Thyroid UK

Could it be a hormonal problem in stead of a thyroid one?

So I've been a member for this community for quite a long time. Recently, I went to a new doctor because I didn't trust my old GP anymore.

My TSH has always been between 5 and 7, but T3 and T4 were always within range. Now they found out my Sex Hormone Binding Globulin is 190 (should be maximum 120 for an adult female) and my B12 was also low.

My symptoms are:

- always cold

- anxiety

- tiredness

- no libido,..

My doctor is going to order some cortisol tests and stuff, but does anyone recognize this? Maybe it is more a hormonal problem than a thyroid one! But could this affect the TSH-level then?

16 Replies


Your TSH appears highish but thyroid hormones are within range … BUT when SHBG is elevated, thyroid hormone can bind to it, making it inactive. (Remember it is only the “FREE’ that is important. ie: free T4 (FT4) & free T3 (FT3) that brings well being).

Elevated SHBG can be caused by elevated sex hormones & will bind to thyroid hormones making them inactive. That means your blood stream can show to have adequate levels of thyroid hormone that is unavailable for use … so you may feel hypothyroid symptoms.

Also elevated SHBG can be caused by low cortisol levels (in turn caused by low thyroid hormones) ... as when cortisol lowers, oestrogen can soar, causing higher SHBG levels. … vicious circle ! ! ..

Low thyroid hormone eventually affects many other hormones as all work in unison. There is room for compromise but only for so long. The pituitary gland could be working overtime as your decent levels of thyroid hormones aren’t working properly.

Have you had Vit D, ferratin & folate tested ? ? ..

Vit B12 low ? ? ... ummm .. are you still receiving the B12 injections ? ? …


Thanks for the answer, radd! I'll take my time to read into it!

Yes vit B12 was quite low (145). I received some injections a while back, but not anymore, since I tested negative for parietal cell antibodies :)

The cortisol thing is tested I think, since I think my GP was thinking (lots of thinking lol) that it might have something to do with a low adrenal function?

But I don't get that really, because my main anxiety symptoms are in the morning, but cortisol is high in the morning and not low??

Vit D was low but not very low (25), folate quite low (3,4) and ferritin also quite low (23 and I think the range was 21-200).


These vitamins are all too low


But I have a healthy diet though? I truly don't get it. First GP (the one that I dumped lol) says it's all psychological, but I've been seeing a psychologist for 2 years now and still no real improvement..


It has absolutely nothing to do with how good our diets are

It's to do with malabsorption in the gut due to gluten intolerance and/or low stomach acid

Under treated Hashimoto's causes depression and anxiety.


I do have candida though (in all my body, not just on my tongue or something) so maybe that has something to do with it?

I've been tested for some antibodies, I think thyroid antibodies, and those were negative.


So if you are not on thyroid hormone and you have TSH of 5 or 7 that still strongly suggests you have thyroid problem

Candida is common when hypo as we tend to have low stomach acid

The fact your TSH is so high (despite FT4 and FT3 are in range

Plus the fact you have candida and all these low vitamins ......I would strongly suspect you are hypothyroid

I would get all your vitamins optimal and then retest thyroid with full test from Medichecks or Blue Horizon

Make sure to do any thyroid test as early as possible in morning and fasting


How can something psychological cause high TSH and low vitamins? More likely the other way round. There are no objective, scientific tests for "psychological problems", but there are for physical ones and you can see your deficiencies in black and white.



I edited my post & still managed to repeat sentences ! !... 🤪 .. lol .

Your ferritin is very low considering you "may" have a thyroid hormone issue. ( I assume you are not medicating thyroid hormone yet as haven't mentioned it ? ? ).

Iron is key for conversion of T4 - T3 (the active hormone that brings well being) whether medicating or not... and low levels may decrease deiodinase activity resulting in conversion to reverse T3 ( rather than the active hormone). This means you could be hypothyroid (with low ferritin levels) and yet appear “normal” according to standard thyroid hormone labs.

High or low cortisol levels will inhibit good thyroid hormone synthesis and impaired thyroid hormone synthesis will compromise adrenal hormones further ... another vicious circle. Anxiety is a classic imbalanced cortisol symptom.

Vit B12 and folate are frequently found in the same biochemical pathways as work together to help create and regenerate red blood cells and make iron work properly.

