Help with these results

[Jason15]

Hello

I had a TFT test done by the nhs last week despite being told over the phone results were normal I am having trouble interpreting the results they were

"Serum TSH level" 5.29 mU/L (0.27 - 4.20) "High"

"Serum free T4 level" 19.3 pmol/L (11.0 - 25.0)

"Serum Ferritin" 314 ug/L (15 - 300) "High"

I have been suffereing with fatigue for the last 6-7 months when I get up in the morning I am wiped out by 4pm lightheaded to tired to talk even and ready for bed I guess what I am asking is there any other specific tests related to thyroid I should be asaking for and do those results seem normal

Thanks

[SeasideSusie Remembering]

Jason15 How on earth can they say they're normal when two are over range and marked high??

You need to make an appointment with your GP to discuss these. Point out that your TSH is over range and that you have taken advice from NHS Choices recommended source of information and advice about thyroid disorders and you understand that the aim of a treated hypo patient is generally 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.

From ThyroidUK's main website:

"According to the BMA's booklet, "Understanding Thyroid Disorders", many people do not feel well unless their levels are at the bottom of the TSH range or below and at the top of the FT4 range or a little above."

Also, Dr Toft, leading endocrinologist and past president of the British Thyroid Association, states in Pulse Magazine:

"TThe appropriate dose of levothyroxine is that which restores euthyroidism and serum TSH to the lower part of the reference range - 0.2-0.5mU/l.

In this case, free thyroxine is likely to be in the upper part of its reference range or even slightly elevated – 18-22pmol/l. Most patients will feel well in that circumstance.

But some need a higher dose of levothyroxine to suppress serum TSH and then the serum-free T4 concentration will be elevated at around 24-28pmol/l.

This 'exogenous subclinical hyperthyroidism' is not dangerous as long as serum T3 is unequivocally normal – that is, serum total around T3 1.7nmol/l (reference range 1.0-2.2nmol/l)."

You can obtain a copy of the article by emailing [e-mail] then you can print it off to show your GP.

Also, ask him the significance of over range ferritin.

[Jason15 in reply to SeasideSusie]

Thanks for the advice will make an appointment to discuss the matter, so to sum it up i should be on some sort of thyroid medication or at least be considered for it.

My B12 and Folate were in the normal range

B12 755 ng/L (180 - 900)

"Serum Folate" 9.0 ug/L (> 3.8)

"Please note change in the folate cut-off from 01/12/2016 due to a change in the method. Results are approximately 20% lower than previously reported.

Thanks for help

[SeasideSusie Remembering in reply to Jason15]

Jason15 Sorry, I didn't realise you aren't on thyroid meds. The information I gave was for a *treated hypo patient*.

Was that your first thyroid thyroid function test? If so you don't stand much chance of a diagnosis with your TSH at that level. Most doctors wait until it reaches 10. If you've had thyroid tests done before and your TSH is rising you might stand a slight chance of a diagnosis.

You could ask for thyroid antibodies to be tested. There are two types - Thyroid Peroxidase (TPO) and Thyroglobulin (TG). NHS can do TPO but rarely do TG. If either are over range that would mean you have autoimmune thyroid disease aka Hashimoto's where antibodies attack the thyroid and gradually destroy it. You can get both antibodies tested privately through Blue Horizon or Medichecks, they do home fingerprick tests.

Your B12 and folate are good.

Did you get Vit D tested?

[Jason15]

Thanks for that will ask for the TPO to be tested then and also the Vit D as I did not get that one done either

did have another that was high

"Serum bilirubin level" 26umol/L (<21) "High"

Don't really know what that is though

Thanks again

[SeasideSusie Remembering in reply to Jason15]

Jason15 You can look up any tests you don't understand here

labtestsonline.org.uk/under...

Bilirubin is part of the liver function test normally.

[Susieibbo301 in reply to SeasideSusie]

I have been trying to get diagnosed for nearly two years with TSH of around 6, and below the range T4, then I had a private test done with Doctors Laboratory which showed the TSH going up to 10.7. After that, I have seen a Doctor of Environmental and Nutrition Medecine (fully trained medic in London) who also did the antibodies which were sky high. Took that back to the gp and finally (by seeing a different gp) , I was diagnosed with Hashimotos and given a starting dose of 25mg. thyroxine. However, I am also trying to do the diet and gut issues, etc. I think that I had been borderline for about 10 years and the gp wouldn't do anything, so I agree that having the antibody test may help you.

[Jason15]

I just changed gp today have an appointment next week will see if i can get the tests done then thanks everyone for the help it is very much appreciated.