised 200 years ago.

    So, for example, I put a very generous teaspoon of coconut oil in my morning coffee. I then take my vitamin D and some other supplements soon after.

    Fat soluble vitamins like vitamin D need fat to help them be absorbed.

  • humanbean,

    oooh, I love the sound of coconut oil in coffee - alas that is my latest sacrifice is in giving up coffee to see if I feel any better.

    I feel a lot less breathless, but I don't half miss it - waking up with a fruity tea (decaf) is just not as civilised.

    The Archers omnibus definitely doesn't sound as good with a decaffeinated brew in hand :-)

  • I'm sure you could try coconut oil in something else, but you'll just have to experiment to find what you enjoy.

    I found coconut oil in coffee was a bit of an acquired taste. I also have coffee with butter in sometimes, but I prefer the coconut oil most of the time. Coffee without my usual addition(s) doesn't taste as satisfying to me now.

  • Your FT4 is low in range - and needs to be higher. An increase in your dose maybe ? Also there needs to be a FT3 reading to see if the poor result is converting into T3 ....

  • thank you Marz!

    I'm not on any dose - the consultant insists that I'm normal based on these readings.

    I'd have to ask my Dr for any further tests - ie T3 and antibodies, but as the consultant that I was referred to (for the goitre) has said 'normal' I'm wondering if my doc would consider it??

  • You need thyroid antibodies testing, plus check levels of vitamin d, b12, folate and ferratin. These all need to at good (not just average) levels for thyroid hormones (our own or replacement ones) to work in our cells

    Both types of thyroid antibodies need checking There are two sorts TPO Ab and TG Ab. (Thyroid peroxidase and thyroglobulin) Both need checking, if either, or both are high this means autoimmune thyroid - called Hashimoto's the most common cause in UK of being hypo.

    (NHS rarely checks TPO and almost never checks TG. NHS believes it is impossible to have negative TPO and raised TG. It's rare, but not impossible, there are a few members on here that have this.)

    Make sure you get the actual figures from tests (including ranges - figures in brackets). You are entitled to copies of your own results. Some surgeries make nominal charge for printing out. Alternatively you can now ask for online access to your own medical records. Though not all surgeries can do this yet, or may not have blood test results available yet online.

    When you get results suggest you make a new post on here and members can offer advice on any vitamin supplements needed

    If you can not get GP to do these tests, then like many of us, you can get them done privately

    Blue Horizon - Thyroid plus eleven tests all these.

    This is an easy to do fingerprick test you do at home, post back and they email results to you couple of days later.

    Usual advice on ALL thyroid tests, (home one or on NHS) is to do early in morning, ideally before 9am. No food or drink beforehand (other than water) If you are taking Levo, then don't take it in 24 hours before (take straight after). This way your tests are always consistent, and it will show highest TSH, and as this is mainly all the medics decide dose on, best idea is to keep result as high as possible

    If you have Hashimoto's then you may find adopting 100% gluten free diet can help reduce symptoms, and lower antibodies too.

    You do not need to have ANY obvious gut issues, to still have poor absorption or gluten intolerance

    Best advice is to read as much as you can. Vitamin and minerals levels are very important, but standard NHS thinking, doesn't at the moment seem to recognise this. You will see, time and time again on here lots of information and advice about importance of good levels of B12, folate, ferritin and vitamin D, leaky gut and gluten connection to autoimmune Hashimoto's (& Grave's) too.

  • wow! many thanks for all that info SlowDragon. Some great leisure time reading!

    I got referred to an endocrinologist because a dodgy nodule showed up on my scan, I just assumed that as she was a thyroid specialist, she might have wanted more tests doing. Otherwise how could she categorically say that I didn't have hypothyroidism, in fact she laughed at me when I suggested it! It was why in a previous post I asked if Hashimoto's could be diagnosed from a biopsy, as she had only the 2 results to draw her conclusions from.

    I don't really understand why there seems to be such a reluctance to even acknowledge thyroid ill health. I felt like a fraudster!

    If I do go down the route of having my thyroid levels etc checked privately, is there also medical resistance getting docs to acknowledge any problems found or/and treat them?

  • Well, low normal FT4 and normal normal TSH with hypo symptoms suggests secondary or central hypothyroidism, but you need to check your B12, ferritn, D3 and folate as sub-optimal levels can cause hypo-type symptoms and you don't really know what is going on without FT3 result

  • thank you Angel_of_the_North,

    I haven't even explored pituitary and hypothalamus!

    The consultant said that my 'hypo' symptoms must be due to something else because she considered the thyroid levels (just the two Ive posted) as 'normal'. I just don't have faith in her judgement <-- terrible to say as she is a consultant, but I wish she'd have explained it to me and I felt like I understood it. I actually felt like a hypochondriac. :-(

    Good job I didn't know about and suggest central and secondary hypo then, I think she would have really blown her top!

    Thank you for your thoughts re vit deficiencies. Yes, D3 is low, but haven't had the others tested. Perhaps that's the excuse I need to go back to my GP.

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