Normal TSH & T4?

[Lynsey24782]

Hi, I have a lot of symptoms of an under active thyroid but my blood test shows normal TSH & T4 levels. Even my GP was surprised they came back normal. Is it possible to still have one if that’s the case? If so what further tests are needed? Ive heard the initial tests can miss it. I also have a vit b12 deficiency treated with injections and my blood test showed a high haemoglobin estimation. Not sure if that’s relevant? My sister has a b12 deficiency and under active thyroid too. Thank you

[BadHare]

If your GP was surprised ask them to treat your symptoms rather your test results as they fud prior to TSH testing. You could also ask them to check your pituitary hormones as I t could be that your issue lies there. Secondary hypothyroidism has normal test results but with the same symptoms, & the treatment is the same. My GP & endocrinologists have been quite ignorant regarding this so I self medicate following advice from this forum. It’s important to get your micronutrient ducks in a row to make sure there’s no deficiency issues.

[Lynsey24782 in reply to BadHare]

That’s great advice, thank you. I have a telephone appointment with my GP next week so will discuss with them again. I have unexplained weight gain (been a size 10, 5ft 9 and 10st all my life and with no change in diet or lifestyle I’m now 13st. Hair, eyebrows & eye lashes thinned, nails brittle & thin cuticles disappeared as have the little ‘half moon’ bits in your nail near the cuticles (always had thick healthy hair - same with my nails), skin problems, hoarse voice (people keep asking if I’m getting a sore throat), tiredness, muscle aches. I’ve tried various things myself to rule stuff out with no luck at all.

[BadHare in reply to Lynsey24782]

You’re welcome!

Hope you get the support ( medication & supplements) that you need to help you feel better. If not, ask GP to at least support you self medicating & monitor your blood levels. There is lots of excellent advice on the forum so keep reading to help yourself.

[greygoose]

'Normal', just means 'in-range'. But, 'in-range' isn't necessarily 'normal' - if you see what I mean. The ranges are too wide, so you would feel a vast difference if your results were at the top to the range, too how you would feel if they were at the bottom. But, doctors don't understand that.

So, the best thing to do, if you want helpful comments, is to post the actual results AND ranges, and let's have a look.

[Lynsey24782 in reply to greygoose]

Hey, I’ve now managed to get the screen shot of my results to upload. It wouldn’t work before! Thank you

[greygoose in reply to Lynsey24782]

Well, your FT4 is pretty low, only 25% through the range. And, your TSH is low considering that low FT4. So, what you really need to see now, is your FT3. If that's is also low, then you need to consider Central hypo - don't know if you know about that. It would also be a good idea to get your antibodies tested.

[Lynsey24782 in reply to greygoose]

Ok I’ve made a note of FT3 from someone else’s response that’s given me a list of stuff to get tested. I’ve not heard of central hypo - what’s that? Thank you

[Lynsey24782 in reply to greygoose]

I’ve just looked it up! That’s very interesting thank you. I was just looking at a site called thyroidpharmacy and it suggests TSH over 2 may be considered high unless you’re elderly then it’s 2.5 (I’m in my 30’s).

[greygoose in reply to Lynsey24782]

Well, it depends who's doing the considering! I don't think you'd find a GP/endo in the UK that would consider it high. The NHS likes it to get to 10 before they will take any notice. I think the site you're referring to is an American site.

As for the elderly having a higher TSH, that's another fob-off not to treat elderly people. The TSH of the elderly is not that high, and it's only relevant if the elderly person in question is euthyroid, and if all they test is the TSH, they cannot possibly know if the person is euthyroid. They have all these sneaky ways of getting out of diagnosing and treating people!

[Lynsey24782 in reply to greygoose]

Ahh I see. Yeah I had this with my vitamin B12 deficiency. A blood test I had done years ago had a reading of 182 and my gp said that’s a normal level! It’s sooooo not! I ended up dropping to 48 where I was very ill (I had hundreds of ulcers in my mouth & couldn’t eat or drink) and finally got diagnosed and offered quarterly injections. I’m now about 650.

[greygoose in reply to Lynsey24782]

They just have no idea!

[SlowDragon Administrator]

First thing is, do you have any actual blood test results? if not will need to get hold of copies.

