Possibly hypothyroid even with results in range?

[Zanna_88]

I had some blood tests done privately as I’ve been feeling very tired and finding It difficult to get gp appointments.

Initially had a fatigue screen and thyroid (TSH, T4 and T3) although it was not in the morning or on an empty stomach, which I’ve read on here can make a difference.

The results are in normal range so the GP did not think much of them, however I have so many of the symptoms of hypothyroid I’m wondering if it is worth it to test again along with vitamin levels to be sure?

TSH 2.26 uu/ml (0.27 - 4.20)

Free T4 14.1 pmol/l (11.0 -26)

Free T3 4.0 pmol/l (3.9 - 6.8)

The only other thing from the fatigue screen showing out of range was low lymphocytes and high creatinine - I’ve added the other items tested in the photo in case useful.

[SlowDragon Administrator]

There’s very little thyroid related there

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 D, folate, ferritin and B12 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)

Is this how you did your 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...

Often cheaper if order on a Thursday

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

[greygoose]

A TSH over 2 does suggest that your thyroid is struggling. A euthyroid TSH is around 1, never over 2, and you are hypo at 3. Although you would never get an NHS doctor to admit that!

That said, TSH is not a thyroid hormone, it is a pituitary hormone - Thyroid Stimulating Hormone. And, when a doctor says that the TSH tells him all he needs to know, he's assuming that all pituitaries function perfectly. The problem is, they don't.

So, let's have a look at your thyroid hormones themselves:

Free T4 14.1 pmol/l (11.0 -26)

20.67%

Free T3 4.0 pmol/l (3.9 - 6.8) 3.45%

A euthyroid FT4 would be about 50% through the range. Yours is only just over 20%;

A euthyroid FT3 would be somewhere around 45-50%. Yours is only 3.45%! That is very, very low. And, with a low FT3 like that, one would expect the TSH to be quite a bit higher.

So, it's quite possible that what you are looking at here is Central Hypo. Central Hypo is when the problem comes from the pituitary (Secondary hypo) or the hypothalamus (Tertiary Hypo), rather thant he thyroid itself (Primary Hypo).

If that's what you have - and you can't really claim that on the basis of one blood test - but if that's what you have, the treatment would be the same as any other form of hypothyroidism, but the difficulty is getting diagnosed! The majority of doctors have never even heard of Central Hypo. So, before tackling your doctor on this subject, I would suggest you do your homework, so that you know what you're talking about and can fight your corner against doctor-ignorance. And, it certainly would be worth getting tested again, but maybe leave it for a couple of months? I don't know, you don't say when these tests were done.

[Zanna_88 in reply to greygoose]

Thanks very much I’ll definitely look into central hypo before my next appointment 🙂 - I did these blood tests 2 months ago so was thinking of doing vitamin levels anyway soon so may as well do the thyroid too at the same time

[greygoose in reply to Zanna_88]

Yes, that sounds like a decent time gap.

[userotc in reply to Zanna_88]

Re CH, you could try to find it's root cause when you research it. I'm working on what I believe is mine.

[Nanaedake]

If these were my results, I'd be discussing the creatinine result with my GP, getting a GFR, kidney blood test and ruling out a urinary tract infection. As these were 2 months ago though, what's happened in the intervening period? Have you seen your GP?

[Zanna_88 in reply to Nanaedake]

Yes I’ve seen the gp mid- may and she is going to have the out of range ones retested after a month so mid- June. I did have GFR done at the same time as these bloods it’s at 75 (abnormal ref <60), but I do also have abdominal pain and had asked about urinary tract infection at my very first appointment back in February, but as I didn’t have other symptoms of it and I did have melasma, excess hair and fatigue I had an ultrasound for PCOS which didn’t show anything (this also took longer as the internal machine was broken so needed to go back again) - then I decided to just get some blood tests done myself as the wait for a gp appointment was another 3 weeks. I’ll definitely ask about testing urinary tract infection again

[humanbean]

You might find this thread of interest :

healthunlocked.com/thyroidu...