Is it a borderline underactive thyroid?

[Luna00]

Had a routine blood test just over a month ago which came back with readings indicating an under active thyroid. The test was redone last week and was told it was borderline and no medication needed but would need retesting in 6 months. However on requesting the results and checking online, I’m confused as, as far as I can see look to show a clear result?? Tsh 7.8, T4 .7 and TPO of 55. Any advice?

[SeasideSusie Remembering]

Luna00

If you can post both sets of results, and include the reference ranges (they differ from lab to lab so we need them), then members will be able to comment.

[Luna00 in reply to SeasideSusie]

Unfortunately I don’t have either. I haven’t seen the doctor, just had a telephone call from the receptionist.

[SeasideSusie Remembering in reply to Luna00]

Luna00

I thought you said you checked your results online.

In the UK we are legally entitled to our test results. You can pop along to your surgery and ask for a print out of your results, don't accept verbal or handwritten results as mistakes can be made, make sure you get a print out. You don't need to ask a doctor, it's easier and less hassle to just ask at reception.

[Luna00 in reply to SeasideSusie]

I received a phone call from the receptionist this morning and asked for the readings and have since tried to find more information online. Thank you though, I will request a hard copy of the results.

[williamsad19 in reply to Luna00]

. Did you have your blood test first thing in the morning before any food or milk? Mine was 7 and I felt awful I asked for an endocrine opinion and they wrote back saying I should be started on levothyroxine!

[Luna00 in reply to williamsad19]

No, it was taken midday- no fasting

[SlowDragon Administrator in reply to Luna00]

All thyroid tests should 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)

Each lab has different ranges so we need the ranges for these results. But TSH looks high and FT4 looks low, and TPO range is very often anything over 34 is positive for Hashimoto's (autoimmune thyroid disease). If this is the case, then result of 55 would confirm Hashimoto's

Ask GP to test vitamin D, folate, ferritin and B12

These are often too low as result of being hypothyroid. If low they will need supplementing

So 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

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

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)

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_...

[trelemorele]

Your t4 is much too low, though I've noticed they recently lowered bottom range from 10 to 7 (?!). Your TSH is high too.

If it was me I'd insist on treatment and if refused monitor progress very regularly I.e don't wait 6 or 12 months.

[Katiethedubs]

My TSH was not as high and my T4 actually still just in range but low (10) and I was started on meds. I’d definitely get copies of your results, seem a second opinion and do your research- often GPS know very little. Private tests through medichecks can give you a much fuller picture if you don’t mind paying.

For me, I didn’t have any symptoms, in fact I felt fine. But i did have unexplained secondary fertility following the birth of my daughter and my GP was convinced the thyroid was to blame. I’ve been on meds now since November and am 7 weeks pregnant!

[Luna00 in reply to Katiethedubs]

Congratulations! I’ve been putting all of my symptoms down to being 44 with a very energetic 6yr old, but after a bit of research, realised I could tick most of the boxes for underactive thyroid symptoms! I’m going to collect a hard copy of my results today.

[Luna00]

So, just collected a hard copy of my results - 1 month ago T4 11.9 (lab range 11-23), TSH 11.8 (0.27-4.5)

Last results T4 14.7, TSH 7.8 and TPO antibodies 55 (<34)

[SlowDragon Administrator in reply to Luna00]

Make an appointment to see your GP and request that treatment is started as your bloods show you have high thyroid antibodies which confirms you have autoimmune thyroid disease and high TSH and low FT4

NHS guidelines saying standard starter dose is 50mcgs

beta.nhs.uk/medicines/levot...

Do not agree to less than 50mcg Levothyroxine

Request testing of vitamin D, folate, ferritin and B12 as well, these are often too low as result of being hypothyroid (especially with autoimmune thyroid disease- also called Hashimoto's) and need supplementing to improve

Bloods will need retesting in 6-8 weeks and dose of Levothyroxine is increased in 25mcg steps (retesting 6-8 weeks later each time) and this continues until TSH is around one and FT4 towards top of range and FT3 at least half way in range and symptoms have improved

Always take Levo on empty stomach and then nothing apart from water for at least an hour after. Many take on waking, but it may be more convenient and possibly more effective taken at bedtime

verywell.com/should-i-take-...

Many people find Levothyroxine brands are not interchangeable. Once you find a brand that suits you, best to make sure to only get that one at each prescription. Watch out for brand change when dose is increased or at repeat prescription. Many patients do NOT get on well with Teva brand of Levothyroxine. Though it is the only one for lactose intolerant patients

All thyroid tests should be done as early as possible in morning and fasting and don't take Levo in the 24 hours prior to test, delay and take straight after. This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip, GP will be unaware)

[Luna00 in reply to SlowDragon]

Thank you

[Hidden]

I had ten years of this before becoming too ill to work and still they wouldn't listen to me,I would ask to see another doctor and take some evidence with you x

[shaws Administrator]

A month ago you would have been diagnosed in the UK as TSH is over 10.

If you were diagnosed and given levothyroxine (T4) a lab range of 11.9 for T4 is too low when it should be towards the top of the range. TSH should be 1 or lower when on levothyroxine.

SlowDragon has given appropriate advice on the timing of blood tests. It means the difference between getting diagnosed or not or an increased dose of not.

I'd ask for another blood test as you've been misled a little by the doctor not seeming to understand that an a.m. result differs from a p.m. result due to the circadian rythm.

Why is the circadian rhythm important?

Circadian rhythms can influence sleep-wake cycles, hormone release, eating habits and digestion, body temperature, and other important bodily functions.

[Luna00]

I finally had an appointment with my GP to discuss my results and, despite a long list of symptoms, I’ve been told that as I ‘dont appear to have put on any weight’ and my T4 results are in range, it’s still a wait and see. They’ve moved my next blood test forward from February to December and offered me anti depressants if I feel the symptoms are getting me down. Not sure whether to just wait until the next test and hope my results have changed, or if I can argue against it.