Normal TSH result. Where to go from here?

[RebsterRoo]

Been suffering with extreme tiredness and fatigue of late, along with various other hypothyroidism symptoms. Got bloods done at GP, only thyroid testing was TSH, and results were normal. But I still feel awful. Where do I go from here? Is it worth getting other thyroid tests when my TSH isn't even slightly elevated or am I barking up completely the wrong tree?

Full results

Serum TSH level 1.4 mu/L [0.35 - 4.7]

Serum sodium level 138 mmol/L [135.0 - 144.0]

Serum potassium level 4.4 mmol/L [3.5 - 5.3]

Serum chloride level 106 mmol/L [96.0 - 109.0]

Serum bicarbonate level 22 mmol/L [24.0 - 32.0]

Serum urea level 5.6 mmol/L [3.0 - 7.6]

Serum creatinine level 78 umol/L [55.0 - 87.0]

Serum bilirubin level 12 umol/L [< 21.0]

Serum alkaline phosphatase level 57 iu/L [30.0 - 125.0]

Serum alanine aminotransferase level 7 iu/L [5.0 - 45.0]

Serum total protein level 68 g/L [65.0 - 82.0]

Serum albumin level 47 g/L [36.0 - 48.0]

Serum ferritin level 79 ug/L

Serum folate level 9.0 ug/L

Serum vitamin B12 level 400 pmol/L [115.0 - 1000.0]

Haemoglobin concentration 141.0 g/L [120.0 - 160.0]

Total white blood count 5.1 10*9/L [4.0 - 11.0]

Platelet count - observation 177 10*9/L [150.0 - 400.0]

Red blood cell count 4.54 10*12/L [4.0 - 5.2]

Haematocrit 0.407 [0.36 - 0.46]

Mean cell volume 89.6 fL [80.0 - 100.0]

Mean cell haemoglobin level 31.1 pg [26.0 - 34.0]

Red blood cell distribution width 12.2 [11.5 - 16.5]

Neutrophil count 2.90 10*9/L [2.0 - 7.7]

Lymphocyte count 1.54 10*9/L [0.8 - 3.4]

Monocyte count - observation 0.50 10*9/L [0.2 - 0.8]

Eosinophil count - observation 0.17 10*9/L [0.04 - 0.4]

Basophil count 0.03 10*9/L [0.01 - 0.1]

[SlowDragon Administrator]

Suggest you get TSH, FT4 and FT3 plus both TPO and TG thyroid antibodies tested

Via Medichecks or Blue Horizon

medichecks.com/thyroid-func...

Make sure to do blood tests as early as possible in morning and fasting

Vitamin D get tested via

vitamindtest.org.uk

[Treepie]

B12 is too low ,no range for ferritin but looks low.

[shaws Administrator]

I agree with SlowDragon as the TSH alone doesn't inform us (the patient) if we're low in either FT4 or FT3. Both should be towards the upper part of the ranges.

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

The TSH is not a thyroid hormone, it is from the pituitary gland and it rises when our thyroid gland begins to struggle to send out hormones.

[SlowDragon Administrator]

Ferritin should be half way in range. - what's the range on this?

[RebsterRoo in reply to SlowDragon]

It says

Serum ferritin level 79 ug/L

Ferritin 20-100 cannot exclude iron deficiency

with coexisting chronic or inflammatory conditions

[phoenix23002]

Remember.... normal is NOT optimal. We are all so different and as someone else noted, TSH is not a measure of thyroid hormone. You may have to go private to get your antibodies and your free T 3 and free T 4 checked. Those tests are a measure of thyroid hormone and will give you a better picture of what is going on. And it is important that your D 3, B 12 and iron levels are optimal.

[Angel_of_the_North]

You need to get your actual thyroid hormones tested as you might have central hypothyroidism when the TSH level cannot rise as there is a problem with the hypothalamus or the pituitary. GPs seem to think it is rare, but that is because they only test TSH.

[RebsterRoo in reply to Angel_of_the_North]

Thanks. How would that be indicated in results? Low T3?

[Angel_of_the_North in reply to RebsterRoo]

Low or normal TSH with low/low normal free t3 and free T4. In other words, thyroid hormones which are too low for the TSH level.