Sub clinical hypothyroidism- how long can you h... - Thyroid UK

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Sub clinical hypothyroidism- how long can you have this before it gets worse?

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Hi just looking for some advice. So after looking at symptoms of hypothyroidism I done a private test through Thriva to check my thyroid function, the results came back slightly high tsh but other levels in range but high antiperoxidase antibodies and high antithyroglobulin antibodies.

TSH 6.28 (0.27-4.3)

FT4 14.12 (12-23)

FT3 4.39 (3.1-6.8)

T4 90.2 (64.5-142)

TPEX 158.9 (0-34)

TGAB 619.8 (0-115)

I told gp that I had paid privately to test and they said they would test again for their own records so about 3 weeks later had another blood test.

TSH 6.45

FT4 18.2

TPEX 300 & Something, can't remember exact figure.

They also checked b12, iron and said that was normal. I don't know the ranges for gp results as they don't give a copy.

Gp said no need to treat as ft4 still in range but probably will develop into hypothyroidism as I have antibodies so just to wait until it gets worse as medication might cause side effects. To go back in 3 months for another test.

Sorry for the long post but I'm just wondering if anyone else had subclinical hypo before which ended up hypo and does anyone know how long you can have this before it gets worse? Is there anything I should ask next time I'm at gp? Anyway to reverse it or improve readings?

Thanks 😊

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How long is a piece of string? Ask your GP for the lab ref ranges next time you get your results because they're pretty meaningless without them. If you are symptomatic you should ask your GP to commence Levothyroxine treatment now.

Dr A Toft, consultant physician and endocrinologist at the Royal Infirmary of Edinburgh, has recently written in Pulse Magazine, "The combination of a normal serum T4 and raised serum TSH is known as subclinical hypothyroidism. If measured, serum T3 will also be normal. Repeat the thyroid function tests in two or three months in case the abnormality represents a resolving thyroiditis.2 But if it persists then antibodies to thyroid peroxidase should be measured.

If these are positive – indicative of underlying autoimmune thyroid disease – the patient should be considered to have the mildest form of hypothyroidism.

In the absence of symptoms some would simply recommend annual thyroid function tests until serum TSH is over 10mU/l or symptoms such as tiredness and weight gain develop. But a more pragmatic approach is to recognise that the thyroid failure is likely to become worse and try to nip things in the bud rather than risk loss to follow-up."

Email if you would like a copy of the Pulse article to show your GP.

Thyroid peroxidase antibodies are positive for autoimmune thyroid disease (Hashimoto's). There is no cure for Hashimoto's which causes 90% of hypothyroidism. Treatment is for the low thyroid levels it causes. Many people have found that 100% gluten-free diet is helpful in reducing Hashi flares, symptoms and eventually antibodies.

hi Lisa

Your results for TSH look very high and suggest Hypothyroidism and not sub-clinical Hypo. How are you feeling?


Lisa1323 in reply to Dreamer12

Hi Dreamer12

I feel cold most of the time especially my hands & feet, weight is stuck even if I try eating healthy it doesn't budge. I had a sick bug and felt wrotten for a few days then hardly ate but thought oh yes maybe I'll shed a few pounds haha but nope a pound off then back on when I started eating normal again. Also get dry skin, acne, brittle nails & hair, tired especially afternoon or early evening but then toss & turn half the night, my memories quite bad as well I do have quite a few brain fog moments πŸ€”

Just wondering whether even a low dose of meds would help a bit rather than just waiting for things to get worse.

Lisa 😊

Dreamer12 in reply to Lisa1323

Hi Lisa

Feeling cold is one of the common symptoms of underactive Thyroid . I'm quite new to all of this myself but when I was diagnosed with TSH 4.24 (0.3-6) and FT4 12.1(9-24) I felt very breathless, missing outer part of eyebrows, body hair and severe exhaustion. High cholesterol and blood pressure. When I started Levothyroxine 5 months ago I felt much less tired and breathing almost perfect after a few months and eyebrows grew in!!! Still a long way to go but getting there. You will get lots of good help on the forum and I hope you will get better soon. Take care of yourself πŸ˜€ Xx

Lisa1323 in reply to Dreamer12

Thank you, glad you're starting to feel better! Sure I'll be reading up loads to be better armed with questions for gp next time I go.

