test results: hi - just had results today of TSH... - Thyroid UK

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test results

scorp0811 profile image
13 Replies

hi - just had results today of TSH 4.91, T4 16.6

The only other result they'd give me was Ferr: 46 and B12 1131

I've been taking iron and b12 for the last 6 months, but still feeling exhausted and very down. The receptionist just said the doctor wants an non-urgent phone call in a weeks time.. so no doubt he's going to do nothing. I have asked for a referral to an endocrinologist in the past but been told it isn't necessary.

I feel powerless and depressed. Any advice please...

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13 Replies
Smotv80 profile image
Smotv80

Your B12 is good, and your ferritin isn't optimal but it's going in the right direction.

Your TSH is far too high, so you are under medicated. Did your doctor not test your T3?

scorp0811 profile image
scorp0811 in reply to Smotv80

hi.. thanks for fast reply.

no.. they won't / don't do T3 in UK I'm told.

Smotv80 profile image
Smotv80 in reply to scorp0811

That's absolute rubbish! I get T3 tested each time I have a blood draw!

helvella profile image
helvellaAdministratorThyroid UK in reply to Smotv80

Smotv80,

If you mean that is possible to get Free T3 tested in the UK, well, yes, it can be done.

Few of us here have had Free T3 tested in our NHS tests. In general, even if a GP requests an FT3 test it is likely not to be done. Some areas seem to have a policy that Free T3 is only tested on authority of an endocrinologist. Even then, we have seen reports where that was not sufficient.

Many of the UK-based Free T3 test results posted here are from private tests.

scorp0811 profile image
scorp0811 in reply to helvella

ok.. I'll find a private testing place.. thanks.

Smotv80 profile image
Smotv80 in reply to helvella

I didn't say it was impossible. I said that gp's can check FT3 levels. A lot of gp's refuse as they don't see it as 'necessary' but they can request the labs check it. You shouldn't have to go private to have it checked. It is a test done by the NHS and you are well within your rights to request/demand it if your not feeling well and your TSH and T4 are coming back ok. I know RT3 isn't checked by NHS, most doctors don't even acknowledge RT3, but free T3 can be done. It's checked as standard in my surgery

helvella profile image
helvellaAdministratorThyroid UK in reply to Smotv80

Apologies, my first sentence was mis-corrected as I typed and I failed to notice. Now corrected to:

If you mean that is possible to get Free T3 tested in the UK, well, yes, it can be done.

GPs often cannot get a free T3 test done by a lab.

I was involved in complaints about this many years ago - using PALS, even my MP. The GP was mystified as to why despite signing the request, it was never done. Eventually the head of the lab relented but that only helped one person (not me). There are absolute blanket refusal policies in place in some areas.

So, yes, it is a test that NHS labs can do. No, you should not have to go private. The reality is that for many, it might as well be a test NHS labs don't do and people do have to go for private tests.

PS The idea that a lab can refuse but not communicate that refusal back to the requesting doctor is, in my view, unethical. Every request should have a report back - even if that says "Get lost". The loop must be closed.

Smotv80 profile image
Smotv80 in reply to helvella

That is disgusting. I wasn't aware that this goes on in certain parts of the country.

I know labs can refuse certain tests but I've no idea why. It certainly is unethical that they can do this. When the test is ordered by a doctor or specialist, who are they to refuse!

helvella profile image
helvellaAdministratorThyroid UK in reply to Smotv80

There seems, at root, to be only one reason: Money.

What we cannot reaily know is if this is because the NHS is grossly over-paying for the tests (analysers, reagents, etc.), or because they don't have sufficient funding.

puncturedbicycle profile image
puncturedbicycle in reply to Smotv80

Yes, my gp always requests the t3 test (I take t3 as well as t4) but it can be an almighty palaver to get the lab to do it.

shaws profile image
shawsAdministrator

Scorpio0811

You haven't filled in your Profile but I've looked down a couple of past posts and find you have been diagnosed with hypothyroidism a few years ago.

You are still complaining of being unwell, and I am not at all surprised due to your TSH being nearly 5, which I suspect will be the top of the range. (you've not put the ranges on your results above).

Sack you doctor as you have been made permanently unwell, it would seem to me, due to your lack of sufficient thyroid hormones and your doctor's ignorance about clinical symptoms of undertreated patients.

Email louise.roberts@thyroiduk.org.uk and ask for a copy of Dr Toft's Pulse Online article. Highlight the following and post it to your GP with a note, telling him you are now a member of Healthunlocked Thyroiduk.org.uk who are the NHS Choices for advice and help about dysfunctions of the thyroid gland and you need sufficient levothyroxine to bring your TSH down to below 1. (it should be gradual increases). Excerpt from Pulse online. Dr Toft was President of the BTA:-

6 What is the correct dose of thyroxine and is there any rationale for adding in triiodothyronine?

The 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.

scorp0811 profile image
scorp0811 in reply to shaws

ah.. thank you for doing that. I tried to find my past posts as I knew I contacted you a while back. Yes, I have Hashimotos.

don't know how to sack my doctor - they are much of a muchness around here. I will e-mail Louise though and forward that article. thank you..

(I was at 0.1 TSH on 175 mg so they reduced me to 100 mg. Felt dreadful.. and they put it up to 125mg 2 months ago. )

thanks again... good to feel heard!

shaws profile image
shawsAdministrator in reply to scorp0811

I just don't know who does their tuition when they are student doctors. As millions of people appear to get hypothyroidism why cannot we be trated optimally instead of adjusting our doses up/down to get the TSH into somewhere in the range, when the aim should be 1 or lower - not 'somewhere' 'anywhere' in the range and given other prescriptions for remaining symptoms. Also they seem to unaware that the TSH is highest early a,m and drops throughout the day.

I think many members have recovered their health by support from members.

p.s. to see your past posts click on your name.

web.archive.org/web/2010103...

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