Doctor wont treat until TSH 10 is that right?

[maplewood]

serum TSH level 4.00mu/l (0.35 - 4.7) and serum free T$ level 8.0 pmol/l (7.8- 21.00). Does this show hypothyroid or borderline ? Thank you

[SilverAvocado]

Maplewood, whether a doctor will treat you is a bit of a roll of the dice. Some want to wait till it reaches 10, others treat if it's out of range others want to see it substantially out of range or to remain out of range for several months. If you have bad symptoms it may increase your chances, so don't forget to mention them. Hopefully others more knowledgeable will comment on what you're entitled to in the guidelines.

I assume the other result is freeT4? This is quite a low result, so you're unlucky your TSH isn't a bit higher.

In terms of whether these results show you have thyroid illness or not, they very much do. My personal cut off for TSH is 2.5, and yours is a long way beyond that. Its vanishingly unlikely a person could have a TSH and matching freeT4 like that and not have a thyroid disorder.

Unfortunately the hard part is getting a diagnosis and treatment. Luckily you are not too far off, because your TSH is high in range. It's possible if you get a retest it will be higher on a different day. In future make sure you get the earliest blood draw in the morning , and fast with only water before the test. This will give you the highest TSH (as well as the most reliable test), and if you didn't do it last time it may be high enough to go over range.

Other than that the other thing you can try is shopping round with doctors. Eventually you may find one willing to treat you. If you have Hashimotos autoimmune thyroiditis which 90% + of hypo people do, then its a progressive illness and your TSH will rise over time (and symptoms worsen).

[maplewood in reply to SilverAvocado]

Thank you for your reply you have made more sense for me.

[SlowDragon Administrator]

Just testing TSH and FT4 is completely inadequate

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 you have autoimmune thyroid disease (Hashimoto's) diagnosed by raised Thyroid antibodies

Recommended on here that all thyroid blood tests should ideally be done as early as possible in morning and before eating or drinking anything other than water .

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 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

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 primary 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 .

1 in 5 Hashimoto's patients never have raised antibodies

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

thyroiduk.org.uk/tuk/about_...