Take care too ☺x

Dreamer12 in reply to Lisa1323

Hi Lisa

I've found gps and Endo very unhelpful indeed but got lots of help on here as you will. Xx

Dreamer12 in reply to Dreamer12

I have had no side effects of Levo xx

Lisa1323 in reply to Dreamer12

Yeah I think sometimes it's best asking advice from other people in a similar situation as gps just go by numbers and if it looks normal on a chart then they think you shouldn't have any symptoms πŸ˜•

Lots of helpful advice already and good to hear other peoples stories and progress as well.

Thank you 😊

Jaju in reply to Lisa1323

Hi Lisa,

My TSH was 8.2 but my T4 was borderline so my GP put me on 25mg of Levothyroxine which I have been taking since Aug 2016. I feel much better and actually sleep through the night which after 3/4 years of not doing is fantastic. My weight had started to creep up but since taking the medication it is slowly coming down.


Lisa1323 in reply to Jaju

Glad your doctor started treatment and good to hear it actually helped make a difference. I think some gps are reluctant to give meds if tsh is below 10 and think everything should be fine if ft4 is in range

Lisa 😊x

Hi Clutter

Thanks, think I'll mention hashimotos to gp next time I go. I might try going gluten free as well if it might help.

Lisa 😊

shawsAdministrator in reply to Lisa1323

You should request a copy from of Dr Toft's article as many doctors don't know that if antibodies are present you have an Autoimmune Thyroid Disease called Hashimoto's. That's why Dr Toft (ex President of the BTA) recommends starting levothyroxine.

Lisa1323 in reply to shaws

Thanks, looking at symptoms on the link I can check off quite a lot of those boxes so think that'll be handy to show gp along with the article.

Lisa 😊x

" ... Is there anything I should ask next time I see GP? ..."

Yes Lisa. I would see GP asap and ask him/her to send you for an Ultrasound scan of your Thyroid.

I did, and morning after scan I was refered urgently to Endocrinologist who did full blood tests including antibodies and arranged Short Synacthen Test to check my adrenals first.

Make a list of your symptoms to take with you.

I can't think what 'side effects' of Levothyroxine your GP is refering to, but if you have Hashimoto's Autoimmune Thyroiditis you need your Levothyroxine.

I chose to wait until I 'd had all the tests before starting my Levothyroxine.

Can I ask why you did private blood tests? Was it because your GP refused?

Have you any unexplained weight gain, is your body temperature ever slightly low? Any hair loss or facial hair growth?


Hi, i paid privately because I don't really like going to gp unless I'm really ill and know that half the time they tell you nothings wrong anyway so thought I'd get a test then I could tell the gp the results so they would follow it up. I know that they also only check tsh & ft4 so when I showed her the antibody results she said she'd check that again as well although they only retested antiperoxidase. I'm not sure if its just the gp that deals with it or if they do referrals to endocrinologist here as she didn't mention anything about that or a scan just to go back for a blood test in 3 months and that was all.

I haven't actually took my temperature but i always feel cold or shivery, my hands and feet are worst, usually walking about the house with my housecoat over my clothes to keep warm. I do get excess hair growth on chin, some thicker & darker hairs, usually have to pluck or wax but hair on head is thick, dry & frizzy but starting to snap and thin around hairline, probably doesn't help that I have to use straighteners but Its a lot worse at breaking than before. I'm about a couple of stone overweight, been like that for a while now and hard to lose, the doc says my ft4's fine so shouldn't affect metabolism πŸ˜•

Thanks for your reply, I'll make sure I ask about getting a scan when I go back to gp.

Did you have to ask for a scan or was your gp happy to send you? How are you feeling since you began meds? Hope all's well,

Lisa 😊

Hi Lisa I asked for scan because a lovely woman on a Thyroid helpline LISTENED to me tell all my symptoms, then said 'you have Hashimoto's Autoimmune Thyroiditis' and told me to ask GP for the scan.

I didn't pluck up the courage to then, though, as like you I didn't like going to GP because of the unhelpful attitudes I'd experienced sometimes.

Lisa I just finished lengthy reply and then lost it so will write more again soon.

When you ask GP for scan if she asks why just tell her ALL your symptoms. Or say that As you have symptoms of Hashimoto's Autoimmune Thyroiditis, you would like to eliminate or confirm it.

If she refuses ask for referal to Endocrinologist. If you get nowhere with her see a different GP at the practice.

I wouldn't wait 3 months.