I am not too hot on Vit D but think it optimal 75-125 ng/mL. What was your range & units ? / ..


optimal vit D was starting at 30!

And no, I am not medicated, since my T3/4 are fine!

The weird thing is though, my ferritin is low, but my iron is too high! (200 when ranges are 30-180)


Arrrr ....

You reply to SlowDragon you have candida ! ! ...

Read the following link ...


Wow so weird that it's all linked!

But my doc prescribed me medication for the candida I should start taking in two days, is this the same thing as 'starving' candida?



There are many different micro-organisms/different strains of yeast, essential for healthy gut flora which may become unbalanced due to low stomach acid caused by low thyroid hormone. But low thyroid hormone will encourage the low gastric acid & candida to flourish ... another vicious circle.

Healthy bacteria keeps yeast in check but when there is not enough, the yeast may become abundant. I have read that candida can weaken the adrenal glands that may in turn affect good thyroid function further.

I am an advocate for holistic support with issues such as this as most meds doctors prescribe cure one thing but cause another.

Obviously one’s diet plays a major role in minimizing refined foods/sugars consumption whilst addressing adrenal and immune system support. If you google "gut dysbiosis" this will give you protocols to follow.

You may find optimising nutrient deficiencies and addressing gut/malabsorbtion issues improves thyroid hormone absorption/conversion/function.

Lotsa luck but I would still get sex hormones tested as well..

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If the VitD was tested in the UK then the measurement is in nmol/L and at least 100-150 is Optimal ! In the US and other countries the measurement is ng/L and 60 is the minimum level needed to prevent so many serious conditions - including cancer.


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Well if you are on Levothyroxine TSH should be one (or even slightly less) not between 5 and 7

No wonder you felt rubbish you have been extremely under medicated

Essential to know if you have high thyroid antibodies, this is Hashimoto's also called autoimmune thyroid disease

Hashimoto's and PCOS are linked

PCOS may be responsible for high sex hormone

For full evaluation you ideally need TSH, FT4, FT3, TT4, TPO and TG antibodies, plus vitamin D, folate, ferritin and B12 tested

See if you can get full thyroid and vitamin testing from GP. Unlikely to get FT3

Private tests are available

Medichecks Thyroid plus ultra vitamin or Blue Horizon Thyroid plus eleven are the most popular choice. DIY finger prick test or option to pay extra for private blood draw. Both companies often have money off offers.

All thyroid tests should be done as early as possible in morning and fasting and don't take Levo in the 24 hours prior to test, delay and take straight after. This gives highest TSH, lowest FT4 and most consistent results

Link about antibodies

Link about thyroid blood tests

Print this list of symptoms off, tick all that apply and take to GP

See Box 1. Towards end of article

Some possible causes of persistent symptoms in euthyroid patients on L-T4

You will see low vitamin D, folate, ferritin and B12 listed

Low vitamins are common due to under medication

Detailed supplements advice from SeasideSusie in these two posts

Dr Toft, past president of the British Thyroid Association and leading endocrinologist, states in Pulse Magazine,

"The appropriate dose of levothyroxine is that which restores euthyroidism and serum TSH to the lower part of the reference range - 0.2-0.5mU/l.

In this case, free thyroxine is likely to be in the upper part of its reference range or even slightly elevated – 18-22pmol/l.

Most patients will feel well in that circumstance. But some need a higher dose of levothyroxine to suppress serum TSH and then the serum-free T4 concentration will be elevated at around 24-28pmol/l.

This 'exogenous subclinical hyperthyroidism' is not dangerous as long as serum T3 is unequivocally normal – that is, serum total around T3 1.7nmol/l (reference range 1.0-2.2nmol/l)."

You can obtain a copy of the articles from Thyroid UK email print it and highlight question 6 to show your doctor

please email Dionne:


All your hormones, including thyroid hormones, work together and need to be in balance. Most healthy people have a TSH around 1.2, so your TSH suggests a problem (and no one really knows if the free t4 range is "correct", so if you are near the bottom, you are probably hypo). High oestrogen or SHGB can stop your thyroid hormones working properly. But high SHGB can be caused by low thyroid, so you nee dto get the whole lot sorted out. Don't be fobbed off by a GP who wants to tell you it's menopause or some such female problem


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