Very low TSH, Near to highest edge T4 and norma... - Thyroid UK

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Very low TSH, Near to highest edge T4 and normal T3



I'm going to my first endocrinologist appointment next week but just wanted to post to see if people with the same measures have similar to mine symptoms.

TSH 0.04 and T4 is near to 24, T3 is absolutely fine.

I'm having temperature throughout the day in last 3 weeks, goes up to 38 until I bit it with paracetamol. I also feel terribly weak, fainting feeling in most of the times. My main worry is pain in thyroid gland, moving neck to any direction is very painful and it swollen, a little bit visible from outside. People with the same measures of thyroid in blood, did you have similar symptoms?

As a regular woman I'm also worried about hair loss. Any vitamins I can take to prevent it?

Many thanks for your help


35 Replies
HiddenThis reply has been deleted
in reply to Hidden

Thanks. How the non stick coated cookware,foil, etc. affects it, in positive or negative way?

I know for example that meat is good source of B12, I can't call myself vegetarian.

Have you had your antibodies and ferritin tested?

No, I'm waiting for the results next Monday. If you experience with those blood tests, any chance you know if doing test early in the morning with empty stomach can make any difference. My first test with TSH, T4, T3 outcome had been done on Friday midday, and I had pretty nice lunch before that :). I would expect NHS to warn me if it had to be hungry, but checking just in case (they are famous for basic mistakes!)

The NHS has no idea about that sort of thing! Yes, it would make quite a difference if you had your test done early morning and fasting. TSH is highest early in the morning and drops throughout the day. It also drops after eating.

Interesting, thank you. I'm new to NHS so by default was trusting them. Now, lesson learnt, will be asking for second blood test.

Doubt if you'll get one for at least six weeks! Doctors don't seem able to understand that the TSH varies throughout the day, they say it's all the same whatever time of day you do the test. And, the lab would refuse to do the test because you've only just had one! And, under the NHS, the lab over-rules any doctor!

that's very positive, thank you :)

You're welcome. :)

in reply to lilitasatrian

Early morning test, fasting (you can drink water) and if you were taking thyroid hormones you'd allow a gap of 24 hours between last dose and test and take afterwards. What we have to do :)

in reply to lilitasatrian

Also if you are given thyroid hormone replacements allow 24hours between last dose and test (early a.m. fasting (you can drink water ) and take afterwards.

Hi Lilitasatrian, your results are almost identical to mine and I’m getting nowhere in NHS, have gone private but that’s taking just as long because they want to do more tests. I feel like screaming ‘ct my pituitary!!!’ because all signs point to it being secondary/pituitary hypothyroidism. So this is me jumping onboard of your thread to keep posted and I’ll let you know if I get anywhere at my end.

Thank you very much, yes, let's keep posted. Something that I do want to test is deficiency of B12 and vitamin D. I believe private labs will do it quickly. Symptoms of vitamin D deficiency in this article matches one by one to what I have

No one talks about thyroid gland ache though, do you have that as well?

I meant 'Symptoms of vitamin B12 deficiency ' above

in reply to lilitasatrian

Hi lilitasatrian. Saw your post and think your results are similar to mine. TSH 0.02 for me. I also get extreme fevers with rigors though these are not regular still makes me think something isn't right. I have a small goitre, been there 25 years but I don't have the pain you experience in my neck. I'm waiting to see an endo, could be months yet I suppose. Like Hillz2000 above I'm thinking it could be pituitary problem. I wish I could offer advice, but honestly I find all the readings etc difficult to understand so putting my faith on the endo and hoping something becomes clear.

I shall look out for your posts, best wishes to you in getting this sorted. j x

HiddenThis reply has been deleted
in reply to Hidden

Right, sorry I'm confused. My TSH is very low but T4 and T3 looks ok. T4 is near to highest edge (23) but T3 is = 6.5 is in normal range. Sorry if I misunderstood it

HiddenThis reply has been deleted
in reply to Hidden

Ah, got it thanks. All the best. I hope we all get well very soon, will pray for every member posting in this forum.

Weakness is a symptom associated with overtreatment. High temperature could also be overtreatment. Or infection, which would lower your T3 result. So you could be slightly over treated, but perhaps in the context of something else going on, as others have said. If you also posted the ranges for tsh, T3 and T4 it might enable others to comment and advise. Good luck with your appointment.

in reply to Aurealis

Yes, it could be that you are slightly over treated - that's the way I feel when I have a little too much especially if you hadn't taken your meds that day yet?

Edit, Apologies, I assumed you were hypothyroid and treated with levo etc but it looks like you may not be? Yes possibly a little hyperactive, you might want to get your Rt3 checked out?

thank you, i havent treated yet, GP said that the thyroid should be lowed down with medication but on the background of swollen neck and high temperature she advised to wait endocrinologist advice before starting any medication. I will see if RT3 can be tested.

