Just watched the Trust me I'm a doctor programme and wondering if anyone knows what low ths with high t4 results mean with symptoms of hypothyroidism? This includes low Basel temperature readings, dry skin, non weight loss, coldness, low mood, white dry elbows and knees, the usual thyroid symptoms!
Many thanks 
Hi - impossible to tell with so little info. Have you been diagnosed as hypothyroid or are you trying to find a cause for symptoms? If you also give us the blood test results, rather than just 'low' or 'high' we might be able to advise. It is not wise to use guess work in this area as hypo type symptoms can be caused by many things.
Gillian xx
Thanks to all for your help. New subjects can be very difficult to find good info on especially when learning what it all means!!
TSH 0.29 VERY LOW
T4 26 ON THYROXINE
T3 4.2
NEXT TEST
TSH 1.93 LOW
T4 18.6
NEXT TEST
TSH 1.22 LOW
T4 18 HIGH
T3 4.7
Any thoughts?
Thanks again
Hi - yes there is a lot to learn! A bit more knowledge for you - when posting results also give the ranges - the figures in brackets after the number as labs differ and it can be hard to interpret without the range.
Anyway, a couple more questions, what dose of thyroxine - levo? - are you on and did you change doses between the various tests you have quoted? Were all tests done first thing in morning, fasting and 24hrs after last levo?
Have you ever had anti-bodies tested for Hashimotos auto-immune? Also it is important that vit d, vit b12, folate and ferritin are all at optimal (not just in range) levels for thyroid to work effectively. Have you had these tested at all?If you have please give results for a complete picture.
If you haven't then ask your gp to test. If they won't then private testing is easy through Blue Horizons or Medichecks.
Hang on in there, with the assistance of all the very helpful experts in this group you will learn all you need to know and feel better - it will just take a while and a bit of patience, commitment and experimentation.
Gillian xx
Thanks to all for your help. New subjects can be very difficult to find good info on especially when learning what it all means!!
TSH 0.29 VERY LOW range 0.27 -4.20
T4 26 ON THYROXINE OVER 100mg a day range 12-22
T3 4.2 range 3.1-6.8
NEXT TEST
TSH 1.93 LOW range 0.27 -4.20
T4 18.6 range 12-22
NEXT TEST
TSH 1.22 LOW range 0.27 -4.20
T4 18 HIGH range 12-22
T3 4.7 range 3.1-6.8
Any thoughts?
Thanks again
Hi - your first results look a bit odd but the last two look better. You appear to be converting ok from t4 to t3, but as you still have some hypo symptoms there is room for another dose increase to push both a bit higher. Don't worry about tsh dropping a bit further, it is the ft3 that is important - the lack of that is what gives you symptoms. Maximum increase should be 25mcg a time, wait 6-8 weeks and then re-test.
Next time you test try to get the anti-bodies, vit d, vit b12, folate and ferritin checked as well.
Hope you feel better soon,
Gillian xx
With just saying those two results I am assuming those are the only tests that have been done and many doctors would say it means you are well managed but it doesnt say whether you are converting the stored T4 in your body to the necessary active T3!
This gets me so cross! FT3 reading can tell us so much more and if we are all tested for this as we set out on our thyroid journey then many of us would live normal lives, more firms would produce T3 and more doctors would be aware of how to deal with it!
Rant over!
When TSH is low it can becime irrelevent.
Are you diagnosed and on thyroxine
Do you have your latest blood test results, TSH and including FT4 & FT3
If they have not been done ......Suggest you ask GP to check levels of vitamin d, b12, folate and ferritin. These all need to at good (not just average) levels for thyroid hormones (our own or replacement ones) to work in our cells
Also do you know if you have had thyroid antibodies checked? There are two sorts TPO Ab and TG Ab. (Thyroid peroxidase and thyroglobulin) Both need checking, if either, or both antibodies are high this means autoimmune thyroid - called Hashimoto's the most common cause in UK of being hypo.
If you have Hashimoto's then you may find adopting 100% gluten free diet can really help reduce symptoms, and lower antibodies slowly over time too.
Did your dose change at any time during the above period of results?
Did you have your ferritin, folate, Vit D and B12 tested?
And what time were the bloods taken, were they fasting bloods and had you taken levo less than 24 hours before?
Most importantly, HOW DO YOU FEEL!
TSH is not low when it is within range. Some of your TSH results have been marked as LOW when they are above 1. 95% of people with healthy thyroids have a TSH between 0.5 and 1.5. That's why it is a good idea for people who take Levothyroxine to increase their dose until their TSH comes down to 1. Even then many people feel better with their TSH well below 1, and some people do best when their TSH is supressed. People who have had their thyroid removed due to cancer are often medicated until their TSH is zero.
Normally people with hypothyroidism need their FT4 and FT3 levels in the top 75% of the range to feel good. Often it's easy to get the FT4 high enough but the FT3 stays stubbornly low. There are lots of reasons for this, but having healthy amounts of Vitamins D and B12, plus Ferritin can help a lot, and hypothyroid people tend to have low levels of these nutrients. People who still can't get their FT3 levels up even when their nutrient levels are really good can end up taking T3 in some form (synthetic T3 or NDT). Getting an NHS doctor to prescribe either of these can be very difficult though.
I hope this helps.
High t4/High TSH
Very low TSH and High T4
High T4 low TSH
Low TSH High T3 Normal T4 Total Thyroidectomy
