Low FT4 high TSH?

[Runner169]

Morning. My daughter had bloods where TSH was 5.34 & FT4 9.3. I’ve been told they are normal but reading Dr Google aren’t. Any thoughts? Thanks.

[SlowDragon Administrator]

Are you in the U.K.

How old is your daughter?

Please add ranges on these results (figures in brackets after each result)

Just testing TSH and Ft4 is completely inadequate

For full Thyroid evaluation she needs 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

About 90% of primary hypothyroidism is autoimmune thyroid disease

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)

adjusting time or splitting of dose day before test

Is this how you do your tests?

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 antibodies and vitamins

medichecks.com/products/adv...

Thriva Thyroid plus antibodies and vitamins By DIY fingerpick test

thriva.co/tests/thyroid-test

Thriva also offer just vitamin testing

Blue Horizon Thyroid Premium Gold includes antibodies, cortisol and vitamins by DIY fingerprick test

bluehorizonbloodtests.co.uk...

If you can get GP to test vitamins and antibodies then cheapest option for just TSH, FT4 and FT3

£29 (via NHS private service ) and 10% off down to £26.10 if go on thyroid uk for code

thyroiduk.org/getting-a-dia...

monitormyhealth.org.uk/

NHS easy postal kit vitamin D test £29 via

vitamindtest.org.uk

[Runner169 in reply to SlowDragon]

Thanks. That’s some really useful information. She’s VIt & B12 deficient so taking supplements. The lab ranges are 0.34-5.6 TSH & 7.9-13.6 FT4. Ferritin is fine. Can’t see they’ve tested folate. She was 16 when they took the bloods & everything I’ve read suggest the levels aren't right. It all came about because she had some pre 9am low cortisol levels 182/292, but the endo discharged her without a SST. I complained and now she’s having this. She’s been so ill. Migraines like 20 in 6 weeks. This has now reduced to one a week, only at night, but unusual for her. Her eyesight decreased, unexplained vomiting only at night. They’ve done an MRI on her brain but she has dental work. They are going to do an EEG too as we think she may have had seizures at night. She also has POTs. I am literally clutching at straws in trying to find a diagnosis. Thanks for your reply.

[SlowDragon Administrator in reply to Runner169]

Blue horizon will allow testing of children

Suggest you get FULL thyroid and vitamin testing done

Come back with new post once you get results

All thyroid tests should be done as early as possible in morning before eating or drinking anything other than water

Only do test early Monday or Tuesday morning and post back via tracked 24 hour postal service

If taking any supplements that contain biotin (eg vitamin B complex) stop these a week before ALL blood tests as biotin can falsely affect test results

[Runner169 in reply to SlowDragon]

Thank you 😊

[Runner169 in reply to SlowDragon]

Sorry one last question. Should she stop her vit D & B12 supplements to get a true reflection before doing the bloods? Thanks

[Bearo in reply to Runner169]

Just in case no one picks up your last question, no, as far as I know you don’t need to stop vitamins B12 or D for thyroid tests, just anything containing biotin (which includes B complex).

But if she was going to have B12 tested then it might be different, I’m not sure about that one, I think she’d need to stop well before the test.

I’m not an expert on vitamins. Or anything else.

[Runner169 in reply to Bearo]

Thank you 😊

[SlowDragon Administrator in reply to Runner169]

Her B12 is extremely low considering you say been supplementing

This suggests pernicious anaemia as B12 supplements won’t work with PA

With Pernicious Anaemia it’s essential to have B12 injections