GP not listening .....
Hello all just got my results back, all symptoms of hypo and here are the results:
TSH @ 2.23 (range of 0.27- 4.2)
Free T3 @ 4.18 (range 3.1-6.8)
Free T4 @ 10.5 (range 12-22)
THYROID PEROXIDASE ANTIBODIES @ 31.1 (range 0-34)
My doctor says all is fine!
Yet I clearly have low T4 and my antibodies are high...
What are people’s thoughts on here with those results? What would you do?
Thank you x
Welcome to the forum
Was this your first ever thyroid test?
Presumably you are not on any thyroid medication?
Was test via GP or private?.
Clearly Ft4 is below range
Bloods should be retested 6 weeks after a first abnormal test result
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
You will 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 as NHS currently rarely tests Ft3 or thyroid antibodies or all relevant vitamins
List of private testing options
thyroiduk.org.uk/tuk/testin...
Medichecks Thyroid plus ultra vitamin
medichecks.com/products/thy...
Medichecks often have special offers, if order on Thursdays
Thriva Thyroid plus vitamins
Blue Horizon Thyroid Premium Gold includes vitamins
bluehorizonbloodtests.co.uk...
Hello, not on any medication and this was first test. As can be seen antibodies also high! X
Your TPO anti- bodies are in range ...
Not really, even the GP admitted that! The scale runs from 0-34 and mine are at 31,1 - so indicative that somethings not quite right for them to almost in the problematic range (34) x
Anti-bodies do not cause symptoms .
greygoose
No offence, but you’re not being very helpful! GP agreed that high antibodies with low T4 was indicative of something.....but won’t prescribe. These results plus symptoms of hypo is why I was asking for advice 😉😊 x
Many people with Hashimoto’s only have high TG antibodies and frequently struggle to get diagnosed
As TPO antibodies are within range NHS won’t test TG antibodies
healthline.com/health/antit...
What’s your diet like, are you gluten free,dairy free, vegan, vegetarian or standard mixed diet
Standard mixed diet x
Have you recently been ill or on any new medication
Recommend Getting vitamin D test now and full thyroid and vitamins tested in 2 months
No offence but having been an active member here since 2011 I am not in the habit of being unhelpful. Maybe take a look at my Bio - number of Followers - Posts and Replies ! I carefully read your post and could see that you had been given excellent advice by SlowDragon - so additional advice not needed at this point. I also HELPFULLY tagged greygoose who has excellent knowledge on anti-bodies and no doubt will be along soon.
If your GP can't recognize low FT4 s/he doesn't know much about thyroid, so probably doesn't know much about TPO antibodies
Not as far as I know, they don't, no. It's T3 that causes symptoms when it's too high or too low.
But, Rosie, I think your main problem here is your GP. If she doesn't know what high antibodies and low T4 is indicative of, then she's never going to make you well.
You say this is your fest test for thyroid. So, did she suggest you go back for a retest in six weeks? That is the protocol when one has an abnormal blood test, to see if it is still abnormal, and not just a fluke. It's not usual to rush into prescribing after the first test. If she didn't suggest retesting, then there is a problem with her.
At the moment, despite your low FT4, you're not actually hypo. And, whilst a more intuitive doctor might realise that you're more than likely going to go hypo in the not so distant future, your doctor doesn't sound like the intuitive type. And, she's probably scared rigid of losing her licence if she goes against the party-line - and the party-line is very anti-hypo.
As for being helpful, I'm not sure what help you're expecting us to give. Except that, for the time being at least, you need to sit it out and see what happens. See how things involve. At the moment, your TSH isn't that high - and that's all that most doctors look at, anyway - your FT3 isn't too bad, and your antibodies are still in-range. Doctors know nothing about symptoms, so telling your doctor you have 'all the symptoms of hypo' is not going to cut any ice - and, by the way, did you know there are over 300 hypo symptoms? All a doctor is interested in - although 'interested' is a bit of an exaggeration at the best of times! - all a doctor looks at is the numbers. And, on that test…
But, all that could change in the blink of an eye. So, keep testing. If that's not helpful, I'm sorry, but there's no magic formula to make a doctor change her mind. So, the only other advice anyone can give is to self-treat, and I wouldn't recommend that quite yet, it's too soon. 
You could test vitamin D now
£29 NHS postal kit
Come back with new post once you get results
Ask for a referral to an endo who specializes in central hypothyroid or pituitary problems (low FT4 and FT3 with normal or low TSH)
THYROID PEROXIDASE ANTIBODIES @ 31.1 (range 0-34)
Doctors usually only recognise TPO antibodies as being high if and when they are in the hundreds. I agree that your result is high in range, and probably indicates that you have Hashi's already or will develop it in the future (antibody results fluctuate a lot). But doctors really don't care about that - they fixate on the ranges when it suits them, and when it doesn't suit them they will ignore the range unless a result is miles out of range.
TSH @ 2.23 (range of 0.27- 4.2)
Free T3 @ 4.18 (range 3.1-6.8)
Free T4 @ 10.5 (range 12-22)
With your Free T4 under range and your Free T3 only 29% of the way through the range you are clearly suffering from hypothyroidism. But your TSH isn't responding well to your low T4 and T3, (TSH should be a lot higher than it is with such low levels of T4 and T3), suggesting that your pituitary is not capable of producing sufficient TSH for your needs. This occurs in a condition called "Central Hypothyroidism" or "Secondary Hypothyroidism". Getting a diagnosis of that is very difficult because doctors think that TSH is all they need to worry about.
If you have central or secondary hypothyroidism then your thyroid may actually be healthy. Thyroid hormone levels are low because your pituitary isn't producing sufficient TSH - Thyroid Stimulating Hormone. In other words your thyroid isn't being stimulated to produce more thyroid hormone when it should be.
There are various reasons for the pituitary not to produce sufficient TSH. The following isn't a complete list :
head injury
whiplash
tumour
Sheehan's Syndrome (en.wikipedia.org/wiki/Sheeh...
Sheehan's syndrome is a condition in which a pregnant woman rapidly loses vast amount of blood during childbirth and it causes necrosis of the pituitary. The effects of this condition usually take months or even longer to become obvious after the damage has occurred.
You need an endocrinologist to diagnose central hypothyroidism, a GP can't do it.
[Edit : I made a typo in the previous sentence and had to change "can" to "can't" !]
Note :
Central hypothyroidism is hypothyroidism caused by a problem with the pituitary OR the hypothalamus. The hypothalamus releases a hormone that the pituitary should respond to. If either the hypothalamus or the pituitary is faulty this causes Central Hypothyroidism.
Secondary Hypothyroidism is specifically hypothyroidism caused by a faulty pituitary.
Tertiary Hypothyroidism is specifically hypothyroidism caused by a faulty hypothalamus.
So people with central hypothyroidism actually have secondary or tertiary hypothyroidism, or possibly even both, but without tests nobody will know which.
Relatively low TSH is common with Hashimoto’s...as levels change continuously TSH often seems to give up trying to respond
Most important results are Ft4 and Ft3
Getting ultrasound scan of thyroid can be helpful
What time of day was your blood test? It is best to have It as early in the day as possible eg 8 - 8.30 and preferably no later than 9am. TSH is at its highest at this time.
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