TSH 4.96 and Free T4 11.9

[Slosh]

So my daughter 36 - latest test (UK) was TSH 4.96 and Free T4 11.9.

They say this is normal - no action.

She is egausted all the time, can't lose weight etc etc.

Her previous tests were TSH 3.43 and FT4 12.1

And prior to that TSH 5.99 and FT4 12.9

Could anyone shed any light. She is not on any treatment and never had been.

Thank you.

[shaws Administrator]

Welcome to our forum.

I am sorry your daughter is not feeling well. When you give results of tests we have to also have the ranges of them (these are in brackets after the results). The reason being that labs differ in their machines and also have different ranges. We compare the results according to the ranges. Before blood tests were introduced along with levothyroxine, we were all diagnosed upon clinical symptoms alone. That has now gone by the wayside and why we have such a lot of members who are not diagnosed or undertreated.

Nowadays, the modern way, of diagnosing is only by blood tests and if you are in the UK, sometimes it is impossible to be diagnosed as it is stated that our TSH has to reach 10 before being diagnosed despite disabling symptoms (they now know none). However, in other parts of the world patients are prescribed when TSH reaches 3+. I think the person(s) who thought up that number must be hypo themselves, i.e. have brain fog.

I shall give you some links further down the page. When we have blood tests for thyroid hormones it has to be the very earliest possible, fasting, and if diagnosed and taking hormones, you allow a gap between last dose and test and take afterwards. If taking thyroid hormones they have to be taken on an empty stomach with one full glass of water and wait about an hour before eating. Usually we take it when we get up. Others prefer a bedtime dose, so you have to have last eaten about 3 hours before if it contains protein. Usually we have low stomach acid so takes longer to digest food.

thyroiduk.org.uk/tuk/about_...

thyroiduk.org.uk/tuk/testin...

thyroiduk.org.uk/tuk/testin...

A Full Thyroid Function Test is TSH, T4, T3, Free T4, Free T3 and thyroid antibodies. (if GP or lab wont do all if TSH is 'in range' we can get them privately. We have two good labs). The most important is the FT4 and FT3. GP should definitely test B12, Vit D, iron, ferritin and folate. We can be deficient which also causes symptoms.

If antibodies are present these attack the gland - and wax and wane until the person is hypothyroid but treatment is the same. If antibodies are present it is called an Autoimmune Thyroid Disease or Hashimoto's (hashi's for short).

Always get a print-out with the ranges for your own records.

[Slosh in reply to shaws]

Thank you for your response. She was tested for antibodies last year and did have them - as do I. I have been on treatment for about 5 years. Lately mine is up and down.

The lab ranges in each test was as follows

TSH = 0.35 - 5.00 mu/L

FT4 = 9.00 - 22.00pmol/L

[SlowDragon Administrator in reply to Slosh]

Then if she has high antibodies, she should be started on Levothyroxine

Try a different GP

Also definitely check vitamin D, folate, ferritin and B12

Likely to be too low

[Slosh in reply to SlowDragon]

Thank you SlowDragon.

Her Vit D is low - she takes Vit D and co factors.

Her folate is not optimum.

Strangely her Vit B12 is highish - she supplements occasionally but should probably have a 'available b12 ' test.

Will check Ferritin.

Yes probably time to see another doctor.

[SlowDragon Administrator in reply to Slosh]

Vitamin D being low is extremely common with Hashimoto's

hypothyroidmom.com/92-of-ha...

It's also extremely common for patients to turn up here having been on too small a dose from GP for YEARS, with level still too low

With Hashimoto's we struggle to absorb any from food and possibly need more too

Better You vitamin D mouth spray avoids the gut absorption issues

Vitamindtest.org.uk £28 private postal kit

Test twice a year until you work out what dose needed to keep level up around 100nmol

Good she's taking magnesium and vitamin K2

A good vitamin B complex (with folate in not cheaper folic acid) to keep B's in balance and will improve folate

If you are taking vitamin B complex, or any supplements containing biotin, remember to stop these 3-5 days before any blood tests, as biotin can falsely affect test results

endo.confex.com/endo/2016en...

endocrinenews.endocrine.org...

All thyroid tests should be done as early as possible in morning and fasting and if taking Levo, don't take it in the 24 hours prior to test, delay and take straight after. This gives highest TSH and most consistent results

[Slosh in reply to SlowDragon]

Thank you for your valuable input.

Much appreciated

[shaws Administrator in reply to Slosh]

Her fT4 is low - should be towards the upper part of the range. The most important is FT3 but this is rarely taken. T3 is the only active thyroid hormone and it is required in our T3 receptor cells.