You are legally entitled to printed copies of your blood test results and ranges.

The best way to get access to current and historic blood test results is to register for online access to your medical record and blood test results

UK GP practices are supposed to offer everyone online access for blood test results. Ring and ask if this is available and apply to do so if possible, if it is you may need "enhanced access" to see blood results.

In reality many GP surgeries do not have blood test results online yet

Alternatively ring receptionist and request printed copies of results. Allow couple of days and then go and pick up.

Important to see exactly what has been tested and equally important what hasn’t been tested yet

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

Ask GP to test vitamin levels and thyroid antibodies if not been tested yet

You may need to get full Thyroid testing privately as NHS refuses to test TG antibodies if TPO antibodies are negative

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

thyroiduk.org.uk/tuk/testin...

For thyroid including antibodies and vitamins

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 you can get GP to test vitamins and antibodies then cheapest option for just TSH, FT4 and FT3 £29 (via NHS private service )

monitormyhealth.org.uk/thyr...

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 .

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_...

[Lynsey24782 in reply to SlowDragon]

Thank you so much for such a detailed reply. I had a feeling I may have to get private blood tests done and that’s fine as I’ve done that before via medicheck. I’m a great believer in that you’re your own best doctor and none of what I’m suffering is right for me and as it’s all happening hand in hand, it has to all be connected. I have now uploaded a screen shot of my TSH & T4 results as it wouldn’t upload before. I’m speaking to my GP in the morning as a phone appointment so I’ll see how I get on.

[SlowDragon Administrator in reply to Lynsey24782]

How long ago was your B12 issue picked up

Were you tested for Pernicious Anaemia?

Often low B12 is a result of being hypothyroid

Ask GP to test thyroid antibodies, vitamin D, folate and ferritin too

[Lynsey24782 in reply to SlowDragon]

Hey, the vitamin b12 was diagnosed about 4 years ago. I had the blood test for pernicious anaemia but they were negative so I’ve never been given a cause of the deficiency. Ok thanks for the info. I’ll see what the GP says and will update tomorrow!

[SlowDragon Administrator in reply to Lynsey24782]

When hypothyroid, low stomach acid often results...this results in low vitamin levels.....but don’t expect GP to be aware of this

articles.mercola.com/sites/...

thyroidpharmacist.com/artic...

stopthethyroidmadness.com/s...

healthygut.com/articles/3-t...

naturalendocrinesolutions.c...

[Hidden]

Hi lynsey24782

Sorry to hear that you are not in the best of health

And yes, by your symptoms, you may well be hypothyroid

And, as greygoose suggests, please do include results AND ranges

So that the forum can make comments

'Normal' results mean nothing at all, if you still do not feel well

Thanks

Alps

[Lynsey24782 in reply to Hidden]

Hey, thank you for your reply. I attached a screen shot of my results when I posted but it didn’t upload. I’ve tried editing to add it on but it’s not having it! My results were TSH: 2.08 miu / L & T4 14.5 pmol / L. I will keep trying to add the screenshot!

[Hidden]

Hi lynsey27482

Yes I Can now see the ranges, which are exactly like Medichecks

And again, yes you 'may' be hypothyroid

As healthy people have their TSH under 1

And FT4 in the upper part of the range

Good luck with GP tomorrow, but the chances are they will say you are Normal - as you are 'in range'

If that happens, do consider self treating, as I and many others on here do?

Alps

[Lynsey24782 in reply to Hidden]

I will see what they say tomorrow but am happy to pay for private blood tests to get results. Can you self treat this in the UK then? Thank you

[SlowDragon Administrator in reply to Lynsey24782]

First step is full testing...come back with new post once you get results

[Hidden]

Ok lynsey

Please get back tomorrow with an update

Then we can discuss your options

Alps

[Lynsey24782]

Hi Everyone, my GP agreed to do another blood test for thyroid antibodies & T3. She’s also added quite a few other bits (full blood count / vit D / B12 etc). Until the COVID-19 crisis is over, they won’t be able to actually do the blood test though. So I have ordered a medichecks thyroid ultra test to do at home for now as this could go on for months. Not sure how I’ll get on with the fingerprick blood test as they always struggle to get blood from me but we shall see! 😳. I’ll update when I know more but thanks so far for all of your advice x