what do my results mean: 6 months ago I was... - Thyroid UK

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what do my results mean

rain13 profile image

6 months ago I was diagnosed with thyroiditis and had the following levels;

Free T4 of 36

TSH 0.01

now I have the following;

Free T4 of 13.4

TSH 4.23

I'm confused as I've been told my new TSH means I have an underactive thyroid, but my new Free T4 means I have an overactive ?

Am I right.

51 Replies
SlowDragon profile image
SlowDragonAdministrator

Please add ranges on Ft4 and TSH

Ft4 looks likely low in range

Autoimmune thyroid disease (also called Hashimoto’s) almost always starts with transient hyperthyroid results and symptoms, before becoming increasingly hypothyroid as thyroid gets more destroyed

For full Thyroid evaluation you need TSH, FT4 and FT3 plus both TPO and TG thyroid antibodies tested.

Very 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)

Low vitamin levels common as we get older too

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)

Private tests are available as NHS currently rarely tests Ft3 or all relevant vitamins

List of private testing options

thyroiduk.org/getting-a-dia...

Medichecks Thyroid plus antibodies and vitamins

medichecks.com/products/adv...

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). Ord’s is autoimmune without goitre.

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 too

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...

rain13 profile image
rain13 in reply to SlowDragon

vitamin D, folate, ferritin and B12 Are all low as I have a condition where my stomach won’t absorb those vitamins. I’m on calcitriol tablets daily and b12 injections too but these still remain lowTSH RANGE 0.01 -5.00

Free T4 range 8-12

T3 was within normal range on this test and previous

TPO was normal now and before.

Tg antibodies were and are negative

The consultant said my TSH was at the upper end of normal but my Free T4 was also at the high end ? Which isn’t usually the case?

When I had thyroiditis I was told I had an overactive thyroid and it was swollen and had nodules on. I had no symptoms apart from a swollen neck and pain in thyroid.

Symptoms now are weight gain, sweats, blurred vision and hair loss.

Within 6 months my TSH has gone from 0.01 to 4.23 and my free T4 has gone from 36 to 13.4

SlowDragon profile image
SlowDragonAdministrator in reply to rain13

“I have a condition where my stomach won’t absorb those vitamins”

Yes….it’s call hypothyroidism …..most likely Hashimoto’s

Extremely common to have low vitamin levels when hypothyroid

Endocrinologist likely a diabetes specialist

When I had thyroiditis I was told I had an overactive thyroid and it was swollen and had nodules on. I had no symptoms apart from a swollen neck and pain in thyroid.

Symptoms now are weight gain, sweats, blurred vision and hair loss.

Within 6 months my TSH has gone from 0.01 to 4.23 and my free T4 has gone from 36 to 13.4

Yes that’s pretty text book Hashimoto’s

Exactly what vitamin supplements are you currently taking

What were most recent results for vitamin D, folate, ferritin and B12

optimal vitamin levels are

Vitamin D at least around 80nmol and around 100nmol maybe better

Folate and ferritin at least half way through range

Serum B12 at least over 500

rain13 profile image
rain13 in reply to SlowDragon

I take magnesium. Vit c. Muti vit. Cod liver oil and evening primrose Vit D is nearly non existent

FolAte and ferritin in bottom half of range

B12 on a normal range of 180-914 ng/L mine is 80ng/L on average and 98ng/L after my injections

SlowDragon profile image
SlowDragonAdministrator in reply to rain13

Multivitamins are never recommended on here.

They are for the worried well, too little to make any difference, usually cheap, poorly absorbed ingredients

Most contain iodine best avoided with autoimmune thyroid disease

Always stop taking any supplements that contain biotin a week before ALL BLOOD TESTS as biotin can falsely affect test results

B12 injections

You should have been started on loading injections. Several injections, over first few weeks, then moving to once every 2 months….or possibly more frequently

Low folate

Are you currently prescribed folic acid

Ferritin

Have you had full iron panel test for anaemia?

If not …..request one

Or test yourself

medichecks.com/products/iro...

How low is vitamin D

How much vitamin D are you currently taking

NHS Guidelines on dose vitamin D required

ouh.nhs.uk/osteoporosis/use...

