Hello! I have low T4 but normal TSH. Should I be taking Levothyroxine? Thanks

[marbo]

Hello,

I was wondering if you could help and make any suggestions.

My T4 level is low – (8.4pmol/l) but my TSH level is normal (2.25 mIU/L)

I have the following symptoms;

Fatigue

Weight Gain (spare tire)

Cannot lose weight regardless of how little I eat

Cold intolerance

Painful muscles and joints

Anxiety and/or depression

Forgetfulness and poor focus

Excessive thirst and urination

I also have low testosterone levels

My doctor says there is nothing wrong with my thyroid or pituitary.

I am starting to suspect an issue with my pituitary which causes issues in other parts of the endocrine system.

What do you think is likely to be the problem?

Should I try taking Levothyroxine to raise T4 even though my TSH is normal?

Thanks for your help

[SeasideSusie Remembering]

marbo

What is the range for your FT4? The ranges vary from lab to lab. With my lab's range of 7-17 you wouldn't be below range but for all the others we see posted on the forum it will be.

[marbo in reply to SeasideSusie]

Hi - thanks for your reply. The range was 7-17pmol/l so although low it is not considered abnormal by the NHS. However I do have a lot of symptoms so something is definitely wrong. Do people just self medicate if their doctor is not being helpful? thanks

[SeasideSusie Remembering in reply to marbo]

Marvo

Next step would be to have thyroid antibodies tested and key nutrients. Low nutrient levels or deficiencies can have symptoms which overlap with symptoms of hypothyroidism:

Vit D

B12

Folate

Ferritin

If GP wont or can't do all tests then we have recommended private labs that offer them.

MEDICHECKS Advanced Thyroid Function or BLUE HORIZON Thyroid Premium Gold.

Details and discount codes here:

thyroiduk.org/help-and-supp...

[SlowDragon Administrator]

Always test thyroid levels as early as possible in morning before eating or drinking anything other than water.. this gives highest TSH

Important to regularly retest vitamin D, folate, ferritin and B12

Have you had thyroid antibodies tested?

[marbo in reply to SlowDragon]

I have just ordered a thyroid and antibody test. It will give thyroglobulin antibodies and Thyroid peroxidase antibodies levels so should have more information.

My Vit D is 138 nmol/l (range 50 -250)

Folate is 24ugl (range 3-20 so mine is Abnormal)

Vit B12 869 ugl (range 145-910)

Ferritin is 95ugl (range 15-200)

I do take Vitamin supplements which might explain the high levels?

[SlowDragon Administrator in reply to marbo]

Yes, likely to need to reduce vitamin supplements a little

Exactly what vitamin supplements are you currently taking

You should always stop any supplements that contain biotin a week before ALL BLOOD TESTS as biotin can falsely affect test results

[silverfox7]

Most feel better if TSH is nearer 1 or even lower. So I would take that into consideration.

[marbo in reply to silverfox7]

Do you think my TSH is too high. Is this likely because T4 is low and it is trying to stimulate production of T4 but failing so TSH permanently elevated?

[silverfox7]

TSH is on the high side but don’t fall in the trap of changing too many things at once as both you and your thyroid could get confused! Remember that each time you change something that it could affect other readings so you don’t want to end up just being confused but look at cause and effect. It can be safer not to seconded guess-you may be right but you could also be wrong so look more on what else changes and does this help your issue. Get used to listening to your body and feeling what it is saying. We can offer suggestions but only you know and feel the response and always go slowly. Nothing works quickly in our thyroid world so if something doesn’t cause upset then maybe give it time to develop but always make notes on the journey as it can sometimes slip your mind what you have changed.

[PixieElv]

Hi MarcoYou could have central or secondary hypothyroidism, which is what I have. Apparently nothing obvious wrong with my thyroid or pituitary gland but the pituitary gland just isn’t functioning properly. According to my Endo that’s a thing.

Levothyroxine changed my life.

I had all the symptoms you have but feel so much better now!

It took me 4 years to get a diagnosis as this condition is so rare. You are told there’s nothing wrong with you & is all in your head (well the pituitary gland is in your head 😊)

Don’t let them fob you off but get them to treat your symptoms.

Good luck!

[marbo in reply to PixieElv]

Hi PixieElv - how did you find out if there was nothing abnormal on your thyroid tests? How did the endocrinologist test for it? Did you have to go private or was it done on the NHS? thanks

[PixieElv in reply to marbo]

Hello I went private as the GP kept telling me I was fine (I knew I was not as I had all the symptoms)

I’m lucky I have private medical insurance through work.

The private Endo really listen to me. Did all the blood work tests

But he also did an MRI on my pituitary gland to check for any abnormalities.

Mine was just fine, just not working properly.

He then kept slowly increasing my Levo. I am not finished my journey but I feel SO MUCH BETTER!

I’m able to enjoy my kids and friends and I’ve even found a bit of libido…

So if you are able to go and see a private Endo. Unfortunately the NHS does not have the resources. But if you can’t keep pushing and tell them to check for central or secondary hypothyroidism. GPS don’t know about it and Endos don’t check because it’s so rare.

Best wishes

[klr31]

Have you had your blood sugars measured as you mention excessive thirst and urination?

Karen

[marbo in reply to klr31]

Hi Karen - the only thing i have is the Haemoglobin A1c (HbA1c) level which is meant to check Diabetes. My result was 37.29 mmol/mol (range 20-41) So although within range it does seem high considering I have a healthy diet.

[marbo]

I have my results now and have created a new post as advised

healthunlocked.com/thyroidu...

thanks

😀