Thyroid test is “normal” but still have signs of thyroid issue

[CuriousGuy1]

Hello everyone, I’m a 21 year old male and think I have a problem with my thyroid. My sister had issues with her thyroid in the past and now I feel I might have something. I Recently got a test result that said my T4 was 18.1 pmol/l and the reference range was 9.0-19.1. This is 1 away from being hyperthyroid. I know it’s “normal” but it is still very high, even my doctor said so. Any advice or similar stories would be great. Thanks.

[greygoose]

Impossible to tell if you're hyper without testing your FT3 and antibodies.

Did he not test the TSH? If so, what was that?

[CuriousGuy1 in reply to greygoose]

The TSH was 0.93 mIU/L and the reference range was 0.3-5.00

[CuriousGuy1 in reply to CuriousGuy1]

Also there was no test for FT3

[greygoose in reply to CuriousGuy1]

Well, the TSH was good. But those two test don't tell the whole story. You need :

TSH

FT4

FT3

TPO antibodies and Tg antibodies for Hashi's

TRAB or TSI antibodies for Grave's

And, refuse to accept any diagnosis without having all of these tests done first. Doctors are far too fond of jumping to conclusion and dishing out the wrong treatment. Get the tests done first.

[CuriousGuy1 in reply to greygoose]

Okay thank you very much, does the high T4 ring an alarm bell for you ?

[greygoose in reply to CuriousGuy1]

Well, not an alarm bell, exactly. But my first thought would be : we need the other tests.

[CuriousGuy1 in reply to greygoose]

Yeah the only tests I got was Free T4, TSH

[greygoose in reply to CuriousGuy1]

Sometimes that would be enough, if say your TSH was 20 and your FT4 8. But, here, it's far more ambiguous, so more tests are needed.

Your TSH is good, but your fT4 is slightly high for someone not on thyroid hormone replacement. It could be that that is normal for you, but as you've never been tested before, we don't know. So, we need the fT3 to compare with it, see if it's just a fluke - errors do occur in labs - and your antibodies tested to see if you have an autoimmune disease - Hashi's or Graves.

[CuriousGuy1 in reply to greygoose]

Thank you

[Angel_of_the_North in reply to CuriousGuy1]

No, many people need slightly over range free t4 in order to have enough to convert to T3. Get a copy of the Dr Toft article. But you need to know TPO and TG antibodies and free T3, plus folate, ferritin, B12 and D3 - without those at optimal levels you can't use the levo properly.

[CuriousGuy1 in reply to Angel_of_the_North]

Thank you. I got Ferritin, Vitamin B12, and folate done also. They were all normal. I am going to get the TPO and TG tests done.

[Angel_of_the_North in reply to CuriousGuy1]

Was ferritin over 80 (assuming you are male), b12 over 500, D3 over 100 and folate at least half way up range?

[CuriousGuy1 in reply to Angel_of_the_North]

Yes I am male. My Ferritin was 128.6 ng/mL and the reference range was 21.8-275 ng/mL. My B12 was 1322 pg/mL and the reference range was 187-883 ng/mL. I didn’t get D3 tested. And my Folate was 3.3 ng/ml and the reference range was 3.1-20.5 ng/ml.

[Angel_of_the_North in reply to CuriousGuy1]

Mostly good, but folate is truly dire. Needs to be around 12 or more. Some people can't absorb folic acid and change it into its active form, so taking a B vit that contains it makes their folate status worse. If you can't eat more folate rich food (or already are) try a methylfolate supplement. Worth getting vit D tested, costs less than £30 from NHS in Birmingham (City Assays) by post vitamindtest.org.uk/

[CuriousGuy1 in reply to Angel_of_the_North]

Ok thank you, do these tests result point to issues in thyroid ?

[Angel_of_the_North in reply to CuriousGuy1]

Low folate can inhibit conversion of T4 to T3, and low vit D can cause similar symptoms to hypo. If you aren't supplementing B12, it could indicate liver problems. If you are, it's fine. Nothing obvious to indicate thyroid problems, but you need the other tests as others have said.

[CuriousGuy1 in reply to Angel_of_the_North]

Thank you.

[shaws Administrator]

I am assuming the doctor tested your TSH level as well as the T4. If so, can you post the results for TSH.

Did you have the blood test at the very earliest and fasting (you can drink water)?

[CuriousGuy1 in reply to shaws]

The TSH was 0.93 mIU/L and the reference range was 0.3-5.00

[CuriousGuy1 in reply to CuriousGuy1]

I had the test done in the morning and I was in an empty stomach

[shaws Administrator in reply to CuriousGuy1]

That is a good TSH.