I think some peoples responses were thinking you were treated for hypothyroidism so there's a little confusion there.

Yes, docs right to as could just be subacute thyroiditis or Dr Quervain's thyroiditis as this presents with high thyroid levels, specifically pain in thyroid and high temperature etc. This is normally self limiting to a few months with a phase of hyperthyroid followed by hypothyroid before normalising so you don't want anyone medicating anything until they're certain. I believe radioactive iodine uptake tests and in depth thyroid antibody tests including all three types can help differentiate between this and graves/true hyperthyroidism but don't know much about it to be honest. Also some people who have autoimmune hypothyroidism could dump a lot of thyroid hormone into their blood as their thyroid tissue is killed off called a hashi's flare although this is normally more slower and on and off than yours appears but we're all different. This would show erratically in repeated blood tests. I would hope that this is subacute and is just temporary especially if you were put on antibiotics for infection recently. Maybe you can pay to get the full thyroid panel like we all do a few times to keep an closer eye on your levels

make sure you read up all you can about the different things it can be and make sure they've done the relevant tests as you don't want to be put on the wrong treatment. If it it just subacute thyroiditis - generally caused by a viral infection of the thyroid and temporary, you don't want to be treated for graves/hyperthyroidism. The doc is right to refer you before treating - just got to hope you get a good endo who's not just a diabeties specialist.

They could put you on beta blockers in the meantime if your heart's too fast etc maybe if it's that bad?

Medichecks are doing the full thyroid panel and vits on offer for £79 this month.

Hope you feel better soon :-)

Thank you very much, yes I'm learning about various factors as much as possible and this forum, you people, were incredibly helpful, thank you for that. I hope we will be treated very soon and will have enough luck to meet right people in right time in our lives. I had a look to medic heck, prices are really good. Do you have any experience with private endocrinologies? (I don't). I'm just afraid of passing this tests and hear from him afterwards that he can't trust the source and ask for their own labs test results?

May be easier just to check with him directly without making assumptions?

The labs are perfectly credible - it's just more if you want to do your own checks and make sure nothing missed - these are for your piece of mind or to fill in gaps docs have left out. The docs will always do their own tests anyway regardless of whether you do medichecks and will generally take no notice of them. I have no experience with private endos, just the nhs ones and they're not amazing - it's just hard to find those more knowledgeable on thyroids. I trust the opinions on here or my own ones moreso than any doc lol!

You can ask for a print out of any blood tests they do from your GPs surgery and come and post results here if you would prefer :-)

You're not taking any medication, and your TSH is suppressed and FT4 high, with pain and swelling in your thyroid, elevated temperature and feeling weak and faint? I'd say your GP has done the right thing to refer you! You could well have vitamin deficiencies, but I think you need to get a full thyroid test, including antibodies, as well as ferritin, folate, B12 and vitamin D. As others have said, the TSH varies through the day, so early morning is best. Your NHS doctor won't repeat bloods again so soon, so I'd suggest getting a private test. If you look on here you'll find reference to Blue Horizon, and there are other companies offering testing by post. If you do this, post your full results on here, with the ranges, and you will get good advice. I wish you the very best!

Thank you very much, I will look into blue horizon for additional test. Why NHS is in such a bad state and why it is difficult to give patients proper instructions for preparing for test. They making more work for themselfs first by making inaccurate results with wrong instructions, oh well, entire country is complaining, they definitely falling apart!

My view and own tactic with swollen thyroid glad area is to take / increase iodine supplementation on the chance the glad(s) are deficient. Do you live in a goiter area?

Recent sickness, flue, virus? That may have infected the thyroid?

Good book on the general iodine topic: The Iodine Crisis/Lynne Farrow.

Your TSH/T4/T3 to me are great but given your symptoms are either extreme hypo or actually hyper can slam you onto the couch as well. Would be interesting re missing number: rT3 ? General Antibodies?

Hi, thank you very much for reply. It started 3 weeks ago all of a sudden. I can't recall any virus or infection. I'm pretty healthy otherwise. I had terrible stomach ache before this pain started, not sure if I can connect it to each other. I'm still waiting from my blood test results for antibodies rt3 etc.

Do you think you could be suffering from a viral infection? A temperature of 38 is bound to make you feel weak and ill, and the most likely cause is some kind of infection, which can sometimes drag on for a while.

it takes quite long for infection. I took very strong antibiotics about 10 days ago, while was taking pain disappeared and was literally back on the day I stopped it. I'm not sure if this gives any clue for infection?

If you have a viral infection, antibiotics won't have any affect. However, sometimes a secondary bacterial infection can set in on top of a virus, and if the antibiotics helped with some of the symptoms it may be because they were fighting the bacterial infection, but unfortunately a viral infection usually has to run its course. Good luck and I hope you feel better soon.

thank you so much, very helpful indeed

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