Please help with Dad's blood results

I convinced my Dad to get his thyroid tested. I happened to mention his health issues to Dr P and he said he should be tested as you never know.

The only challenge I have is that I don't have the lab reference ranges for some strange reason. Tests were done privately and first thing without food. Antibodies look good though.

TSH 2.43 uI/mL (0.35 - 4.94)

Free T4 12.9 pmol/L (9 - 22)

Free T3 3.67 pmol/l (2.63 - 5.70)

Anti-thyroglobulin abs. 14 (0 - 40)

Anti-thyroperoxidase abs. 15 (0 - 35)

Does Dad have a thyroid issue? Also what are the values for somebody who is healthy and normal? Thanks.

Updated with test results.

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33 Replies

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  • Difficult without the ranges. It would help if you had an earlier set to compare...are your dad's records online ?

  • These were done privately so not sure if they are. I don't think his thyroid has been tested before. I'm going to try and get the reference ranges. Thanks.

  • No maybe not privately but if he has had comprehensive bloods before and his surgery is online via patient.emisaccess.co.uk even bloods done before the nhs was dragged kicking and screaming into the 21st century are documented :) Have a word

  • I'll have to investigate the online blood result website. Thank you for the link.

  • Serendipitious Who did the tests, was it Blue Horizon or Medichecks? Some of us are familiar with their ranges.

  • SeasideSusie it was a clinic in Devonshire Place in London. Dad went there for his regular PSA prostate blood test and I convinced him to get his thyroid tested too. He returned from his follow up today with the printout which I'd asked for but it looks like they left out the reference ranges.

  • Oh, that's a shame.

  • I'm going to try and get them somehow. They're not very useful without the reference ranges. He doesn't have obvious hypothyroid symptoms like myself but it's worth investigating.

  • You could ring the clinic and ask for the ranges. If they dont have them, ring the lab they used.

    X

  • This is from TUK and ignoring what the ranges would be (going by the lowish Frees) I would say it is very possible - being mindful I am not medically qualified. Look at this link from TUK

    Free T4 12.9

    Free T3 3.67

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

  • shaws thanks for that link.

    Do you know what percentage of the reference range your Free T4 and Free T3 should be? That link talks about low and lower end but it would be useful to know what exactly that is.

  • You'd have to know the ranges for the particular test. It is because labs use different machines (just to make things awkward) so they have different ranges. It is comparing the result with the ranges which gives an idea if low/high.

  • It is ridiculous that we have to learn these things ourselves if we want to resolve all of the symptoms that can come along with non-diagnosing or inadequate dosing,

  • It is ridiculous and highly frustrating. I haven't got myself well yet and now I'm also investigating my parents' thyroids! :-D

  • There can be a familial connection with regard to autoimmune diseases, unfortunately. I hope you are not getting too stressed.

  • The interesting thing is I know my maternal aunt is hypothyroid but I wasn't expecting my Dad to be. There again I need to get those reference ranges to be absolutely sure. Dad's been on statins and a multitude of medications for years. I wonder if his high cholesterol is linked to his thyroid. He doesn't appear to have any raised antibodies like myself which is a good sign.

    My mum on the other hand is very energetic and is usually quite well. I haven't even started with her. However I'm not convinced she has any issues.

    I don't have the energy to feel stressed tbh but I've been through some stressful times in the past and now I'm just focusing on rectifying what I can.

  • A higher cholesterol level is a clinical symptom of hypothyroidism. When diagnosed and given levothyroxine, it should reduce without any other prescription

    There's about 300 which older doctors used to diagnose patients. Nowadays, the know none. but will prescribe for a symptom and not the cause.

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

    Nowadays it's only upon the TSH which might never rise high enough.

    Statins :

    drmalcolmkendrick.org/books...

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

    drmalcolmkendrick.org/

  • Let's hope I can wean him off those horrid statins...baby steps

  • shaws thank you again for the information about Dr Malcolm Kendrick. I'm really grateful. I'm going to read his book and get my dad off statins too.

    Going back to myself, my cholesterol has always been around 6 whilst on Levo. I expect you mean cholesterol should come down if a patient is adequately treated. In my case I haven't been adequately treated for years.

  • My surgery's lab has a range of 3.5 to 6.5 for free T3 and 9 - 25 for free T4.

