Symptoms but normal TSH?

[Bearfam]

Hello I've come across the forum looking for advice as I'm not feeling good and getting nowhere with my GP.

My TSH is 4.33 the range for normal on the print out I was given of my blood test is 0.30 to 4.50. This was in May my TSH was 3.60 in March so has risen in a few months.

I know this is is in the normal range but I'm wondering if you can still get symptoms when you're near the top of normal? Surely symptoms don't just start like a switch at 4.50?

As a bit of background I've had really low vit D and mild insulin resistance. I'm gaining weight and really hungry and low on energy.

Thanks for any help you can give me.

[shaws Administrator]

Welcome to our forum and you've come to the right place as many members have had an experience similar to yourself.

First thing when getting a blood test for thyroid hormones is to get the very earliest possible and fasting (you can drink water). This helps the TSH to be at the top as it drops throughout the day and may mean the difference between being diagnosed or not.

The problem in the UK is that it has been decided that no-one will be diagnosed until the TSH reaches 10 - whereas in other countries people are diagnosed when it goes above 3 with symptoms. Symptoms can develop ahead of the TSH rising.

We have to read, learn and absorb what others have also gone through in the attempt to get diagnosed and relief of symptoms and we do get better - even if the doctor isn't very up-to-date.

You need a TSH, T4, T3, Free T4, Free T3 and thyroid antibodies. If antibodies are present it means you have an Autoimmune Thyroid Disease also called Hashimoto's and you then, definitely, have to be prescribed levothyroxine.

When you are diagnosed you will be given 50mcg of levothyroxine which has to be taken, usually first thing, with one full glass water and wait an hour before eating. A blood test will be taken every six weeks (second paragraph) and an increase of 25mcg of levo. You will be surprised when you read the following link:-

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

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

You need a Full Thyroid Blood Test which is:-

TSH, T4, T3, Free T4, Free T3 and thyroid antibodies.

B12, Vit D, iron, ferritin and folate.

The NHS don't usual do all of the T's but we have two labs that will do the tests you require or the ones that the GP will not do.

The private labs do home finger pin-prick tests and if you decide to do this make sure you are well-hydrated a few days before the blood draw.

Always get a print-out of your blood test results, with the ranges for your own records and you can post if you have a query. The aim is a TSH of 1 or lower (not somewhere in range as many GPs think) with FT4 and FT3 in the upper part of the range.

[greygoose]

Your TSH may be in-range, but it's anything but normal. You are hypo when your TSH hits three, and in some countries you would be treated at that level. You could start having symptoms when it's around 2 - I certainly wouldn't want my TSH to go that high!

Besides, it's not TSH that causes symptoms, whatever the level. It's low T3. I should imagine your FT3 is quite low.

[Bearfam in reply to greygoose]

Thanks very much for your replies. I'm going to change GP practice as the practice I'm currently with only has locums. So seeing the same GP is almost impossible and they're not great anyway. So I'll see how far I get with a new practice. I feel it's probably not going to be a simple process from doing a bit of reading.

I have been referred to an endocrinologist. But the appointment was fairly useless. The letter I got which was a copy of the one sent to the GP was not really accurate in what it said. For example it said I'd always been overweight and struggled to lose weight. I wasn't asked about that and it's not true. I feelike they copied and pasted someone else's letter!

I was going to get in touch to say that and I will request the tests recommended. I did have my free T4 tested it was 15.2 which seems normal?

I'm mildly anemic, my ferritin stores are low and my red blood cells are a bit on the small side. My B12 is on the low end of the scale too. I'm not sure how relevant these things are. I had other tests but I'm not sure what their relationship to thyroid issue is either!

[Saggyuk in reply to Bearfam]

These are very relevant as your body and thyroid need these to be optimal to work efficiently.

Post your vit level results including anything else relevant such as blood countalong with any meds you've been prescribed for them in a new thread with ranges for advice on what to do about them.

The docs are unlikely to do full testing of your thyroid but you can get these done yourself for a more thorough look at what's going on and it's not that expensive.

Unfortunately most docs are useless because they often know nowt about thyroid.

[greygoose in reply to Bearfam]

I'm afraid that happens all the time, the ficticious specialist letters. And it's not just in endocrinology and not just in the UK! I live in France and went to see a cardiologist. His letter to my GP left me wondering who on earth he was talking about, because it wasn't me! And, what's more, I was there when he talked into his dictaphone, and I heard he gave the blood pressure results that I'd seen him take. But in the letter, they were much, much higher! So, who's to blame for that, I wonder!

Need the range for your FT4 to be able to comment on it.

[Bearfam in reply to greygoose]

The free t4 range is 10 to 22 pmo/l. Thanks

[greygoose in reply to Bearfam]

FT4 is just under mid-range, then. Not too bad. But, you need an FT3 reading to get the full picture.