Thyroid UK
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Can someone help me interpret these results?

Hi there, I've just got these results from my GP who told me they were fine and no action needed. However, I have practically every hypothyroid symptom there is and have had for a couple of years. I was told last year (while pregnant) to take anti-depressants and there was nothing else wrong with me. I'm now wondering if these reults indicate a thyroid problem and if i've maybe had this for some time.

my TSH level is 4.91 (range 0.35-5.50)

T4 is 9.2 (range 7.86-14.41)

Many thanks in advance

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Katmell

Your TSH is very high in range. One would expect to see a normal healthy person with a TSH of around 2. In another country hypothyroidism is diagnosed when TSH reaches 3, in the UK they make us wait until it reaches 10.

Your FT4 is also low in range.

Your thyroid is struggling.

Have you had thyroid antibodies tested - Thyroid Peroxidase and Thyroglobulin? If these are raised it confirms autoimmune thyroid disease aka Hashimoto's which is where the antibodies attack the thyroid and gradually destroy it. Raised antibodies along with your TSH result may get you a trial of levothyroxine from an enlightened GP.

If you have symptoms of hypothyroidism with a TSH between 4 and 10 then you may be able to get a diagnosis of subclinical hypothyroidism and a trial of Levo.

List of symptoms you can print and tick off:

thyroiduk.org.uk/tuk/about_...

Information about subclinical hypothyroidism and Hashi's

thyroiduk.org.uk/tuk/about_...

"The 'UK Guidelines for the Use of Thyroid Function Tests' state that, "There is no evidence to support the benefit of routine early treatment with thyroxine in non-pregnant patients with a serum TSH above the reference range but <10mU/L (II,B). Physicians may wish to consider the suitability of a therapeutic trial of thyroxine on an individual patient basis." If your TSH is above the range but less than 10, discuss a therapeutic trial of thyroxine with your doctor.

Subclinical hypothyroidism (where there are elevated TSH levels, but normal FT4 levels, possibly with symptoms) has been found in approximately 4% to 8% of the general population but in approximately 15% to 18% of women over 60 years of age.

Subclinical hypothyroidism can progress to overt hypothyroidism (full hypothyroidism with symptoms) especially if there are thyroid antibodies present.

If thyroid antibodies are found, then you may have Hashimoto's disease. If there are thyroid antibodies but the other thyroid tests are normal, there is evidence that treatment will stop full blown hypothyroidism from occurring.

Dr A Toft, consultant physician and endocrinologist at the Royal Infirmary of Edinburgh, has recently written in Pulse Magazine, "The combination of a normal serum T4 and raised serum TSH is known as subclinical hypothyroidism. If measured, serum T3 will also be normal. Repeat the thyroid function tests in two or three months in case the abnormality represents a resolving thyroiditis.2 But if it persists then antibodies to thyroid peroxidase should be measured.

If these are positive – indicative of underlying autoimmune thyroid disease – the patient should be considered to have the mildest form of hypothyroidism.

In the absence of symptoms some would simply recommend annual thyroid function tests until serum TSH is over 10mU/l or symptoms such as tiredness and weight gain develop. But a more pragmatic approach is to recognise that the thyroid failure is likely to become worse and try to nip things in the bud rather than risk loss to follow-up."

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Thanks so much for your quick reply and for all the information.

I have felt unwell for quite a while but only went to my GP when it was especially bad during my pregnancy. I was told all pregnant women feel like that. I have so many symptoms though (awful fatigue, mental as well as physical, slow heart rate, low BP, heavy periods, sensitive to cold (also have raynards), brittle dry hair, depression, reduced libido. Some days I feel so tired and unable to take part in life or work I could just cry. Everytime I go to my GP they tell me all is fine. I had very low ferritin during pregnancy (around 3) they evntually gave me an IV dose because I thought it might be that but it didn't improve my symptoms.

It wasnt until I recalled one of them saying my metabolism looked quite low (they didn't do anything about it) that I started looking into thyroid testing.

I'll go back to GP this week, armed with the info you've given me and ask for a T3 test and a trial of thyroxine.

Many thanks again

K

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As a follow-up to my last post...I saw my GP who said he thought my thyroid results looked fine (TSH level is 4.9, range 0.35-5.50: T4 is 9.2, range 7.86-14.41) and shouldn't cause me any problems. He wouldn't test my T3 or antibodies and said he thinks it's depression causing me the symptoms. I think these symptoms have caused my depression, not the other way around. I pointed out I'm a psychologist so well positioned to understand this myself but he still disagreed.

