Need some urgent advice prior to GP appointment in an hour

I'm very new to this forum right now and not had chance to fully intro myself yet but hoping for some feedback asap please. I'm about to take my niece to see GP in about an hour because she's been told her blood tests are normal and nothing wrong with her, FULL STOP!! I beg to differ as her T4 level is lower than mine has ever been in ten years of struggling to be treated.

T4 - 8.2 (7.86 -14.41)

TSH - 1.82 (0.35 - 5.50)

Serum ferritin - 39.7 (22.00 - 322.00)

She can't lose weight even though being quite active but feels tired all the time. Lately she's been sleeping more than 12 hours per day and is feeling very low mood.

She's only 24 years old and this is not her usual character and behaviour.

Any suggestions on how I can tackle this with the GP please?

Many thanks all xx

2 Replies

  • Caggie61,

    Your niece's thyroid levels are euthyroid because they are within range. Her FT4 is very low, however, which makes it likely her T3, which is the active hormone, is also low. Unfortunately, it is very unlikely your niece's GP will be able to order a FT3 test as her TSH is not <0.03. NHS will not usually prescribe Levothyroxine until TSH is >5.50 or FT4 is <7.86. Her GP could prescribe a 3 month trial of Levothyroxine to see whether her symptoms improve but I think it is unlikely s/he will be willing to do so.

    Your niece's ferritin is very low and this may be contributing to her fatigue. Ferritin is optimal halfway through range. Your niece's ferritin is within range so it is unlikely NHS will prescribe iron but she can buy iron without a prescription and supplement. Iron should be taken with 500-1,000mg vitamin C to aid absorption and minimise constipation.


    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.

  • Serum ferritin - 39.7 (22.00 - 322.00)

    The above result is 13% of the way through the reference range. To us it seems obvious that this is too low. But to a doctor with a tight budget it is in range therefore is normal.

    If your niece had a mid-range result it would be 172, and for many people that is the level they need to have a hope of feeling well, particularly if they have or are developing an underactive thyroid.

    If your niece wants help with iron supplementing, be aware that prescription-strength iron supplements can be bought without a prescription. You need to know where to ask and what to ask for.

    It is also possible to get blood testing done without the involvement of a doctor. So your niece could take iron supplements and get tested with a finger prick test as necessary to check where her levels are.

    Your niece should ask for B12, folate and vitamin D testing. If the doctor won't agree these can be tested for privately too. Just ask for details.

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