'normal' TSH and T4, low T3: Hi everyone, I have... - Thyroid UK

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'normal' TSH and T4, low T3

izzysophia01 profile image
12 Replies

Hi everyone,

I have been experiencing some debilitating fatigue, brain fog and other symptoms including feeling cold, dry skin etc. I decided to get a blue horizon blood test for Thyroid function and cortisol, the findings from which were confirmed by GP blood tests when I requested these. The results are attached.

T3 is the concerning one and am wondering if this could be what is contributing to my symptoms. Cortisol is also high. My GP has not contacted me yet to go through my results with me and I'm worried he will not trial me on any medications because I dont meet the normal hypothyroidism criteria.

I am really struggling with symptoms and would like to at least try medications to see if they improve how I feel. Thanks!

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12 Replies
SlowDragon profile image
SlowDragonAdministrator

Looking at previous post you were considering self medicating with NDT

Did you start any NDT?

As per your previous post

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 .

Last dose of Levothyroxine 24 hours prior to blood test. (taking delayed dose immediately after blood draw).

This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip)

When on T3, or NDT day before test, split dose into three smaller doses roughly equal 8 hour intervals. Taking last dose T3 at roughly 8-12 hours 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

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

thyroiduk.org/if-you-are-un...

Email Thyroid UK for list of recommend thyroid specialist endocrinologists...NHS and Private

tukadmin@thyroiduk.org

Extremely important to have optimal vitamin levels

20% of Hashimoto's patients never have raised antibodies

healthunlocked.com/thyroidu...

Paul Robson on atrophied thyroid - especially if no TPO antibodies

paulrobinsonthyroid.com/cou...

izzysophia01 profile image
izzysophia01 in reply to SlowDragon

Hi slowdragon, thanks for the reply. I was considering NDT however decided to get further tests first. I took the blue horizon test which is what the results show, and then my GP agreed to test the same markers, all of which came back almost exactly the same. I am not and never have been on any medication including Ndt but am still seriously considering it because I'm desperate for relief, mainly of the fatigue.

SlowDragon profile image
SlowDragonAdministrator in reply to izzysophia01

So you need to get thyroid antibodies and vitamins tested

Perhaps consider ultrasound scan of thyroid, if both TPO and TG antibodies are negative

Your cortisol is very high

GP/endocrinologist should be testing for Cushing disease

izzysophia01 profile image
izzysophia01 in reply to SlowDragon

After gp reviewing results she has booked me for another blood test on Tuesday for antobodies that I should have by the end of the week. Had vitamins tested a few weeks ago and no matter how much I ask for the results, they claim they haven't got them??? So hoping no news is good news there. I take vitamin D, have a diet rich in vegetables, meat and dairy and have never experienced any digestive issues but I will keep chasing them up.

jimh111 profile image
jimh111

Could be central hypothyroidism or ‘low T3 syndrome’ if you have a concurrent illness.

Beetranquil profile image
Beetranquil

Hello, I'm new to this group so I'm very inexperienced about thyroid issues, I have just done a home test through Monitor my health as I'm convinced I have hypothyroidism. It's in my family, my son has it from the age of 10, cousin & also aunt. I have Chronic fatigue syndrome, Vestibular Migraine & Endometriosis. My fatigue has gotten worse, I feel the cold terribly, have a hoarse voice quite often, feel low, aching joints, my vertigo has worsened & I have dry skin on my legs & have started to have itchy skin on my face. I also have no get up & go. The brain fog is terrible, but I take Topiramate for my Vestibular Migraine 200mg daily, which is known to cause this. I take Bio Identical HRT which has helped me, but even that isn't getting me through. My results are TSH - 3.07

FT4 -14.8 pmol/L

FT3 - 3.6 pmol/L

Any advice would be greatly appreciated. Thank you very much x

😊

Gingernut44 profile image
Gingernut44 in reply to Beetranquil

It would be a good idea to start your own post. This will almost certainly get lost in this one

SingingInTheSnow profile image
SingingInTheSnow

Hi,

I had similar results, low T3, elevated cortisol. The body slows down conversion from T4 into the more potent T3 hormone to protect itself during stressful times. Instead of T3, it can turn T4 into reverse T3 (rT3) which is kind of the evil twin of T3. It will slow your metabolism down instead of making it run smoothly by competing with T3 at the receptors and you get all the Hypothyroidism symptoms. Cortisol might be high from physical stress like chronic infections, inflammation, allergies, extreme diets and fasting, environmental toxins etc. or emotional stress or both.

Conversion disorders can also stem from a lack of zinc, selenium, chromium and/or magnesium and B12. I'm sure vitamin D plays an important role as well. But as your cortisol is elevated, it looks the first scenario is more likely.

You can try natural adaptogenic herbs like Siberian ginseng (eleutherococcus), Rhodiola or Ashwanganda which can help to balance the cortisol levels. Also magnesium and vitamin D are very helpful. Pure Encapsulations has a nice mixture called Energy Xtra, but I'm sure there a similar supplements. You usual find them under the category "adrenal support".

But it might be not enough and I can say from personal experience that I tried so many things, but I had to take T3 (Thybon in my case) it helped a lot! But I also had lots of underlying chronic health issues like Lyme disease with every possible co-infection, inflammatory bowel disease, lead- and arsenic poisoning and lots of allergies and my body was very malnourished for many years.

(I know many people with chronic lyme disease who have a conversion disorder and need T3.)

I hope that helps! All the best for you, get well soon!

izzysophia01 profile image
izzysophia01 in reply to SingingInTheSnow

Very interesting and informative! Although I have never had any physical illnesses of note, I was very stressed and malnourished during most of my teen years. I am actually on ashwagandha and rhodiola rosea at the moment but they don't seem to be doing much. Have been on them for about a year now. Thing is GPs and endos here in the UK don't prescribe t3 so I would have to self medicate which I am more than happy to do. Expensive but if it makes me feel better I don't mind. Having antibodies tested now on Tuesday and will have results by the end of the week. I will update then. Thanks!

SingingInTheSnow profile image
SingingInTheSnow in reply to izzysophia01

Yes, I had to fight for many years until I finally found a doctor who was willing to give T3 a go. But at least, T3 is available in Germany. How do you get hold of it yourself in the UK?

It is such a shame that you do not get a prescription by the NHS when it is so obvious that you have low T3-Syndrome. The London Endocrine Centre seems to be familiar with T3, at least they mention it on their website but I have never been there in person. And I had many, many really bad experiences with endos in Germany, so I'm very skeptical now, no matter how skilled they sound.... I hope you get better soon!!

DrND profile image
DrND

Normal TSH and normal T4 with low T3 could mean genetic hypothyroidism. Conversion issue. Might be a problem converting T4 to T3. That is what I have. Let me know if that’s what it turns out to be . I’ve had a lot of weird experiences because of it and I might be able to save you some aggravation.

izzysophia01 profile image
izzysophia01

So tpo antibodies have come back as 35. Not sure what that means. Says normal levels are below 60 but taking their reference values with a grain of salt. Havent spoken to gp yet.

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