Hi Everyone, could someone take a look at my last few Thyroid results and offer an opinion? TIA xx
29 Aug (NHS)
TSH 7.52 (0.27 - 4.20)
FT4 14.80 (11.00 - 26.00)
Ferritin 149 (12.0 - 233.0)
Folate 4.7 (2.4 - 26.0)
B12 353 (191.0 - 663.0)
Vit D 108.9 (>50)
18 Sept (Medichecks)
TSH 7.29 (0.27 - 4.20)
FT4 15.300 (12.00 - 22.00)
FT3 4.57 (3.10 - 6.80)
21 Dec (Medichecks)
TSH 7.50 (0.27 - 4.20)
FT4 16.10 (12.00 - 22.00)
FT3 5.16 (3.10 - 6.80)
RT3 18 (10.00 - 24.00)
RT3 ratio 18.66 (15.01 - 75.00)
24 Dec (NHS)
TSH 8.48 (0.27 - 4.20)
FT4 14.7 (11.0 - 26.0)
Symptoms are fatigue, weight gain, joint and muscle pain, poor digestion.
Latest GP note states “further test in 6 to 12 months to see if overt hypothyroidism develops”. I’ll be speaking to GP next week, as I’m not prepared to feel like this for another 6 months.
My thoughts are that my T3 isn’t getting into my cells, or I have a conversion issue, and I should supplement with T3?
Grateful for your views ❤️
Written by
Sue_Moo
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You currently have what is classed as "subclinical hypothyroidism" which is where the TSH is between 4 and 10 with a normal FT4. Your GP is waiting until your TSH reaches 10 (current guidelines), aren't our doctors here in the UK wonderfully cruel - we have to wait until TSH reaches 10 regardless of our symptoms, many countries diagnose hypothyroidism when TSH reaches 3. However, there are some GPs who will start Levo when TSH is over range but hasn't reached 10.
If TSH is between 4 and 10 mU/L and FT4 is within the normal range
◾In people aged less than 65 years with symptoms suggestive of hypothyroidism, consider a trial of LT4 and assess response to treatment 3–4 months after TSH stabilises within the reference range — see the section on Prescribing information for further information on initiation and titration of LT4. If there is no improvement in symptoms, stop LT4.
◾In older people (especially those aged over 80 years), follow a 'watch and wait' strategy, generally avoiding hormonal treatment. If a decision is made to treat, prescribe LT4 and recheck TSH two months after starting and adjust the dose accordingly.
◾In asymptomatic people, observe and repeat thyroid function tests (TFTs) in 6 months.
You have had a Medichecks test done, did you have thyroid antibodies tested too? When antibodies are present, there's more chance of being prescribed Levo, but you could use the NICE CKS to try and persuade your GP to start Levo, or see a different doctor.
B12 353 (191.0 - 663.0)
What is the unit of measurement for B12 - pg/ml or ng/L (both the same) or pmol/L? If that is pg/ml or ng/L then it is low and needs to be at least 550.
Folate 4.7 (2.4 - 26.0)
Your Folate is very low in range, it should be at least half way.
Ferritin was fine.
What about Vit D?
My thoughts are that my T3 isn’t getting into my cells, or I have a conversion issue, and I should supplement with T3?
You don't need T3 at this stage. Your current FT4 and FT3 are actually showing good conversion in those tests. But you need Levo to bring your TSH down to around 1 and your FT4 into the upper part of it's range. If FT3 is in balance with FT4 (in the upper part of the range) then your conversion is good. If FT3 is then low in range then T3 could be indicated.
Essential to test both TPO and TG thyroid antibodies for autoimmune thyroid disease
Also ask for coeliac blood test
For full Thyroid evaluation you need TSH, FT4 and FT3 plus both TPO and TG thyroid antibodies tested. Also extremely important to test vitamin D, folate, ferritin and B12
Low vitamin levels are extremely common, especially if Thyroid antibodies are raised
All thyroid blood 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, best not mentioned to GP or phlebotomist)
Private tests are available. Thousands on here forced to do this as NHS often refuses to test FT3 or both antibodies
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 special offers, Medichecks usually have offers on Thursdays, Blue Horizon its more random
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 .
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