Hi I wonder if someone could have a look at these results - they refer to a friend of mine who is suffering badly with thyroid issues for a very very long time but who has not been prescribed any Levo or T3 or any treatment at all. In fact has been told by an eminent Endo that her results are 'normal' and that she take psychiatric medication.
Her results are as follows on the 6th December
Free T3 3.5 ( 3.5 - 6.5)
Free T4 16.4 ( 10 -20)
TSH 6.5 ( 0.35 - 5)
On the 20th June this year her TSH had gone down to 2.11 ( 0.35 - 4.78 )
She a graph which is showing wild swings in her TSH from 1.7 right up to 6.6 ( same reference ranges )
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Steni
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When you say her TSH was 2.11 in June, were the two tests done under exactly the same conditions?
Thyroid testing should be done no later than 9am before eating and drinking anything but water. This is because when we are looking for a diagnosis of hypothyroidism we need the highest possible TSH. TSH is highest early morning and lowers throughout the day. TSH can be lowered after eating, and drinking coffee can affect TSH. So testing under those conditions, and doing it the same every time, means that we can accurately compare the tests.
Has she had thyroid antibodies tested? If she had raised antibodies when her TSH was over range at 6.5 then she would have been diagnosed with autoimmune thyroid disease (Hashimoto's) and an enlightened doctor would have prescribed Levo at that time.
Her bottom of range FT3 in the original set of figures would mean that low T3 is causing symptoms.
If she hasn't had full thyroid/vitamin testing then I would encourage her to do a private test with one of our recommended labs. Best tests are:
You can see if it's on special offer tomorrow (Thyroid Thursday where one thyroid related test is on offer). If not code THYROIDUK for a 10% discount on any test not on special offer
Both tests include the full thyroid and vitamin panel. They are basically the same test but Medichecks require a venous blood draw and Blue Horizon can be done with a fingerprick test. There are a few small differences:
Blue Horizon requires 1 x microtainer of blood (0.8ml) for the fingerprick test, or you can arrange venous blood draw at extra cost.,
Medichecks is venous blood draw only.
Blue Horizon includes Total T4 (can be useful but not essential). Medichecks doesn't include this test.
B12 - Blue Horizon does Total B12 which measures bound and unbound (active) B12 but doesn't give a separate result for each. Medichecks does Active B12.
Total B12 shows the total B12 in the blood. Active B12 shows what's available to be taken up by the cells. You can have a reasonable level of Total B12 but a poor level of Active B12. (Personally, I would go for the Active B12 test.)
Blue Horizon include magnesium but this is an unreliable test so don't let this sway your decision, it also tests cortisol but that's a random cortisol test and to make any sense of it you'd need to do it fasting before 9am I believe.
Thank you for the question - I don't actually know the answer about the circumstances of taking the test but she does have this graph which shows the TSH going madly up and down - could this be due to the timing of the test ?
Am I right in thinking that the high aim of medication is to have a low TSH and that this result is seriously out of whack?
she does have this graph which shows the TSH going madly up and down - could this be due to the timing of the test ?
It may be due to the timing of the test but if she has Hashi's her results will fluctuate anyway so it could also be due to that.
If you look at the first graph in the opening post of this thread, you will see how TSH fluctuates throughout the day and why it's important to always test under the same conditions to compare the result:
Strongly recommend she gets FULL Thyroid and vitamin testing privately
Her Ft3 is very low
Presumably she has autoimmune thyroid disease also called hashimoto’s
Low vitamin levels are extremely common with Hashimoto’s
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
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
If that eminent Endo had a TSH of 6.5 and had the symptoms themselves I’m certain that they would NOT conclude their results were 'normal' or that they should take psychiatric medication. 🤬
Makes me so mad that this sort of thing happens. What gives an endocrinologist the right to act as psychiatrist? If it says that in your friend’s medical notes, I’d be asking for it to be removed as not written by a qualified professional.
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