Help to interpret my nieces results would be a ... - Thyroid UK

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Help to interpret my nieces results would be a big help

Steni profile image
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I think these levels don’t look right - my niece has been suffering all the usual thyroid symptoms and has finally had these tests done with Blue Horizon - I don’t know enough to say for sure but I don’t think her TSH should be so high, am I right , and what next ?

Thank you

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Steni profile image
Steni
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SeasideSusie profile image
SeasideSusieRemembering

Steni

What time was the test done? Her cortisol is low and if it was done in the morning she needs to see her GP. Hidden will hopefully pop along with further comments about that.

Her TSH is not high at 1.37. Is she diagnosed hypothyroid and on Levo? If so many Hypo patients feel best when it's 1 or below, but if she's not diagnosed hypothyroid then it' a normal TSH level for a healthy person. A normal healthy person would have a TSH of no more than 2, often around 1, so hers is about right if not diagnosed hypothyroid.

Her FT4 is on the low side, a normal healthy person would have FT4 around mid-range-ish and hers is only 29% through it's range. However, as none of us are tested for a baseline in health then we don't know what our "normal" level is.

What about Vit D, B12, Folate and Ferritin results?

Steni profile image
Steni in reply toSeasideSusie

You asked if she was diagnosed Hypothyroid - she hasn’t been but we wondered if she is Hypothyroid hence the test - does this test not show whether she is or she isn’t ?

SeasideSusie profile image
SeasideSusieRemembering in reply toSteni

Steni

Primary Hypothyroidism is diagnosed when TSH goes over 10, regardless of the fact that the top limit of the range is usually somewhere around 4 or 5 (ranges vary from lab to lab).

If thyroid antibodies are elevated and the TSH is over range, but not necessarily over 10, then a diagnosis of autoimmune thyroid disease, aka Hashimoto's, is often made although some doctors still want to see TSH over 10.

If TSH is normal, low or minimally elevated with a bottom of range/below range FT4 then this suggests Central Hypothyroidism which is where the problem lies with the pituitary (Secondary Hypothyroidism) or the hypothalamus (Tertiary Hypothyroidism) rather than the thyroid itself.

Unfortunately she doesn't come into any of these categories with those results.

It's worth retesting in, say, 3 months time to see if anything has changed. If she still has a similar TSH but FT4 is right at the very bottom of the range or below then she may be looking at Central Hypothyroidism (but very few doctors have any knowledge of this).

What are her Vit D, B12, folate and ferritin results, as asked above? Low levels or deficiencies with these can have symptoms similar to hypothyroid symptoms.

Steni profile image
Steni in reply toSeasideSusie

Thank you so much - I will pass this on to her. She will be disappointed in a way because she feels like there is something wrong - has big weight gain since puberty , PCO , exhaustion etc etc - but looks like this has drawn a blank

SeasideSusie profile image
SeasideSusieRemembering in reply toSteni

But what about the Vit D, B12, Folate and Ferritin? These are so important and could be causing problems.

AS SeasideSusie says, what time of day was the blood taken as that affects what we say about the result? If it was first thing in the morning around 9am then it's on the low side. The oestrogen contraceptive pill. HRT (although I guess she's not on that?) & Biotin can all aggect the result too. Let me know & I'll see if I can help at all.

Steni profile image
Steni in reply to

I’m not sure when it was taken - but I can find out.

humanbean profile image
humanbean

You should take a look at this link to know more about TSH in healthy people without thyroid disease :

healthunlocked.com/thyroidu...

One thing that isn't often clear to either doctors or patients about thyroid hormones is that results of Thyroid Function Tests have a different level and a different pattern in healthy people compared to those in people with thyroid disease.

The most worrying result on that sheet is the Cortisol. But cortisol output is time dependent, so if the blood for the test was drawn after 10am then it may be fine. If the test was done around 8am - 10am then it may indicate a condition called Adrenal Insufficiency which is described here :

en.wikipedia.org/wiki/Adren...

Steni profile image
Steni in reply tohumanbean

Thank you for this - very useful indeed

penny profile image
penny

Would your niece consider posting on here so that you don’t have to keep asking and relaying answers?

Steni profile image
Steni in reply topenny

Maybe but as she doesn’t have a thyroid issue I think she wouldn’t be so interested in it, it’s a bit niche !

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