Subclinical hypothyroidism and hypothyroidism - Thyroid UK

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Subclinical hypothyroidism and hypothyroidism

metrorooms profile image

Hi i am new to this please can anyone tell me the difference between subclinical hypothyroidism and hypothyroidism ?. I have been told that i have subclinical hypothyroidism as my serum free T4 level 14.6 pmol/L [10.0 - 20.0] Serum TSH level 4.6 mu/L [0.5 - 4.4] Are above high reference limits will i have to take medication for this. I feel like crap and tired all the time will it help ?. Thank you for any help.

12 Replies

If your TSH is above range but under 10, it means your thyroid is struggling. Clinicians like to watch and wait, however that's on the basis that you have no symptoms.

New NICE Guidelines came in recently (Nov 2019)

nice.org.uk/guidance/ng145/...

and i believe section 1.5.4 might apply to you. Your Dr may well need to be led in the right direction.

Well, your FT4 is just under mid-range, and your TSH only just over the top of the range. I would call that 'hypo', but doctors prefer to call it 'sub-clinical' so that they have an excuse not to treat it.

Was that your first thyroid test?

Doubtful they'll give you anything as a result of those labs, your TSH will have to get higher before they'll treat. But, it won't be medication as such, it will be thyroid hormone replacement. And, once you're on the right dose - which will take a while - it will help, yes. :)

metrorooms profile image
metrorooms in reply to greygoose

Thanks for the reply yes it was my first test he has said to have it done again in 3 months. I am also having trouble swallowing and was treated for depression last year.

greygoose profile image
greygoose in reply to metrorooms

Depression is a symptom of low thyroid. And trouble swallowing probably means that your thyroid is slightly swollen.

That is the protocol, to have a retest in 3 months, to see if the TSH continues to rise, or reduces again. But, you really do want your antibodies tested, because that changes everything.

metrorooms profile image
metrorooms in reply to greygoose

Thank you for your reply i plan to have a Medichecks Thyroid plus ultra vitamin done next week as i want a better picture of whhats going on myself. Would the doctor take the private test report in to consideration and would my antibodies be low or high with hypo ?.

greygoose profile image
greygoose in reply to metrorooms

That would depend very much on the individual doctor. Some do, some don't.

Antibodies are high if you have Hashi's, if Hashi's is causing your hypothyroidism. There's no direct link between antibodies and thyroid hormone levels.

Sub clinical seems to mean symptomatic but your doctor will ignore that & refuse to treat you. 😡

metrorooms profile image
metrorooms in reply to BadHare

I have appointment with him next week as i see him regular depression and anxiety. The blood test was done because i have a persistent dry cough for four months but it showed up a thyroid problem. Which would explain a lot of the stuff i have been suffering from i just hope he thinks treating the thyroid is worth ago as i have a long history of depression fatigue ect.

BadHare profile image
BadHare in reply to metrorooms

You might have a decent doctor, if not, there’s enough wonderful advice from the admins & good folks on here to treat yourself! 🤗

Even b12 , folate and ferritin deficiency have the same symptoms. Get them tested too.

The difference between subclinical and hypo is some arbitrary numbers on a chart. It varies from country to country. In the UK, hypo is TSH over range (but not treated until over 10) and FT4 under range, Subclinical is TSH over range and FT4 in range. Symptoms are disregarded. Subclinical should mean that you have out of range results but no symptoms, but it does not.

Thank you for your reply. Its not looking good that i am going to get some treatment then.

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