Hypothyroid symptoms but TSH and T4 normal?


This is my first post so apologies if this has already been answered.

I have pretty much every hypothyroid symptom apart from the weight gain and when I came across the symptomology for the condition I felt as though it was a eureka moment for why I'd felt so rubbish for so long!

However, I've just had my NHS bloods back and my TSH and T4 were normal.

I am happy to pay for a private test but I am unsure whether I need to order T3 or Free T3?

Can somebody please help me out? I would be so grateful and also interested to hear of others in the same boat!

Many thanks!


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Do you have the results with ranges of your * normal * TSH & FT4 ? Docs often say normal when they mean in range - however it is where you are in the range that is important ....

Free T3 is the most meaningful test as long as the FT4 is also tested along with the TSH and thyroid anti-bodies - TPO & Tg.


The above link takes you to all things thyroid - including private testing companies.

Also include B12 - Folate - Ferritin - VitD tests as they need to be optimal for your hormones to work well and for you to feel well.

Many thanks for your reply!

I called back to ask and my TSH was 0.83 and FT4 was 12.5.

I'm not really sure what to make of those!

Any help would be appreciated!

Thanks again.

Without the ranges - it would seem both the TSH and the FT4 are low in range. ( Ranges vary from lab to lab ) With such a low FT4 it would follow that the FT3 would also be very low and could be the source of many of your symptoms.

I have read here on the Forum - that when the TSH - FT4 and FT3 are low it can indicate a Pituitary issue and is called Central Hypothyroidism and can be more common than GP's think.



Links for Private Testing and also the Signs and Symptoms list for you to tick :-)

Ahh! I have just read up on Secondary/Central hypothyroidism and it does seem to fit.

The range quoted for TSH was 0.4 - 5.0 and for FT4 was 10 - 24.

So although I am technically within "normal" range does this mean I can still be experiencing symptoms in your experience?

I am so grateful for your input :)

When the FT4 is so low in range - it is usual for the TSH to rise as the Pituitary pumps out the hormone to kick-start the thyroid into producing more T4. Normal is a word Docs love to use - as of course we all want to feel just that - * normal * :-) Sadly it is an opinion and not a result. What they mean - is that the result is in range - but where you are in the range is key !


Here is another link to the main website of Thyroid UK - and a helpful chart that explains the test results.

I have been doing lots of research on the links you provided and many more.

I just can't work out the next step to take. Some say for suspected secondary hypothyroidism then total T3 is the appropriate follow up test. Although some say Free T3. So I'm not quite sure which test to order?!

Do you think my GP would take me seriously if I approached with this additional test that indicates possible secondary hypothyroidism?

As you said, I just want to feel normal again πŸ˜”

I think you should ask for a referral to see an Endo - preferably a thyroid friendly one 😊

There is a Search Box at the top of the page if you are on a PC - type in Central Hypo - press Enter and see what other posts appear. Sorry am on my phone - otherwise I would do the link for you .....


EDIT : above link added.😴

Thanks so much! That information was incredibly helpful! :)

I am going to push for a referral!

so you have low TSH and also a low freet4

this usually indicates CENTRAL or TERTIARY HYPOTHYROID

IF free t3 is also low that clinches it

problem is far too many doctors do not even think about the possibility

have you had a head injury or a massive blood loss at some point

are there other family members with any form of auto immune disease

I lost around approximately 1.3 litres of blood during my emergency c-section approx 2 years ago? It made me very anemic ( I was in the "normal" levels when I entered the hospital) and I required a blood transfusion.

I had only come across head injury as a potential cause so this is very interesting to me!

To be honest, I feel I've never really recovered from childbirth! I have always blamed the "being cold all the time", "baby brain", being super emotional, dry skin, the fatigue (the list goes on!) on being a mum to a toddler who's full of beans and being a student!

I finished my degree last month and the symptoms have not subsided and even when my son is with his gran I'm still drained :(

I am so incredibly grateful to you and Marz and all the information on this site as I feel that without it I wouldn't have the confidence to approach my GP but I am going to make an appointment this week to discuss the above diagnosis!

Thanks again :)

Really hope all goes well for you. Please report back in a new post. Also ask for B12 - Folate - Ferritin - Vit D to be tested. Good levels needed for you to feel well 😊

Louise Roberts - Admin - has a list of Private Endos who are thyroid friendly if you are able to take that route. NHS waiting lists forEndos is long as they mostly deal with diabetes.

Hope you will soon be well.

Good luck and do not under any circumstance take NO for an answer

take an assertive person with you to appt take the best sheet of info you can print and insist on an emergency referral to an endo

its utterly disgraceful that after that blood loss and all your symptoms that no one has put 2 and 2 together

why does it take members of an NHS choices forum to think of the obvious

I honestly don't believe it would have even crossed their minds sadly πŸ˜”

I am already working on my extensive list and I am bringing my other half who takes no crap, I can tell you πŸ˜‚

Will post updates to let you all know how I'm getting on!

"normal " is a heavily overused and abused word that means zilch

please request the actual test results and reference ranges from your doctor ( your legally entitled to them ) because all too often on here when we see the results we recognise what doctors do not understand

Pam636 you have excatly the same situation as my daughter she is just 17 and we are having a nightmare with the doctors helping they have just referred her but will be a long wait so thinking we will have to go private she has low tsh and low t4 ,we are going to do home test with all the thryiod checks she also has low end ferritin and folate her hair loss has been so so bad she has half the hair she had 2 years ago ,will keep you posted with how we get on good luck to you X

Thanks for sharing your story Pls! I hope your poor daughter feels better soon and gets the treatment she needs. Bad enough me feeling this way at 31 let alone 17 :( not fair for her at all.

Yes I definitely think private would be a good way to go.

Would love to hear updates and wishing her a speedy recovery!

Thank u you too will keep u posted xx

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