    Even with variances between labs, it's obvious that his results are in the bottom half of the ranges and, indeed, near the bottom.

  • yes he is hypothyroid his low tsh and very lowt3 would indicate Central Hypothyroid as opposed to primary hypothyroid

  • reallyfedup123 what do you mean by Central and Primary?

  • did you mean tsh was liw as at 2.4 I personally wouldn't consider it low?

  • my lot are all central hypo and all were fiagnosed with TSH of 2.9 but a free t4 and free t3 at bottom of the ranges

  • central hypothyroid is due to pituarity failure thus tsh stays low and cannot kick the thyroid to produce t4

    primary hypothyroid is thyroid failure so tsh climbs trying to flog failing thyroid into action

  • Rapunzel SeasideSusie shaws I have updated my post with the lab reference ranges. Took forever to get hold of the secretary. Thanks.

  • Serendipitious

    TSH 2.43 uIU-mL (0.35 - 4.94)

    Free T4 12.9 pmol/L (9 - 22)

    Free T3 3.67 pmol/l (2.63 - 5.70)

    In a treated hypo patient the aim generally is for TSH to be 1 or below or wherever it is needed for FT4 and FT3 to be in the upper part of their respective reference ranges. However, as none of us have thyroid tests when we are well (to give us a baseline), it's very difficult to say where your dad would be if he was well and whether this is normal for him or not.

    Even so, it looks like his thyroid is struggling. His TSH is mid-range and his free Ts are low in their ranges. Unfortunately this isn't going to get him a diagnosis, his TSH would have to be over range for that, some doctors wait until it reaches 10.

    The only other thing is, as RFU says, possibly central (secondary) hypothyroidism but I don't know if his TSH is low enough for that. You could point this out to his GP and ask for investigations based on this.

    *****

    Anti-thyroglobulin abs. 14 (0 - 40)

    Anti-thyroperoxidase abs. 15 (0 - 35)

    Antibodies are nice and low, no sign of autoimmune thyroid disease with those results.

  • SeasideSusie thank you for your reply.

    Do you know what investigations a doctor could or should do? I just want to arm myself with enough information when we go to see Dad's GP.

  • Serendipitious It could mean a referral to an endocrinologist, one who specialises in thyroid rather than diabetes, and one who has particular knowledge of secondary/central hypothyroidism.

    From medscape.com/viewarticle/43... :

    "The diagnosis of secondary hypothyroidism resulting from hypothalamic-pituitary dysfunction is more difficult, since the TSH level may be reduced, normal, or even slightly elevated in this condition.[11] Evaluation of other pituitary hormone levels (prolactin, growth hormone, cortisol, and gonadotropins) and imaging studies (computerized tomography or magnetic resonance imaging of the brain) may need to be considered."

    Other reading:

    medscape.com/viewarticle/43...

    progressivehealth.com/secon...

    You might want to take some time to do some research and if you think this is what it might be then you'll need some convincing evidence to persuade the GP to refer your dad. I think finding the right endo might not be easy though.

    Good luck and please let us know how it goes.

  • SeasideSusie will I need to create a login/password to access some of those links on medscape? Funnily enough I was able to access this one about central hypothyroidism:

    medscape.com/viewarticle/43...

    It talks about radiation as a possible cause:

    "Most commonly, it is encountered along with multiple pituitary hormone deficiencies resulting from pituitary surgery, apoplexy, radiation exposure, pituitary and other intracranial tumors, infiltrative systemic diseases. or autoimmune conditions such as lymphocytic hypophysitis."

    About two and half years ago my Dad received 6 weeks of daily radiotherapy because he was found to have cancerous cells in his bladder. This was followed by regular injections to lower the amount of testosterone in his body called Zoladex and keep his PSA in check preventing the prostrate cancer from reappearing. I wonder if this has anything to do with the lowish TSH.

  • Serendipitious I didn't have to, I found it by googling 'central Hypothyroidism'. See if this works, it's my Google search page and that Medscape article is the 7th link down, entitled 'A rare form of Hypothyroidism - Medscape'

    google.co.uk/search?q=centr...

  • SeasideSusie yes that's the one I found too. Thanks.

  • So is it true that in a normal untreated hypothyroid patient TSH will be quite high with low Free T4 and Free T3 but in central hypothyroidism TSH will be low or relatively low with a low Free T4 and Free T3?

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