Normal TSH but low T4

[beormakate]

I'm British but live in Montenegro for the summer and just had blood tests as during Ultrasound scan for something unrelated the Radiologist found swelling around my thyroid. Got results yesterday TSH 1,861. FT4 8,12. AntiTPO 6.

I don't have a doc here but have sent them to my GP in UK, awaiting reply. Does anyone know whether the low T4 is an issue? thanks!

[Judithdalston]

Especially since you are abroad ie could be v. different from Uk.....can you add the ranges, and units to results - presume it's a decimal point TSH 1.861 ; FT4 8.12; TPO Ab 6. Did you have the other thyroid antibody tested - thyroglobulin TgAb? Gps would be happy with your TSH( assuming I am interpreting the range correctly); no idea if FT4 in range...

[beormakate in reply to Judithdalston]

Thanks for replying Judith. The range for TSH is 0.380 – 4.310 and FT4 range is 10.6 – 21.0 . Hope that helps...

[Judithdalston in reply to beormakate]

Thanks for ranges; assume TgAb within range at 6. Yes it is your FT4 that is low suggesting your thyroid is struggling. But your TSH is reasonable at 1.86 unmediated ( if you were on levothyroxin it would be suggested to be 1 or under)- your GB doctor , who is likely to use the TSH as an indication of hypothyroidism, will think this is normal as it's under 10 ( though some countries realise hypothyroidism occurs with TSH in 3s). If you have another illness then thyroid hormones might be out because of this, or could be early onset of hypothyroidism. The main cause of hypothyroidism is Hashimoto's disease where thyroid autoimmune antibodies attack the thyroid gland mistakenly believing it to be alien...over time the gland diminishes in size making a sufferer permanently needing supplementary thyroid hormone like levothyroxin. But meanwhile the antibodies have periods of attack when dead thyroid cells, complete with hormones, are dumped into the blood stream ( known as a 'flare') - doctors tend to find this very puzzling as thyroid blood tests show peaks and relative troughs appearing to swing from hyperthyroidism to hypothyroidism. So worth knowing if you have Hashimoto's with other TPO ( perioxidase) antibody test too. Some find going gluten free helps with Hashimoto's. Hashimoto's is also characterised by poor gut absorption, so nutrients from food/drink/supplements often low - worth getting Vit D, B12 , folate and ferritin tested as need to be optimum in upper end of ranges for good thyroid health. If you are a regular visitor to Montenegro see what you can get over the counter in pharmacies there for low thyroid - T4 'meds' like levothyroxin, or T3 ones...as I think your Gp in GB will be highly unlikely to treat you yet, but you might be able to get something to trial yourself.

[beormakate in reply to Judithdalston]

Thanks Judith for such a detailed reply. I will see where I get with my UK GP and may try the doc here too, would be interesting to compare if nothing else.

[Angel_of_the_North]

If free T4 is under range, yes, it is a problem and could indicate central hypothyroidism where the problem is with the pituitary gland or hypothalamus - so TSH stays in range or low in range, but free t4 and free t3 are low.