Hi all, got a copy of my blood test results and need help interpreting them - sorry about all the other stuff, I was tested for loads of other things as well.
I take it the TSH is 1 but not sure what the numbers on the far right mean.
Also is it OK that just the T4 was measured.
I think i might ask for another blood test as this one was from a year ago... But thought it might at least be a helpful indication.
Thanks in advance!
Test from a year ago is too long ago
Just testing TSH and FT4 is completely inadequate
FT4 looks on low side
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
Recommended on here that 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)
Last Levothyroxine dose should be 24 hours prior to test, (taking delayed dose immediately after blood draw).
Is this how you do your tests?
Private tests are available. Thousands on here forced to do this as NHS often refuses to test FT3 or antibodies or all 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 special offers, Medichecks usually have offers on Thursdays, Blue Horizon its more random
Medichecks currently have an offer on until end of May - 20% off
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 .
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_...
List of hypothyroid symptoms
Looking at previous posts....you are not diagnosed as hypothyroid....just considering the possibility?
Would recommend getting Thyroid AND vitamin testing
The numbers on the far right are the ranges that we keep banging on about. 
We always need the ranges when looking at blood test results, because they change from lab to lab.
For the most part, ranges tend to be too wide - your TSH range is rediculous! Technically, you are hypo when your TSH reaches 3, so a range that goes up to 5 will mean that a lot of people that should be diagnosed, aren't.
If you look at the FT4 range - 9-19 - you will see that mid-range is 14 (9+19=28 divided by 2 = 14) and your result is 15, so that's good. But, having a good FT4 and a good TSH does not automatically mean that you have a good FT3. The FT3 is the most important number, because T3 is the active hormone, but doctors don't like testing it because they don't understand it - and labs often refuse to test it for the same reason. So, as SlowDragon says, people often ressort to private tests to get a fuller picture of their thyroid status.
OK. I just going to have to go private. I know what GPS are like and I can't cope with having an argument at the moment. They're not going to have any of it. And the more, 'assertive' I get the more arsey they'll get. They're certainly not going to take any notice of what I read on a forum, they hate it when you mention that you looked it up on the Internet or did your own research. Ffs
Is it right that you're not taking any thyroid hormone?
If that's the case, the thyroid results look spot on, but if you suspect thyroid illness because of symptoms, you reallly want to see freeT3 as well. Probably antibodies, also And if you suspect an issue, you may want to repeater tests every 6 months- year, as if you have Hashimotos autoimmune thyroid disease, your thyroid function will worsen over time.
TSH for healthy people skews towards the bottom of the range, with the majority of people between about 0.8-1.8, so yours is right on track. For freeT4 and freeT3, its a bit different and the range is a normal curve. For people with a healthy thyroid, most will be right in the centre, with smaller and smaller numbers as you get out towards the edge, which means the further towards the edge your results are, the more likely your thyroid isn't doing well. In your case freeT4 is just above halfway.
Once we're taking hormone replacement we want very different numbers.
Oh thanks so much. I appreciate the assistance on here and some advice I got on the LCHF forum, but I was never all that convinced I had an underactive thyroid. No, not diagnosed, no, not taking any meds. Literally the only symptom I have is that I'm tired all the time and slightly overweight, but then I do eat a lot and I do work as a gardener, have anxiety and don't sleep all that well. I told a friend I was feeling really tired and she went into a tirade about how she had an underactive thyroid and wasn't treated for years and became I fertile and urged me to get tested! My little brother has it but it is something he was born with, he was only 12 when diagnosed. Im also following a low carb diet at the moment and thought it might be that, when I posted on the LCHF (low carb high fat) forum about this it was suggested I get blood tests done to assess for thyroid problems.
