Thyroid UK

TSH result

Hello - just had my test result back and been told that it's normal, so I asked for the reading. Answer TSH 0.44. I'm concerned that this at the lowest end of the 'normal' range and this is why I feel so enervated etc. I also have FMS which makes it difficult to explain/separate symptoms. Should I just accept this result and carry on or should I have further tests...which I'm not sure my GP would deem necessary. I've already considered having a private test carried out because I'm not convinced I'm converting T4 to T3, I did asked about this some time ago and was told it wasn't necessary. I have to say my GP is generally excellent but this issue just isn't getting resolved. If poor conversion were to be the case I have no idea how to proceed from there. I'm 71 and far from ready to sit quietly in a corner but my quality of life is diminishing and there doesn't appear to be an answer. Any ideas would be much appreciated. Many thanks.

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I would simply be asking the GP how TSH alone can possibly exclude central or tertiary hypothyroid .....then watch him scratch his head

Primary hypothyroid is the only form that TSH rises in

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Can't tell you how pleased I am to have recently found so many really well informed people! This issue has bugged me for years and the 125mg Levothyroxine I'm prescribed just doesn't seem to work.

Very many thanks for this.

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DippyDame,

TSH 0.44 rules out primary hypothyroidism but without testing FT4 it is impossible to rule out secondary hypothyroidism. If you want to know whether you are a poor converter you will need to test TSH, FT4 and FT3 together. It may be worth ordering a private thyroid test plus ferritin, vitamin D, B12 and folate as low/deficient vitamins and minerals are common in older people and can cause fatigue and enervation.

You can order private tests via thyroiduk.org.uk/tuk/testin...

Medichecks offer #ThyroidThursday discounts healthunlocked.com/thyroidu...

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Clutter...many thanks for this. Currently I take 125mg Levothyroxine. I asked recently to have a Vit D3 test...very low,so have now finished the loading dose and now on maintenance dose. Sorry can't remember figures off the top of my head! I also take Mg and b12 supplements. I was surprised the results only gave TSH level....no FT4, and there seems to be a huge reluctance to check FT3. I'll check out the private test link you give. Really appreciate this support as I feel I've been sailing into the wind for years over this... I also feel what shows in my bloods is not the actual levels I'm absorbing. How do GPs generally react to being presented with private test results? Many thanks.

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DippyDame,

FT3 is rarely tested in primary care now and now the cheapskates are skipping FT4 in a lot of cases unless TSH is abnormal. Low TSH, high (in range) FT4 and low FT3 indicates poor conversion. If you are a poor converter you will need FT4 over range or T3 added to Levothyroxine to improve FT3. It's very difficult to get T3 prescribed on NHS so you may need to consider buying online and self medicating if that is the case.

Some GPs are happy to interpret private test results but some are snotty about them. If the tests show a potential issue some GPs will order NHS tests to double check. GPs can insist on labs doing the tests they order in order to make a clinical diagnosis.

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Have B12, Folate and Ferritin checked as likely to be low too. Runs hand in hand.

B12 600 plus under 500 can start to cause Neurological damage.

Vit D between 60-100 the vitamin d council has good info.

Folate and Ferritin you want to be mid range

Completely agree with Clutter re thyroid results.

Look at bluehorizonmedicals .co.uk if you are thinking about private testing to get a comprehensive thyroid panel done.

Thyroid plus 11,12 and 15 are good. They will also test vitamins. Not cheap but to get a clearer picture it may be worth it.

If you are not converting it may be worth contemplating adding T3 or switching to NDT but get results first then it will be a much clearer picture.

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TSH doesn't make you feel anything, whatever the level. Thyroid Stimulating Hormone, just stimulates the thyroid to make more hormone. Yours, of course, cannot respond, which is why you're taking thyroid hormone replacement.

Doctors have been taught that the TSH tells them all they need to know - I suspect this is a deliberate ploy to stop a lot of people getting diagnosed, and keeping those who do get diagnosed, under-medicated, because it just isn't true. But, you're right, you do need to know what your FT4 and FT3 are - especially if you want to know how well you are converting. So, private tests are the best way to go. Your doctor wouldn't understand what the FT4 and FT3 results meant, even if she managed to get them tested - but we do, so post the results, with the ranges, on here.