Extremely common when hypothyroid to need high dose vitamin D to maintain good vitamin D levels

rain13 profile image
rain13 in reply to SlowDragon

Iron levels are good and I’m not anemic

SlowDragon profile image
SlowDragonAdministrator in reply to rain13

What are ferritin results and ranges

rain13 profile image
rain13 in reply to SlowDragon

110 (11 to 307)

SlowDragon profile image
SlowDragonAdministrator in reply to rain13

So that’s ok

rain13 profile image
rain13 in reply to SlowDragon

Apparently

SlowDragon profile image
SlowDragonAdministrator

Free T4 of 13.4

TSH 4.23

Ft4 Range 8-12

That’s an extraordinary range for Ft4

I should double check that

rain13 profile image
rain13 in reply to SlowDragon

I will check

rain13 profile image
rain13 in reply to SlowDragon

8.4 - 15.6 Range

SlowDragon profile image
SlowDragonAdministrator in reply to rain13

Ft4. 13.4 (8.4-15.6)

It’s a very unusual range

If correct….Ft4 is currently 69% through range

Helpful calculator for working out percentage through range

chorobytarczycy.eu/kalkulator

rain13 profile image
rain13 in reply to SlowDragon

Consultant says my TSH and Ft4 are at opposing ends of what won’t even expected

SlowDragon profile image
SlowDragonAdministrator in reply to rain13

Well you can’t use thyroid hormones if vitamins are low ….often Ft4 is false high if vitamins are dire

Ft3 is low at only 30% through range

Low Ft3 shows you’re hypothyroid

Low Ft3, leads to low stomach acid, low vitamin levels as direct result

rain13 profile image
rain13 in reply to SlowDragon

I have low stomach acid due to an neutropenia

SlowDragon profile image
SlowDragonAdministrator in reply to rain13

Neutropenia is linked with hypothyroidism

ncbi.nlm.nih.gov/pmc/articl...

In conclusion, the frequency of thyroid disease among patients with mild to moderate neutropenia is higher than previously reported. A comprehensive evaluation of thyroid function tests as well as antithyroid Abs in patients with neutropenia is mandatory, even in the absence of related symptoms

oatext.com/isolated-non-aut...

Thus, hypothyroidism should be considered in the differential diagnosis of neutropenia and it is recommended to screen for thyroid dysfunction in front of any leukopenia that does not prove itself.

rain13 profile image
rain13 in reply to SlowDragon

Lol. Might as well put me down 😂

SlowDragon profile image
SlowDragonAdministrator in reply to rain13

Likely to improve once you get thyroid levels optimal

rain13 profile image
rain13 in reply to SlowDragon

They are reluctant to put me on treatment for thyroid due to existing conditions

SlowDragon profile image
SlowDragonAdministrator in reply to rain13

Which existing conditions?

Have you had cholesterol levels tested?

High cholesterol is linked to being hypothyroid

rain13 profile image
rain13 in reply to SlowDragon

Neutropenia and thrombocytopenia and anti phospholipid syndrome and secondary raynauds

SlowDragon profile image
SlowDragonAdministrator in reply to rain13

Thrombocytopenia and hypothyroidism

ashpublications.org/blood/a...

Hughes syndrome strongly linked to autoimmune thyroid disease

pubmed.ncbi.nlm.nih.gov/204...

Hypothyroidism is present among 22% of PAPS patients and thyroid autoantibodies in 18% of them. These findings suggest a common pathophysiologic mechanism between antiphospholipid syndrome and autoimmune thyroid diseases.

Raynauds is extremely common when hypothyroid or under medicated

holisticthyroidcare.net/thy...

healthunlocked.com/search/p...

rain13 profile image
rain13 in reply to SlowDragon

Might look like my thyroid is linked to all my other conditions then !? Thanks for all the help

SlowDragon profile image
SlowDragonAdministrator in reply to rain13

Yes, at least linked to…..or causing

SlowDragon profile image
SlowDragonAdministrator in reply to rain13

Many consultants just don’t understand the interconnection between poor gut function, low vitamin levels and hypothyroidism

Hi rain13, welcome to the forum 🤗

Also welcome to the confusion. Most of which will come from the medical professionals who are supposed to be supporting you. Sorry about that but don’t worry, you’ll get lots of support and patient to patient ‘advise’ here.

