Hi everyone, this is my first post/question. I got some bloods taken recently - the Doctor said they look healthy but having done some research on Hypothyroidism, and considering some of my symptoms, I don't believe the Doctor. Hoping someone can help enlighten me a bit? Thank you in advance!
TSH - 2.87 (0.28-4.20)
Thyroxine free - 12.08 (12.0-22.0)
Welcome to the forum.
How do you feel? I'm guessing not that great or you wouldn't have sought us out 
Are you currently on thyroid meds? If not, you won't get put onto levo with these results. Your GP will want your TSH to be out of range - and possibly waaay out of range first. In most countries you are put on medication when your TSH goes over 3 but in the UK they can wait until it reaches 10 - which is pretty cruel really and rather makes a mockery of having an upper range that is less than half that.
If you are on thyroid meds, you need an increase. Your free T4 is on the floor and you will feel better when you TSH is less than 2, probably less than 1. You will also likely benefit from testing your key nutrients - ferritn, folate, vit D and B12, as your levo works best when these are nice an high. And also testing free T4 and free T3 together, to see how well you convert. GPs seldom test everything you need, so you will see lots of posts here about private testing. One of the firms, Medichecks, usually has a discount on Thursdays.
NewToThis-
Yes, you are right to question this.
Your doctor is saying your results are OK because they are within range. However, a normal healthy person would have a TSH level of no more than 2, possibly nearer 1, with FT4 around mid-range.
Your FT4 has barely scraped into range at 12.08 (12-22) which means that you are producing viritually no thyroid hormone (T4).
I am not medically trained, and I am not diagnosing, but what could be indicated here is Central Hypothyroidism. This is where the problem lies with the hypothalamus or the pituitary rather than a problem with the thyroid gland. With Central Hypothyroidism the TSH can be low, normal or slightly raised, and the FT4 will be low.
TSH is a pituitary hormone, the pituitary checks to see if there is enough thyroid hormone, if not it sends a message to the thyroid to produce some. That message is TSH (Thyroid Stimulating Hormone). In Primary Hypothyroidism the TSH will be high. If there is enough hormone then there's no need for the pituitary to send the message to the thyroid so TSH remains low.
However, with Central Hypothyroidism the signal isn't getting through for whatever reason. It could be due to a problem with the pituitary (Secondary Hypothyroidism) or the hypothalamus (Tertiary Hypothyroidism).
Your GP can look at BMJ Best Practice for information - here is something you can read without needing to be subscribed (you can only read the Summary):
bestpractice.bmj.com/topics...
and another article which explains it:
ncbi.nlm.nih.gov/pmc/articl...
and another here:
endocrinologyadvisor.com/ho...
You could do some more research, print out anything that may help and show your GP.
As Central Hypothyroidism isn't as common as Primary Hypothyroidism (where TSH would be over range) it's likely that your GP hasn't come across it before. You may need to be referred to an endocrinologist. If so then please make absolutely sure that it is a thyroid specialist that you see. Most endos are diabetes specialists and know little about the thyroid gland (they like to think they do and very often end up making us much more unwell that we were before seeing them). You can email Dionne at
tukadmin@thyroiduk.org
for the NHS list of thyroid friendly endos. Then ask on the forum for feedback on any that you can get to. Then if your GP refers you, make sure it is to one recommended here. It's no guarantee that they will understand Central Hypothyroidism but it's better than seeing a diabetes specialist. You could also ask on the forum if anyone has been successful in getting a diagnosis of Central Hypothyroidism, possibly in your area which you'll have to mention of course.
One other thing to do is get the full thyroid panel which would include
TSH
FT4
FT4
Thyroid antibodies
plus a vitamin panel to include
Vit D
B12
Folate
Ferritin
You will then have a complete set of results to give a full picture. If your GP can't or wont do all these tests, we have recommended private labs who will do them with either a home fingerprick test or phlebotomy arranged at a private clinic at extra cost.
You are correct...Ft4 is right at bottom of range
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
Ask GP to test vitamin levels and 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)
Is this how you did this test?
Private tests are available as NHS currently rarely tests Ft3 or thyroid antibodies or all relevant vitamins
List of private testing options
thyroiduk.org/getting-a-dia...
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...
If TPO or TG thyroid antibodies are high this is usually due to Hashimoto’s (commonly known in UK as autoimmune thyroid disease).
About 90% of all primary hypothyroidism in Uk is due to Hashimoto’s. Low vitamin levels are particularly common with Hashimoto’s. Gluten intolerance is often a hidden issue to.
Link about thyroid blood tests
thyroiduk.org/getting-a-dia...
Link about Hashimoto’s
thyroiduk.org/hypothyroid-b...
List of hypothyroid symptoms
Understanding TSH Levels
My update on my TSH level.
My TSH level is under the range.
TSH & Free T4 levels
TSH levels are even higher now after being on Thyroxine!
