Newbie! ....Private test results help please?

[HappySam]

Hello all,

I've recently had some private finger prick blood tests done after experiencing possible hypothyroidism symptoms for some time (cold extremities, tiredness, loose/constipated bm, low temperature, struggling to lose weight despite diet and exercise, feeling cold all the time etc).

I would be grateful if anyone could give any advice at all on my results, they seem to be all in range apart from free t4 which is right at the bottom of the range.

TSH 1.35mIU/L (0.27-4.20)

Total T4 72.9 pmol/L (59-154)

Free T4 12.1 pmol/L (12-22)

Free T3 4.45 pmol/L (3.10-6.80)

Thyroglobulin antibody 16.300 IU/mL (0-115)

Thyroid peroxidase antibodies 23.9 IU/mL (0-34)

So apart from the free t4 being a little low, these all seem normal, am I barking up the wrong tree here?

Any advice would be greatly appreciated!

Thank you x

[Marz]

Could it be you have LOW levels of B12 - Folate - Ferritin - VitD ? Symptoms of low nutrients often resemble low thyroid ....

[HappySam in reply to Marz]

Thanks Marz for the quick reply. What would cause those low levels, do you know? Would it be diet related? I generally eat very well, cook from scratch, plenty of fruit and veg, meat and oliy fish, dairy, nuts etc and try to avoid too much sugar and carbs, except the ones in wine 😉 (I've had tests for diabetes and cholesterol, coeliacs etc and all normal)

Thanks again x

[Marz in reply to HappySam]

We are what we absorb rather than what we eat Have you been tested for the Vitamins and Minerals I mentioned ? Low acid can be the cause of poor uptake in the stomach from foods. if you have the results with ranges do post them and members will comment ....

[HappySam in reply to Marz]

Thanks Marz I'll try and get the docs to do some tests if possible!

[Marz in reply to HappySam]

You could try ! Private Testing is available through Thyroid UK - Testing Kits sent to you in the comfort of your own home See link below ! Docs not good on Vits and Minerals ....

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

[Clutter]

HappySam,

With FT4 bottom of the range one would expect to see TSH higher. Low-normal TSH excludes primary hypothyroidism but I think your GP should consider central hypothyroidism and refer you to endocrinology for investigation.

NICE CKS 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...

Treatment for central hypothyroidism is Levothyroxine which can be initiated by your GP while you await referral.

Thyroid antibodies are negative for autoimmune thyroiditis (Hashimoto's).

[HappySam in reply to Clutter]

Clutter thank you for your reply and info. I will have a good read tonight once the little ones are tucked up. I have read something about possible pituarty gland issues before (including tumours 😱) but perhaps dismissed it prematurely.

Think I'm going to get the vits tested as everyone is suggesting. X

[Clutter in reply to HappySam]

HappySam,

Secondary hypothyroidism is due to pituitary dysfunction. It doesn't necessarily mean a pituitary tumour is the problem. The problem might not be pituitary, it might be the hypothalmus (tertiary hypothyroidism) not signalling the pituitary to issue TSH.

[SlowDragon Administrator]

Pity you didn't get vitamin D, folate, ferritin and B12 tested at same time

Your results suggest something going on as FT4 is very low

Low vitamins are common. Can cause symptoms in own right or upset Thyroid

Why not ring private testing company and see if they can do vitamins at reduced price

Roughly how old are you? As Marz says, low stomach acid is common problem, especially as we get older

Are you on any other medication?

[HappySam in reply to SlowDragon]

Thanks SlowDragon. I think I might just do that, I agree something is a miss. I am 34, 35 in June so I think relatively young to suggest stomach acid but you never know! X

[HappySam in reply to HappySam]

Oh and meds I take are sertraline for panic attacks and inhalers for asthma. I have looked to see if they could be causing any of my symptoms but I think unlikely as I have been using the same inhalers since age 7. I certainly feel my issues have worsened since having children, my youngest is nearly 4. I have ALWAYS struggled with my weight, I only have to look at a cake and I put on weight 😕🍰 but now no matter how hard I exercise It just will not shift. Currently exercising hard 5 days a week atm. And I am just so cold all the time! X

[SlowDragon Administrator in reply to HappySam]

your FT4 is very low, as is TT4 Both suggest you need an increase in Levo

Depression is more common when hyponand a common symptom

Antidepressants tend to lower TSH

Why not ask GP for "3 month trial" of 25mcgs dose increase in Levo

Push for them to test vitamin levels too

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 at

[e-mail]

Professor Toft recent article saying, T3 may be necessary for many, otherwise they need higher FT4 and suppressed TSH

rcpe.ac.uk/sites/default/fi...

[HappySam in reply to SlowDragon]

Right I shall email for that article and push the doctor for a referral. Fingers crossed! Thank you for your advice x

[SlowDragon Administrator in reply to HappySam]

Suggest you start just asking GP for dose increase in Levo plus tests of vitamins. Or get vitamins tested privately

When you get results come back here for advice on supplements

If they refuse Levo dose increase, then look at the list of recommended thyroid specialists from Dionne at Thyroid Uk