Help with thyroid readings please

Advice please - I have been feeling awful for some time (lack of energy, tingling fingers,carpel tunnel, hair loss etc.) and had blood tests. The doctor said my levels were low but come back in 6 months!!!

The results were Serum TSH level = 1.93 miu/L and Serum free T4 level = 7.9 pmol/L

Does anyone understand these results and should I insist on further tests/ medication??

Any advice would be greatly appreciated.

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10 Replies

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  • bestmum Do you have the reference ranges for the results, they're usually in brackets or at the side

    eg FT4: 7.9 (10-22)

    As ranges vary from lab to lab it's not possible to interpret your results without them, especially FT4.

    It would be useful to have a full thyroid panel plus vitamins and minerals which will give a much better picture:

    TSH

    FT4

    FT3

    Thyroid Peroxidase (TPO) antibodies

    Thyroglobulin (TG) antibodies

    Vit D

    B12

    Folate

    Ferritin

  • Thank you for your prompt response and sorry there were ranges in the brackets

    TSH 1.93 miu/L (0.3 - 5)

    T4 level 7.9 pmol/L (8.4 - 19.1)

  • bestmum It looks like your doctor has ignored the fact that your FT4 is under range and just because your TSH is at a reasonable level within the range he's happy to do nothing. I wonder what he is waiting for?

    If you look at Interpretation of Thyroid Blood Tests on ThyroidUK thyroiduk.org.uk/tuk/testin...

    the table shows (in the middle column) that if TSH is normal ie 0.1 - 2 and T4 and T3 at the lower end of range, then consider diagnosis confirmed.

    Print off the list of signs and symptoms of hypothyroidism here thyroiduk.org.uk/tuk/about_... and tick all those that apply

    Then I would go back to your GP with this information (I don't know if you can print that off the results table) and tell him that you have had advice from NHS Choices recommended source of information for thyroid disorders and you would like him to give you a trial of Levothyroxine.

    You may need to fight your corner. Ask for those further tests. Ask for a referral to an endocrinologist if he is unable to interpret the results (might be best to say that politely :D )

    Let us know how it goes.

  • Thank you SeasideSusie. I have printed off the Signs and Symptoms list and easily ticked 22. I will go back to the doctors again, if he still wants me to wait I shall try and get a private referral. I appreciate your advice.

  • bestmum If you are going to see an endocrinologist, private or NHS, then email louise.roberts@thyroiduk.org.uk for the list of thyroid friendly endos/doctors then whoever you can get to ask for feedback on the forum (replies will have to be by private message). That way you can choose one who hopefully you won't be wasting your time with. Many endos are diabetes specialists who know little about the thyroid, so it's important to choose wisely where possible.

  • Bestmum,

    Low-normal TSH rules out primary hypothyroidism but low-normal TSH with FT4 below range indicates central hypothyroidism. Treatment is Levothyroxine to replace low thyroid hormone but management is usually in endocrinology because investigation is required to rule out deficient sex and growth hormones.

    Show your GP the NICE CKS which says:

    Secondary or central hypothyroidism is the result of insufficient production of bioactive TSH due to a pituitary or hypothalamic disorder.

    Urgent referral to an endocrinologist should be arranged if:

    Secondary hypothyroidism is suspected.

    cks.nice.org.uk/hypothyroid...

  • Hi bestmum

    Please get back to Doctor promptly not in 6 months!

    Firstly

    Could you please phone doctors and ask for full results including the normal ranges in brackets and post on here.

    Your T4 looks low to me. Even though you haven't given range you say your Doctor says it's low. If your Thyroxine levels are low, this is Hypothyroidism.

    See doctor or different one at practice and ask for urgent referal to an Endocrinologist. Ask for an Ultrasound scan of your Thyroid. You could also ask for Thyroid Antibodies blood tests and fT3 and ft4. You need proper diagnosis, care and treatment ie commencement on low start dose of Levothyroxine if you have Hypothyroidism. Following this repeat bloods in 6 - 8 weeks and dose increase. Usually after 3 appointments with Endocrinology you would be under care /monitoring by GP for life.

    Hope this helps.

    ps

    Always ask for full details of blood results with normal ranges.

    X

    🐥

    pps I have Hashimoto's Autoimmune Thyroiditis & Hypothyroidism. I asked GP for the scan. Following this he made urgent referal to Endocrinologist. He arranged Short Synacthen Test to check my adrenals first. Had already arranged all the blood tests prior to appointment. Then okayed for me to start my 50mcg Levothyroxine which was increased to 75mcg.

  • Thank you Mary-intussuception - I will definitely be going back to the doctors!!

  • I would insist on urgent referal to Endocrinologist. Why should you have to pay private. If you see NHS Endo ask him to do the other (vit D, B12, Ferritin and Folate ) as well. I have only just found out that I need folic acid and VitD supplements, but was diagnosed 5 and a half years ago.

    If you end up paying private. Then I would ask GP to do all the tests.

    My bloods taken in 2008 by GP and Colorectal consultant were Hypothyroid with other abnormalities including deranged Liver Function tests. However these were not acted upon by either! No one told me. 18 months later the Rheumatologist saw them and retested. I was feeling much better at this time. They came back Euthyroid ie within normal range and I was told Thyroid OK! I applied for copies of my hospital records and saw that they were actually low end of normal. It was another 18 months later that I plucked up the courage to diplomatically ask my most agreeable GP for the Ultrasound scan as I had been advised by a helpline. The morning after the scan he made urgent referal to Endocrinologist.

    All the best. Be careful. Hope you get your diagnosis soon.

    x

    🐥

  • Thank you - I will keep you posted x

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