I started Levo 5&half years ago. I'm OK at the moment - blue sky & sunshine helps! Still have to shave my chin though!!!

When I asked my GP for scan he asked why, so I told him about helpline and some of my symptoms.

Morning after scan he gave me Levothyroxine 50mcg prescription & made urgent referal to Endocrinologist. I chose to delay starting Levo till I'd seen Endo. He was pleased with this and did all the bloods including antibodies. Also arranged urgent Short Synacthen Test to check my adrenals first. He phoned me after all results back to say OK to start my Levo. When I told Endo my temperature was 35 it semed significant to him. When I told a GP she didn't seem to believe me and wasn't bothered about it. So I asked a different GP for the scan.



Thank you, glad you got treated properly and feeling fine just now. I'll try and pluck up the courage to go back and ask for a scan. It definitely helps hearing other peoples stories and hopefully the gp will listen

Take care 😊 x

Oh sorry maybe i spelt it wrong its Thriva. They send out test kit by post, you do finger prick test then post it back same day and they email you results a couple of days later so you can log back online to view 😊


Suggest you try strictly gluten free. Very many of us with Hashimotos find it helps significantly.

Also good probiotics and fermented foods like kefir to improve gut bacteria

Selenium supplements can also help increase conversion of T4 to T3

Vitamin C support adrenals & zinc helps Thyroid. None of these will affect when testing for base levels of vitamin D, B12, folate & ferritin

If not had vitamin D levels checked suggest you do so. - private finger prick test for Β£28

Always get copies of blood test results from GP (including ranges- figures in brackets after each result ). "Normal" is not a result. E.g. B12 range is very wide - typically 210-790. If your result was 213 or 785 GP would say it was "normal". But with Hashimotos many of us find it needs to be right at top end or at least over 500.

See The Thyroid Pharmacist website, also Amy Myers & Chris Kresser sites for how & why gluten free & other diet & lifestyle changes can really help

Lisa1323 in reply to SlowDragon

Thanks for your advice, I'll look into going gluten free although don't think it'll be easy to do (for me anyway lol) seems to be gluten in loads of things 😣. I did buy probiotic tablets (biokult) as thought it might help get things moving as I do get bloated a lot when don't go to toilet. I see about getting other supplements too.

Not sure if they tested vit D, when I phoned for results before I saw gp receptionist said all was fine except thyroid & I said what was the actual number and she said why do you need to know, i said to compare to private test i had done. Gp did show me screen but didn't really remember numbers or see ranges for everything, my memories no that great πŸ˜‚ think I'll ask for a printout to compare.

Thanks again! 😊

Have a read of the things on Thyroid Uk site as I'm sure lots to help you and print out the list of symptoms, annotate it and show to your doctor. I'm sure there could a a few and even some you didn't associate with your thyroid or even ones your GP is treating thinking it is something else.

Dr Skinner always said that subclinical was rubbish. You are obviously hypothyroid. You definately need your t3 checking, also vitamin D, iron and folate. You have symptoms so you should be treated. The sooner the better

Try get a book by Isabelka Wentz - thyroid protocol - or follow her on Facebook - Thyroid Pharmacist, Dr. Izabella Wentz

Lisa1323 in reply to Slosh

Very informative, thanks 😊x

Dont know if my case is relevant - but my T4 was always at 10 or below - bottom of scale for years and they did nothing said borderline. For 20 years l saw a Healer who was complete magic and put all right after a long year of treatment then 3-monthly top ups but sadly lost him, and just gone downhill. l first asked for help over 40 years ago and been ignored by 6 or 7 GPs and one Consultant. Taking the wrong hormones can of course make us worse or wrong amount. Had to make big strop at GP before Xmas and got referred to lovely young lady Endo - who suspected and found Cortisol(Adrenals) is low - and got further tests tomorrow. This is not tested for in normal thyroid test

Lisa1323 in reply to Bluecat101

Aw it's hard trying to get someone to just listen and treat you individually rather than just a number. Glad you finally got to see someone that has listened and checked other causes as well.

Good luck with your tests tomorrow, I hope you finally get the right treatment you need.

Take care

Lisa 😊x

Bluecat101 in reply to Lisa1323

Thanks so much - l have hope now as this Endo is a lovely young lady. After seeing all the other comments on here l feel very fortunate - as its a life and career wrecker. Never had any faith in medics as they rarely ever have done anything for me.

You take care too

Helen x

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