My 24 yr old son’s results are listed below.
Ferritin 87.3 (30-400)
Folate 6.16 (>3.89)
Vit B12 99.9 (37.5-188)
TSH 3.94 (0.27-4.2)
Free T3 5.05 (3.1-6.8)
Free Thyroxine 11.9 (12-22)
Thyroglobulin antibodies 10.8 (<115)
Thyroid peroxidase antibodies <9 (<34)
We did the blood test as on medication for anxiety/depression for past 4 years and symptoms generally well controlled but still suffers from exhaustion etc. Would appreciate any insight into his results.
Thank you
Was this test done as early as possible in morning and fasting? This helps give highest TSH
These results suggest thyroid problem as FT4 is below bottom of range.
TSH is slightly raised, but many medics would not say its high enough to warrant treatment
However some anxiety medication or antidepressants can lower TSH
Antibodies are not raised, so suggest he doesn't have autoimmune thyroid disease (Hashimoto's) though it doesn't definitely rule it out, you can have Hashimoto's and never have raised antibodies
Pity you didn't get vitamin D tested
Strongly recommend you get this done
£29 by postal kit from NHS
Ferritin is perhaps a bit low for a young man. Does he eat meat?
Perhaps look at testing cholesterol and testosterone
High cholesterol is linked to being hypothyroid, so if cholesterol test was high this would support idea that he might be hypothyroid
Testosterone can be low when hypothyroid and would improve as thyroid issue is corrected
thyroidpharmacist.com/artic...
What anxiety meds?
Beta blockers? If so is it propranolol. Propranolol affects thyroid hormones
Suggest you email Dionne at Thyroid Uk for list of recommended thyroid specialists. Some are NHS. He needs to see endocrinologist who specialises in Thyroid
Meanwhile definitely get vitamin D tested and come back with new post once you get result
Thank you. Test was taken first thing in morning, fasting.
We used the medichecks Thyroid Ultra but will look to get the other bloods tested ASAP.
He has been on Venlafaxine (a SNRI) for approx 2.5 years. Prior to starting the psychiatrist asked GP to do bloods, among those results he had TSH 3.22 (0.27-4.20) and T4 16.8 (12-22) nothing else is checked on NHS locally for TFT. Serum 25-HO vit D3 100nmol/L which was evidently ‘optimal’. We only requested a copy of these results recently after joining forum and realising it was an available option - thank you.
He does eat meat occasionally, we all have the same diet so I was surprised to see his ferritin on the lower side of normal when mine and his sisters are above mid range.
Thank you for your time and guidance, will act on your recommendations.
SarahJLD
Presumably he doesn't have a diagnosis of hypothyroidism.
Ferritin 87.3 (30-400)
Although in range, this is on the low side. Ferritin is recommended to be half way through it's range (185 with that range) but I have seen it said that 150 is good for males. This could be a cause of fatigue.
Folate 6.16 (>3.89)
I would want mine in double figures.
Vit B12 99.9 (37.5-188)
This Active B12 and isn't bad. Below 70 would suggest testing for B12 deficiency so he's OK, but maybe aim for mid-range which would be 112+
A good B Complex will raise both B12 and folate levels - consider Thorne Basic B or Igennus Super B, they both contain bioavailable forms of the vitamins.
TSH 3.94 (0.27-4.2)
This is higher than one would expect to see in a normal healthy person, that would generally be no more than 2.
Thyroxine 11.9 (12-22)
Below range so this isn't good.
When TSH is in range, low or slightly elevated, with a low FT4, this suggests possible Central Hypothyroidism.
TSH is a pituitary hormone, the pituitary checks to see if there is enough thyroid hormone, if not it sends a message to the thyroid to produce some. That message is TSH (Thyroid Stimulating Hormone). In Primary Hypothyroidism the TSH will be high. If there is enough hormone then there's no need for the pituitary to send the message to the thyroid so TSH remains low.
However, with Central Hypothyroidism the signal isn't getting through for whatever reason. It could be due to a problem with the pituitary (Secondary Hypothyroidism) or the hypothalamus (Tertiary Hypothyroidism).
Your GP can look at BMJ Best Practice for information - here is something you can read without needing to be subscribed
bestpractice.bmj.com/topics...
and another article which explains it ncbi.nlm.nih.gov/pmc/articl...
You could do some more research, print out anything that may help and show your GP.
As Central Hypothyroidism isn't as common as Primary Hypothyroidism it's likely that your GP hasn't come across it before. You may need to be referred to an endocrinologist. If so then please make absolutely sure that it is a thyroid specialist that you see. Most endos are diabetes specialists and know little about the thyroid gland (they like to think they do and very often end up making us much more unwell that we were before seeing them). You can email Dionne at
tukadmin@thyroiduk.org
for the list of thyroid friendly endos. Then ask on the forum for feedback on any that you can get to. Then if your GP refers you, make sure it is to one recommended here. It's no guarantee that they will understand Central Hypothyroidism but it's better than seeing a diabetes specialist. You could also ask on the forum if anyone has been successful in getting a diagnosis of Central Hypothyroidism, possibly in your area which you'll have to mention of course.
Free T3 5.05 (3.1-6.8)
This isn't bad and could just be his body's way of trying to make enough hormone at the moment, this could eventually fall.
Free
Thyroglobulin antibodies 10.8 (<115)
Thyroid peroxidase antibodies <9 (<34)
Current results don't indicate Hashi's.
No Vit D test?
Thank you for taking the time to respond and the helpful information. He doesn’t have a diagnosis of hypothyroidism but something isn’t quite right, his mental health is the best it’s been for years but sometimes he’s too physically exhausted to do things that give him pleasure. Hence we opted to do the medichecks thyroid ultra.
Those were very interesting articles you linked to, will do some more research into central hypothyroidism so we are well informed before visiting GP.
In previous NHS blood results as requested by psychiatrist, his folate and ferritin were mid range but I note his TSH 3.22 (0.27 - 4.2) was similar to current test but T4 towards mid range 16.8 (12 - 22).
More blood tests to take in the Vit D and those suggested by Slowdragon then a GP visit no doubt requesting a referral.
Thank you for your help.
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