I'm really not convinced and it's not something I particularly want to be spending my time stressing about, so I appreciate the measured and balanced response. I did actually look up the ranges (not the NHS ranges but more detailed info on Thyroid UK et Al and other articles) and yes those numbers seem bang on and fine, so not sure why I would then go on to investigate further just because I'm tired. At what point is it reasonable to start seriously suspecting thyroid problems - is it literally just when you have low energy levels?
Thanks all.
I clicked through your previous posts to see if there were other thyroid things. I saw you've struggled with a keto diet. That can be a symptom of being hypothyroid.
Not sure on the details, but it seems like burning ketones is somehow more intensive in using up thyroid hormone than burning glucose as usual. Which means you start using cortisol instead of thyroid hormones - which is a familiar story that happens in a lot of areas when hypothyroid, cortisol and the adrenal system take over instead.
This results in you just being left with low blood sugar, without the keto system lending a hand. It can feel just how you'd expect low blood sugar to feel - queasy, weak, shaky, weird headache. A bit like a bad hangover or being dehydrated. I think it can also make you feel wired and tired, restless and hot type feeling as well, but I haven't experienced that.
Its probably possible for your sugar metabolism to be messed up in other ways, too. Its remotely possible adrenal fatigue could be the culprit, as the adrenals and the cortisol they make is supposed to support is when we eat strangely. Its possible yours isn't there to give you that buffer for being in keto?
I don't feel weak or shaky or anything like that. I just feel very lethargic, more like I walking through treacle. When I start doing something I want to do, the feeling seems to go away, which made me think it might be a psychological issue. Ie emotional and mental fatigue.
I'm not sure if low blood sugar-type things can feel like that.
To me it sounds more like you're describing fatigue in general. I think it feels like there are always loads of tiny threads pulling against me trying to move, and towards sitting or lying down. Fatigue also reduces when you are very motivated, or if there's social pressure. Its quite squishy and bouncy, so it doesn't feel the same all the time. Some people say being able to do more when motivated is the cortisol taking over and giving you what feels like extra energy. I've never been able to specifically detect the myself, though.
It maybe still worth you getting your ferritin, folate, B12 and vitamin D tested as low levels of these can lead to tiredness. You GP should be able to do them. It might also be worth considering sleep apnea or, low magnesium.
Thought about sleep apnea, but I don't snore so it's unlikely.
If your brother was diagnosed at age 12 that won't be congenital hypothyroidism.
It's more likely autoimmune thyroid disease (Hashimoto's) diagnosed by high thyroid antibodies
Any other family members have any autoimmune diseases ?
Not that I know of. We are of the 'stiff upper lip' british mentality of never going to the doctor and illness doesn't exist until you're dying.
I'm not sure if the details of my brothers diagnosis, but I know that it was found on accident during some routine blood test, so I'm not sure that would be the case. I'll ask him when I see him this weekend.
Anyway the only way to know is to get tested, whether by the GP is privately. Luckily the private testing is relatively affordable - I think I will go for the mid range one, depends how flush I am feeling. I can't afford it right now but I will do it within the next couple of months. Will try the GP first. They seem quite good at mine althoughbthey do seem adamant there is absolutely nothing wrong with me. I want that to be true but I feel like something isn't right. That could easily be the anxiety talking though. I get horrible attacks of stomach pain which have increased in frequency over the years, and after tests (that's what the ones last year were about) and an ultrasound said there's nothing wrong. They don't seem all that concerned, so I'm just thinking it's all in my head or no big deal. But I'm still a bit worried.
Will let you all know how it goes. I do try not to be a hypochondriac.
Make sure to test vitamin levels and thyroid antibodies
You might be astonished to find you have low vitamin D, despite working outside
magnesium may well help you sleep better and reduce anxiety. You might want to try Epsom salt baths before bed. Most people are deficient. Anxiety can be exhausting. Pharmecutical option might be some amitriptayline. I take it at night sometimes 20mg and I also find 10mg useful in the day time if I am feeling anxious. It is not addictive like so many anxiety medication but can make it hard to get out of bed on a morning.
