Thyroid results initially given to me as Free Thyroxine 10.3 Range 12-22
TSH - 2.39 of range 0.27 - 4.2
I am having TPO checked with these again on Monday. I am confused, I thought TSH would be a high reading if the free thyroxine is below range as such to pull the thyroxine level back into range?
I really have no idea what this means. GP was a complete nightmare talking a mile a minute and giving broadbrush generalisations whilst "let me stop you there" type behaviour towards me.
This falling below range free thyroxine has been going on with me since 2018.
Very sick and tired of it all.
Thank you
H...
Written by
HellyLlewelly
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Am I right in assuming that you do not have a diagnosis of hypothyroidism and are not on any thyroid hormone replacement?
If so then you could be looking at Central Hypothyroidism which is diagnosed when TSH is low, normal or minimally elevated with a low/below range FT4.
Central Hypothyroidism is where the problem lies with the hypothalamus (Tertiary Hypothyroidism) or the pituitary (Secondary Hypothyroidism), rather than the thyroid, and the TSH signal can't get through to the thyroid to tell it to make thyroid hormone hence the very low FT4 level.
Here is some information about Central Hypothyroidism.
Your GP can look at BMJ Best Practice for information - here is something you can read without needing to be subscribed:
You could do some more research, print out anything that may help and show your GP.
As Central Hypothyroidism isn't as common as Primary Hypothyroidism it's likely that your GP hasn't come across it before. You may need to be referred to an endocrinologist. If so then please make absolutely sure that it is a thyroid specialist that you see. Most endos are diabetes specialists and know little about the thyroid gland (they like to think they do and very often end up making us much more unwell that we were before seeing them). You can email Dionne at
tukadmin@thyroiduk.org
for the list of thyroid friendly endos. Then ask on the forum for feedback on any that you can get to. Then if your GP refers you, make sure it is to one recommended here. It's no guarantee that they will understand Central Hypothyroidism but it's better than seeing a diabetes specialist. You could also ask on the forum if anyone has been successful in getting a diagnosis of Central Hypothyroidism, possibly in your area which you'll have to mention of course.
Obviously, if you already have a diagnosis and take Levothyroxine, you can ignore everything I've just said 😊
Just testing TSH and Ft4 is completely inadequate, especially as you have endometriosis
Endometriosis and autoimmune thyroid disease often linked
Vast majority of primary hypothyroidism is autoimmune thyroid disease also called Hashimoto’s diagnosed by high thyroid antibodies
GP stonewalling you as they are probably out of their depth
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 with autoimmune thyroid disease (Hashimoto’s or Ord’s thyroiditis)
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)
When were vitamin D, folate, ferritin and B12 last tested
Low ferritin and iron common with endometriosis
Low vitamin levels tend to lower TSH
Private tests are available as NHS currently rarely tests Ft3 or all relevant vitamins
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.
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