Hello all,
My daughter, age 25, just had her thyroid tested because she is tired all the time and her brother and I are both hypothyroid. Do these results look OK, or might she be slightly hypothyroid causing her to be tired?
TSH (0.27 - 4.2) 1.4
Free T3 (3.1 - 6.8) 3.97
Free Thyroxine (12 - 22) 12
Would be grateful for any comments. Thanks.
FT3 and FT4 both very low
But TSH should be much higher in such a situation
She needs further testing
Presumably you and your son have Hashimoto's ?
For full Thyroid evaluation she needs TSH, FT4 and FT3 plus both TPO and TG thyroid antibodies tested. Also 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)
Ask GP to test vitamin levels and both TPO and TG thyroid antibodies
If GP refuse or lab refuses then getting private testing
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
Come back with new post once you get results and ranges
Thanks to everyone who replied. I'm aware that we probably have a bit of a fight on our hands. My daughter's thyroid tests were done by Medichecks, so I'm aware that the GP will probably cast his/her eyes to heaven. It may be best to start from scratch and let the GP test her on the NHS. If you present at the GP with symptoms of exhaustion they presumably test for anaemia and hypothyroidism, but don't they usually just test the TSH and not the T3 and T4. I know the GP only tests my TSH annually (that's why I use Medichecks), but maybe they will test more extensively before a diagnosis is made.
My GP dismissed my Medichecks blood test and said he would only accept NHS blood results he then asked for a TSH and T4 blood test. The lab refused to test my T4 because my TSH was in range, he didn't bother with antibodies because they mean nothing according to him. I am thinking of moving practices but if I do I will be classed as a troublesome patient. I just rang up today for an appointment with my designated GP (yes I can't even choose which Doctor to see even though me and Dr Baldy have clashed in the past) they can give me an appointment in 3 weeks. "sigh"
No I don't think you would be classed as troublesome for moving practices. I work as a nurse for a district nurse team attached to a GP practice, and one of our GPs (now retired) used to say that everyone should change practice once every four years or so, because your regular GP often can't see the wood for the trees, but a new GP will be more thorough.
It's not normal for both fT3 and fT4 to be low/normal and TSH not elevated (her fT4 is low and her fT3 a little low). Usually TSH jumps up when fT4 goes low. Her pituitary is not producing enough TSH. There can be many reasons for this: severe dieting, depression, severe illness and more likely a previous period of hyperthyroidism which often isn't noticed. Whatever the reason she probably needs thyroid hormone supplementation. Since TSH is not performing normally we can't rely on TSH as a marker for her thyroid status (try getting a doctor to appreciate this). It would help to test thyroid antibodies but ultimately the only test is observing whether a trial of thyroid hormone resolves her symptoms.
No those results look rubbish 😔 did she get Antibody tests? Although one would expect a higher TSH result with such low FT4/3 results. The pituitary should be sending out lots more signals to the Thyriod so maybe secondary instead of primary?
When a thyroid is healthy, both freeT4 and freeT3 are around the middle of the range. The further out from the centre they go, the more likely it is that there isn't a healthy thyroid.
In your daughter's case freeT4 is right at the bottom when it should be around 17, and freeT3 is about a quarter up the range, when it should be around 5. These are both very low levels, and often the body keeps freeT3 as high as it can while hormone levels drop, so it's common to see freeT3 a little higher than freeT4 in these situations.
Thyroid Stimulating Hormone (TSH) is a chemical messenger made by the pituitary to ask for more hormone. When thyroid hormone levels are low, this should be high. In your daughter's case this is a very ideal looking TSH for a health thyroid. This means that her TSH hasn't responded to the low hormone as it should by raising.
This suggests she may have central hypothyroidism. This can be secondary hypo, caused by the pituitary not doing it's job, or tertiary hypo caused by the hypothalamus not doing its job and telling the pituitary thyroid hormone is low.
The bad news is that doctors can be extremely ignorant about central hypothyroid 
The guidelines don't give a clear path to diagnosis, so you will have a fight on your hands.
I am in a similar situation except while my T3 and T4 were low my TSH at one point peaked at 6.01 and then dropped a few weeks later to 3.68. My GP made a dx of subclinical hypo and refused to treat - she did make referral to NHS endo who I will be seeing next week - can I raise these issues of central hypo with him or would I be making an idiot of myself?
6 is a fairly high TSH, and anyone reasonable would diagnose you with that. Unfortunately thyroid treatment is a disgrace, and doctors often know very little.
Based on what I've seen on the forum, with Central Hypothyroid the TSH will sometimes rise a bit. I wouldn't be surprised if it rose as high as 3.68, but 6.01 is probably a bit higher than you'd expect. It's hard to know, though, as not much is written about these exact details of Central
Overall, a person is much better off if they can get a diagnosis of Hashimoto's, or find a doctor who is clued up enough to trial thyroid hormone replacement based on symptoms. There is no clear pathway to getting diagnosed with Central hypothyroid, and many doctors will not have heard of it.
Thanks for the reply Silver Avocado. I am symptomatic - quite badly so, so I am hoping that the endo I see [most likely a registrar so I'm not going with any great expectations] will be prepared to look at symptoms as well as blood values. The TSH of 6.01 was my medichecks result which they will likely discount, however I would be contending to them that even the subsequent 3.68 TSH done by my GP when combined with my symptoms is high enough to warrant a trial of something - whether or not T4 is the right way to go or not is a whole other ball game. WE will see how I get on!
If you don't get any joy self medicating may be your only choice.
The alternative is waiting for your TSH to get high enough, if it's Hashimoto's that would slowly happen over time, if it's a pituitary issue it probably won't worsen over time, and this is one of the reasons it's so hard to get a diagnosis.
I don't think I want to wait for my TSH to get any higher than it is; I have been mulling over self medicating for some time now but don't relish the prospect of going it alone. I will see how I get on with the endo referral. Problem re Hashimotos is that I have low levels of antibodies so don't seem to have it and the only way to dx it conclusively might be by ultrasound. I am going to run that by whoever I see at the endo appointment and see if they will order one. My sister has Hashis and my mum is hypo [doubt she has ever had her antibodies tested so we can't rule her out as Hashis yet] so that genetic history may persuade them to order one. I need to know one way or the other definitively if I have that or not.
What do you mean by self medicating? What medication do you take and where do you get it?
By self medicating I mean buying your own thyroid hormone and making your own decisions about what dose to take.
The options are Levothyroxine, T3, or NDT (natural dessicated thyroid).
Where are the safe places to get these medications?
We're not allowed to talk about sources in the forum, as it puts the organisations and people that help us at risk.
If you make a new post saying a little about your plans and asking members to share their sources in private messages you should get some information.
Ok, thanks.
I would suggest you go with her to see her GP and take the Medichecks tests
This is going to be a tough one to make progress on...and she's going to need your help and experience of thyroid problems
Explaining to her GP that you and your son have Hashimoto's, so can she have Thyroid antibodies and vitamin D, folate, B12 and ferritin tested
You may get a flat refusal....or GP may agree....but lab may refused to test .....if so you will be forced to test privately
It's always recommend to get FULL Thyroid and vitamin testing
NHS rarely tests more than TSH
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