Given the current situation, if you discover you aren't converting well, the only way forward is to buy your own T3. Which is still possible, at the moment. But, it might just be that, despite your low TSH, you are still under-medicated. Although I would have thought that 'enervated' sounds more like an over-medicated symptom. What is FMS?

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GG,

I thought that too but enervated means feeling drained of energy or vitality, fatigued etc. I think I was confusing it with energised.

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So it does! Well, well, well. I would have thought that would be denervated. lol Not I word I can remember using at all.

So, if that's what the OP meant, then yes, could either be under-medication, or bad conversion.

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Grey Goose

FMS = fibromyalgia.

Yes Clutter is right...fatigue etc. Sorry if I confused...enervated is a word I regularly use...for obvious reasons! Wish I did feel energised!!

Looks like a private test is next...then onwards from there

Thanks again

PS To what/who does OP refer in your post?

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There is a school of thought (not taken much notice of, sadly) that believes fibromyalgia just one consequence of thyroid disease...

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Thanks steviecat... I have heard of this, which is another reason that I keep digging for answers. I told one GP, a few years ago, that I wouldn't give up doing so and she suggested I just give up, 'just be the patient',and take what is prescribed. So I got another spade out! Trouble is so many conditions may be linked making it difficult - without much research - to extrapolate answers. The obvious illnesses are generally well catered for but anything a bit 'odd' and not considered life threatening becomes difficult to resolve. I appreciate that docs don't know all the answers and that the NHS is vastly overstretched which makes self help the remaining option. Thankfully my current GP doesn't view me as a silly, neurotic old woman...yet!!

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Keep digging, Dippy! Never give up. Doctors love a patient who they can 'dominate'. The questioning types give them the colly-wobbles, because it forces them to wonder at their own sense of superiority.

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It refers to you. lol Original Poster. Yes, I agree with steviecat, your FMS could just be your under-medicated hypo.

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Silly me...should have worked that one out. Thanks

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:D

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Curious - where exactly do you buy T3?

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On-line. Sorry, can't name sites on the forum.

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Could you direct message me? I'm having trouble finding sites. Thanks!

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Why don't you post a question asking for people to share links to their trusted site. That way, you will get a variety of responses. I'm a bit out of the loop since things got difficult in Greece. :)

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Hi Dippy Dame - You also need to test RT3 - and establish the ratio between RT3/T3 - I am around your age and have had similar problems - but had a full thyroid panel done - which as I say includes the RT3 - and that showed that i had a conversion problem. I also tested for the MTHFR gene mutation which i was told, is implicated in thyroid problems including T4/T3 conversion - I tested positive for one gene mutation. Also test B12, D3, selenium, zinc etc etc - i have been on T3 for a few months now and DEFINITELY feeling better - I feel that I am not on my correct dose just yet but getting there! I would get the private blood tests done as recommended on this forum. Onward!!

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Thanks vonni7...GP has now prescribed low dose amitriptyline for Fibro pain and after 4 days I am really struggling to stay alert...the meds are worse than the pain. Having problems opening Bluehorizon's web site...everything else on internet running correctly.. but will phone them on Monday morning and discuss test options. I remain convinced ...over many years...that my problem lies with my thyroid but have never been able to convince GPs that it needs more than a levo dose of 125mcg. As you say "Onwards". Family inc 2 young grandsons arriving in Aug so I'm keen to have zombie like feeling behind me. Many thanks for your support.

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Hi everyone. Going to order a test kit today so will post results here for interpretation as grey goose suggested. This might finally answer the question about conversion that GPs have more or less brushed aside for....years. Just have a 'gut feeling' that this is the key to unlock the problem. Fingers crossed! Huge thanks to all for help and support...so glad I found you all.

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When you have results - pop them into a new post so more people will see them. They will be lost here 😴

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Thank you...will do.

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Another thought, Have you had your antibodies checked?

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Hi! How are you feeling? Everyone is different! If you are not feeling well then I would say see another Dr. Many Doctors dismiss us as patients and really onky look at labs. Dr. Izabella Wentz can contest to this! Please check out her books!

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