Thank you, I love Epsom salt baths. I do lots of these things but not consistently. I tend to let things sldie after a while. I don't really practice self care, or make any time to relax. It's a problem. I will try. Thank you for the suggestions
"There is an array of research that has been conducted with Amitriptyline to investigate how the drug may cause weight gain. Researchers have long claimed that this medication can alter your hormone levels, cause you to crave sweets/carbohydrates, and increase your appetite.Feb 11, 2015" medlineplus.gov/druginfo/me...
When I stopped smoking my brain chemistry went crazy. I was sleeping 12 hours a day and was gaining weight at the rate of 10 lbs a month. I was also curled up on a ball on the sofa, crying uncontrollably. A psychiatrist prescribed amytriptyline.
What a difference. I began sleeping 18 to 20 hours per day. When I noticed I was gaining weight at the rate of 5 lbs per week, I determined it might be because I was craving sweets like crazy which helped to make me feel a tiny bit less depressed; however I was shaky and my resting heart rate went up to 120 BPM.
I went back to the doctor after two weeks and told him what was happening. He shook his head and said that I would need to stay on it for a full six weeks to determine if it was working. I cried all the way home.
Then I got mad. I called up the place and demanded to be seen as soon as possible by any doctor except him. The next day I was seen by a woman doctor who did something her colleague had failed to do. She reached over and took my pulse.
She then immediately wrote out a prescription for Prozac. That cleared up my mood; however, it only slowed, but did not eliminate, the weight gain. Pretty sure I was an undiagnosed hypothyroid back then. These days I take bupropion (Wellbutrin).
tricyclics have always had a tendancy to cause weight gain but are rarely prescribed at the kind of doses that cause big problems these days. I seem to be Ok on it and it sounds as if you had a very bad reaction. I was in an appaulling state on Prozac and used to see a lot of bad reactions with it when I was nursing. It is very much a matter of courses for horses I think with all psychiatric meds. I am taking 5hct at the moment as an anti D and it is fab stuff. Shame nothing really decent is ever prescribed on NHS.
Has a lot to do with genetics.
OK, I tried explaining this to the GP but she's not having any of it. She says they will only refer for antibody and T3 testing if the TSH and T4 tests come back abnormal. She says the antibody testing sometimes comes back as a false negative and she wouldn't waste her money of paying for a test. I don't know who or what to believe. I would like to be able to trust a trained professional and I don't understand it all myself so how can I argue?
Look, your GP is only parroting what she was taught in medical school. Can't fault her for that. She just hasn't kept up, and neither have the ones who wrote the current treatment guidelines.
Lots of research has been conducted concerning autoimmune thyroiditis and the importance of Free T3 (the ACTIVE thyroid hormone that works at the cellular level) since then.
For a nice overview of how it all works, go to this site, click on "About the Thyroid" in the left menu bar and then work your way down way through the options.
thyroiduk.org.uk/tuk/about_...
In the US, we have this: niddk.nih.gov/health-inform...
And more importantly, this: niddk.nih.gov/health-inform...
As well as this: medscape.com/viewarticle/89...
But why in the world would she have a problem with testing your nutritional levels? I was considering having surgery on my bunions, and the podiatrist sent me for testing of my Vitamin D -- required for good bone healing. It was below range -- 23 (30 - 100 ng/mL). I followed what SlowDragon has written about vitamins and got my level up to to 57.
This is good information, too. vitamindcouncil.org/about-v...
Pernicious anemia is only one of the things that can result from low levels of (or inability to absorb) Vitamin B12 and/or low folate levels.
knewhealth.com/blogposts/un...
Here's my most important question: How are you feeling? If you have no symptoms of hypothyroidism, then by all means trust your "trained professional." If you do have symptoms, you need to become your own advocate.
Test results help needed to interpret 
Help please with interpreting test results.
Help with interpretation of blood test results
Please help interpret thyroid test results
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