You say your FT3 is normal but can you tell us what the latest result is and the range. It’s so easy for us to assess your results if they’re written :- Test, result and (range in brackets)

For example :-

FT4 13.4 (8-12)

TSH 4.23 ( 0.01 - 5)

So yes you’re FT4 is just over range but without knowing what your FT3 is we don’t have the full picture.

Your TSH is high in range and so it shows that you are likely low in thyroxine (FT3 - the active stuff that makes everything work) and so your pituitary is sending down ‘Thyroid stimulating hormone’ to your Thyroid to make more thyroxine but it’s falling on deaf ears.

rain13 profile image
rain13 in reply to NWA6

FT3 4.2 (3.1 - 6.8)

NWA6 profile image
NWA6 in reply to rain13

So it’s low in range, if your FT4 wasn’t over range it would be even worse and maybe even below.

Did you start any treatment yet? Shame they didn’t do an FT3 test when your FT4 was 36 because as it stands now, it looks like you don’t convert very well.

rain13 profile image
rain13 in reply to NWA6

No treatment advised. Just to check levels again in 6 months!My ft3 was virtually the same as now when my ft4 was 36

NWA6 profile image
NWA6 in reply to rain13

So, yeah, poor convertor. Did I see in your reply to Slowdragon that the range is actually (8-15), it is an unusual range, are you in the UK? But no matter, you’re FT4 looks ok then, not over range, nearly 70% in range is pretty solid but unfortunately with a low FT3, everything’s going to still feel like you’re walking through sludge. Getting Vits and minerals high enough is akways best but it’s a case of them and thyroid working together and so which comes first. Sometimes, you can’t get your Vits and minerals to a decent level without good thyroid levels and then also we can’t (more natural) get our thyroid levels optimal without good Vits and minerals. It’s a hard balance. But as you’re not started on any Levo yet, really try and get Vits and minerals high first.

rain13 profile image
rain13 in reply to NWA6

It’s a never ending circle of trying to balance stuff out. I have opposing health conditions that I really shouldn’t be able to have in the same body. And as they switch between the two (neutropenia and thrombocytopenia) daily they find it hard to put me on a constant treatment

NWA6 profile image
NWA6 in reply to rain13

🤔 maybe I’ll have to educate myself a little more on those conditions. But I really don’t think they are competing conditions, I suspect they are the product of your Hashi’s.

I wonder if they will correct themselves once you have all your ducks in a row.

rain13 profile image
rain13 in reply to NWA6

They say I haven’t got hashimoto’s

NWA6 profile image
NWA6 in reply to rain13

Yeah, but you most likely have with those swings and a goitre. I bet this is overwhelming. Let it sink in and then the questions will start forming 🤗

SlowDragon profile image
SlowDragonAdministrator in reply to rain13

UK medics never call it hashimoto’s

Only autoimmune thyroid disease….and they completely ignore autoimmune aspect

Your scan shows nodules

Nodules suggests autoimmune thyroid disease

NWA6 profile image
NWA6 in reply to NWA6

No multivitamins. You need individual supplements that target exactly what you need. High folate in order to make those B12 injections properly work.

Vit d (+K2) Betteryou sprays to avoid gut absorption (which you probably have trouble with if you’re not absorbing B12 from food)

Bcomplex to balance out the B12

Selenium to help thyriod function

rain13 profile image
rain13 in reply to NWA6

It’s just getting really complicated

mistydog profile image
mistydog in reply to rain13

Welcome to our world! Unfortunately medics seem to be poorly educated in thyroid matters (take this tablet, it will solve everything, when it doesn't, well it must be something else). You've done the best thing by joining this group, read and educate yourself, always get copies of results and be your own advocate. Good luck, thyroid journeys aren't fun but once you get in balance things will all improve.

SlowDragon profile image
SlowDragonAdministrator

pubmed.ncbi.nlm.nih.gov/286...

Vitamin D deficiency is frequent in Hashimoto's thyroiditis and treatment of patients with this condition with Vitamin D may slow down the course of development of hypothyroidism and also decrease cardiovascular risks in these patients. Vitamin D measurement and replacement may be critical in these patients.

pubmed.ncbi.nlm.nih.gov/273...