All my other bloods were fine (vitamins D, B12, folate, ferritin, calcium) all within or above range. Aside from I have high cholesterol, which I didn't used to have a couple of years ago when everything else was fine too. These results are why he thinks it's depression.

Anyway, after some conversation with him about my symptoms he prescribed 25mg of thyroxine as a trial for 8 weeks. I'm going to pay privately for T3 and antibody testing so I have a fuller picture.

Despite having a prescription which I hope will help me I cannot help but be annoyed by his arrogance and unwillingness to do other tests to explore thyroid function as a cause

Reply

katmell

I saw my GP who said he thought my thyroid results looked fine (TSH level is 4.9, range 0.35-5.50: T4 is 9.2, range 7.86-14.41) and shouldn't cause me any problems. He wouldn't test my T3 or antibodies and said he thinks it's depression causing me the symptoms.

Unfortunately, stock answers from lazy doctors who know very little about hypothyroidism and don't care to investigate.

I think these symptoms have caused my depression, not the other way around.

And I believe you are correct. It can be one of the symptoms of hypothyroidism.

Aside from I have high cholesterol, which I didn't used to have a couple of years ago when everything else was fine too. These results are why he thinks it's depression.

High cholesterol is another symptom of hypothyroidism. Treat the hypothyroidism and the cholesterol should fall.

he prescribed 25mg of thyroxine as a trial for 8 weeks.

That's not really long enough, and the dose is too small. 25mcg is a starter dose for children, the elderly or those with a heart condition. You should have at least a 3 month trial with a starter dose of 50mcg if you don't fall into those categories for 25mcg. When starting on 25mcg people often feel worse, not better, and that will be very convenient for you doctor if you do because he can then say the trial has failed and you don't need Levo. Typical tricks they use I'm afraid.

going to pay privately for T3 and antibody testing so I have a fuller picture.

There are 2 tests that would cover what you need

Thyroid Check Plus covers full thyroid panel including antibodies medichecks.com/thyroid-func...

Thyroid Check UltraVit includes all the above tests plus full vitamins and minerals, it would be useful to get up to date levels to see if they are optimal (not just within range) and it's only an extra £20 medichecks.com/thyroid-func...

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Your TSH is quite high but still in range and FT4 towards bottom of range. These suggest you need to investigate further

For full Thyroid evaluation you need TSH, FT4, TT4, FT3 plus TPO and TG thyroid antibodies and also very important to test vitamin D, folate, ferritin and B12

Low vitamin levels are extremely common and can "hide" thyroid problems. Getting vitamins tested and supplement to improve is often first step

Private tests are available. Thousands on here forced to do this as NHS often refuses to test FT3 or antibodies

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

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 ideally be done as early as possible in morning and fasting. This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip, GP will be unaware)

If antibodies are high this is Hashimoto's, (also known by medics here in UK more commonly as autoimmune thyroid disease).

About 90% of all hypothyroidism in Uk is due to Hashimoto's. Low vitamins are especially common with Hashimoto's. Food intolerances are very common too, especially gluten. So it's important to get TPO and TG thyroid antibodies tested at least once .

Link about thyroid blood tests

thyroiduk.org/tuk/testing/t...

Link about antibodies and Hashimoto's

thyroiduk.org.uk/tuk/about_...

thyroiduk.org.uk/tuk/about_...

List of hypothyroid symptoms

thyroiduk.org.uk/tuk/about_...

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Thank you slowdragon. I'm hoping my GP will be understanding and investigate for me. They tested ferritin and vit d and b12 all of which are normal to high. I've been taking many vitamins for some time now hoping that would help me and I had an IV ferrtin dose a year ago which boosted my levels from pracitually zero.

If I have to get a privtae blood test done and the result was that thyroxine would help me who would prescribe that for me, would I have to take the result to my GP are pay privately for someoone to prescribe?

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If you have high thyroid antibodies then GP should prescribe

If antibodies are normal, but TSH high and FT4 and FT3 low then likely to need to see thyroid specialist

Thyroid UK has list of recommended thyroid specialists

One step at a time........getting full private testing is first, make sure to ideally do test as early as possible in morning and fasting

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