Vitamin D insufficiency was associated with AITD and HT, especially overt hypothyroidism. Low serum vitamin D levels were independently associated with high serum TSH levels.

pubmed.ncbi.nlm.nih.gov/300...

The thyroid hormone status would play a role in the maintenance of vitamin D sufficiency, and its immunomodulatory role would influence the presence of autoimmune thyroid disease. The positive correlation between free T4 and vitamin D concentrations suggests that adequate levothyroxine replacement in HT would be an essential factor in maintaining vitamin D at sufficient levels.

ncbi.nlm.nih.gov/pubmed/300...

ncbi.nlm.nih.gov/pmc/articl...

Our results indicated that patients with hypothyroidism suffered from hypovitaminosis D with hypocalcaemia that is significantly associated with the degree and severity of the hypothyroidism. That encourages the advisability of vit D supplementation and recommends the screening for Vitamin D deficiency and serum calcium levels for all hypothyroid patients.

rain13 profile image
rain13 in reply to SlowDragon

Oh heck this is confusing

SlowDragon profile image
SlowDragonAdministrator in reply to rain13

Being hypothyroid frequently results in low vitamin D

When hypothyroid it’s important to get vitamin D levels optimal by supplementing…..at high dose if necessary

rain13 profile image
rain13 in reply to SlowDragon

I’m on calcitriol for low bit d

SlowDragon profile image
SlowDragonAdministrator in reply to rain13

Likely a minute dose of vitamin D in that - look on the packet

What’s the most recent vitamin D result

When hypothyroid Likely to need at least 2000iu vitamin D daily…..or often even higher dose to increase levels

Once you Improve level, very likely you will need on going maintenance dose to keep it there.

Not unusual to need 2000-3000iu as maintenance dose

Test twice yearly via NHS private testing service when supplementing

vitamindtest.org.uk

Vitamin D mouth spray by Better You is very effective as it avoids poor gut function. There’s a version made that also contains vitamin K2 Mk7

One spray = 1000iu

amazon.co.uk/BetterYou-Dlux...

Hi rain13❤️I was interested in reading your post, first I also have ongoing conditions, chronic fatigue syndrome, fibro, colitis ect, in 2013 I started with awfull symptoms I couldn't connect with my ongoing symptoms (above) my gp did send me to an endo who did tests but I must state I have only found the results of these tests last year when I requested my medical records the gp told me nothing of these reports, the endos report states "this is her second blood tests and again as shown TSH low at 0.08 but her free T3 is again normal having come down from 5.8..to 4.8..(ranges.. 3.10..6.8)..Then in 2014 I had another report ( only saw this last year as I said) it says.. Probably thyroiditis!!! Then a report from 2015.. Thyroiditis?? But goes on to say "physiological tremor, sweating, palpitations, no goiter, probably the menupause, discharged to gp.. Unfortunately for me my gp went with this diagnosis for all my symptoms until sep 18th 2018 when after many trips to my surgery I collapsed and where taken to my surgery were the new gp diagnosed me their and then on my symptoms as hyperthyroidism ( overactive thyroid) I went into thyroid storm and were rushed to hospital where I went on to have a thyroidectomy.. 😠 Sorry for the long story 😔 but the moral is all the jigsaw pieces were their just needed a good specialist to see them, unfortunately I didn't have good specialist or a good gp.. Thank god that gp had only joined our practice because she got it immediately, your probably not getting the treatment you deserve and all your jigsaw pieces are their, like me they will probably just leave you, I know more now about thyroid illness than ever before after joining this group and one thing I've learnt is you have to fight for your own thyroid health, as many endos don't know much about this illness, I totally blame the lack of knowledge on both sides (, GP..ENDOS) I hope you manage to sort it out as you say it is confusing but the great people on here will help ❤️❤️❤️

rain13 profile image
rain13 in reply to birkie

Thanks 😊

Hi rain13!To everyone-

How can Tsh normal range start at 0.01?

helvella profile image
helvellaAdministrator in reply to Ginny52

It looks like a mistake - somewhere!

rain13 profile image
rain13 in reply to Ginny52

My bag. My original result was 0.01 range is 0.5-5

Ginny52 profile image
Ginny52 in reply to rain13

Ah, you’re in the same boat as me! Xx

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