This is new to me
Please advise what these results from my male friend ( 64 years old) mean :
Ref Range
Free T4 15.2 ( 9.1 - 24.4 )
Free T3 3.51. (3.13 - 6.76 )
TSH. 5.88. ( 0.30 - 4.64 )
***C- Reactive protein 7.01. ( > 5.0)
This individual had part of his thyroid removed in his early 20s.
Is your friend taking any thyroid hormone replacement? Because our interpretation of the results would depend on knowing that. 
No he is not been treated for thyroid problems only hypertension
Well, the hypertension is probably due to him being hypo, because it looks like that's what he is.
But, is this test a one off? Or has he had other tests with an over-range TSH?
Free T4 15.2 ( 9.1 - 24.4 ) 40.4%
This is quite low. Euthyroid (someone with no thyroid problems whatsoever) would have an FT4 of around 50%
Free T3 3.51. (3.13 - 6.76 ) 10.74%
This is very low. Euthyroid would be a slightly lower percent than the FT4. So, it looks like he might have a conversion problem as well as being hypo.
TSH. 5.88. ( 0.30 - 4.64 )
This is much too high. Euthyroid is around 1, never over 2, and you are hypo when your TSH reaches 3.
***C- Reactive protein 7.01. ( > 5.0)
This is an inflammation marker. So, he has high levels of inflammation.
Thank you so much for your advise. I have suggested that he see an endocrinologist ASAP.
Well, he does need a retest a couple of months after getting these results, because they won't treat on the basis of one test. But, if a second test gives similar results, then he absolutely should be put on thyroid hormone replacement.
Does he know to get tested as early as possible in the morning - before 9 am - after fasting over-night? That will give him the highest possible TSH and increase his chances of getting treated.
Thank you so much for your advise. He has decided to see an Endo privately, as speed is of the essence.
You're welcome.
Hello Arkenstone and welcome back :
Can I just ask confirm that since your friend has had surgery and is only with 50% of his thyroid that he is already on thyroid hormone replacement , and if so, what is he taking and at what dose ?
The TSH is over the range and if on thyroid hormone replacement this should be down at under 2 and most of us feel at our best when the TSH drops down further towards the bottom of the range.
The TSH will lower with each dose increase in T4 - Levothyroxine :
Generally speaking the starting dose is 50 mcg T4 a day and after 6-8 weeks a further blood test is run and the dose likely increased again by 25mcg a day, and this is repeated every 6-8 weeks until a dose is reached where there is relief of symptoms and with the T3 and T4 remaining in the ranges.
This generally sees the T4 rise into the top quadrant of the range with the T3 rising proportionately in the range at around a 1/4 ratio T3/T4.
Currently the T4 is at just around 40% with the the T3 at around 11% and both these need to rise through the ranges and will do so, with slow and steady dose increase in T4 - Levothyroxine and hopefully whatever symptoms he is dealing with, will be relieved as his T3 and T4 slowly rise up to optimal levels within the ranges.
T4 is a storage hormone and needs to be converted by the body into T3 the active hormone that the body runs on and conversion can be compromised by low ferritin, folate, B12 and vitamin D. inflammation, depression, any physiological stress ( emotional or physical ) , dieting and ageing.
Once your friend is optimal in the ranges , if symptoms remain, there may then be a discussion on how to improve and restore well being with other or additional thyroid hormone replacement options.
Dear Penny,
Strangely, he has never been given thyroid supplements. I was quite shocked to hear that he has not been treated for it. I have asked him to see an endocrinologist ASAP. Thank you so much for your guidance.
Well in the first instance I think his GP should be the person he contacts and s/he will hopefully commence treatment with T4 thyroid hormone replacement and will process a referral to endocrinology if T4 monotherapy doesn't resolve the symptoms being suffered.
A TSH over 3 is where many countries acknowledge the patient is unwell and dealing with hypothyroidism, and in the UK we used to start treatment when the TSH went above 5 - but now we need to be scoring 10 twice at two different blood tests months apart, which is quite ridiculous, but there you go.
Obviously if speed is the deciding factor likely going private will be the next best step but choose wisely, Thyroid UK the charity who support this forum hold a list of recommended endos and specialist both NHS and private which might be useful to refer to for someone within travelling distance
This can be emailed to you by return ,but you'll now ned to 4th/ 5th to find anyone there.
I'd suggest a further private blood test for a full thyroid panel as you'll learn a lot more here in a couple of weeks than the average doctor or endo knows in a life time.
When hypothyroid, metabolism slows down and this in turn makes it difficult to extract essential core strength vitamin and minerals from food, despite eating clean and healthily.
If we know where these sat we could suggest the necessary supplements needed to start building these back up in preparation for optimal absorption of the thyroid hormone replacement which is likely going to be prescribed in due course.
Dear Penny, Your advise was invaluable. As speed is of the essence he has decided to see and Endocrinologist privately.
Maybe cut a corner by getting the private blood test full thyroid panel actioned beforehand so there are some results and ranges for work from.
If there's time before the appointment post the results and ranges on here first so you'll have some information and suggestions to what should happen next :
Keep us in the loop :
Thank you I will do that. On another matter, isn’t it rare for a male to have thyroid issues?
Good morning ;
It would seem so, but it's not unheard of :
There are men on this forum, he's not alone :
Irrespective of sex having had thyroid surgery and struggling on, trying to function, with no thyroid hormone replacement support will have put a massive strain on his entire body.
Recommend he get vitamin D, folate, ferritin and B12 levels tested as next step
Very common when hypothyroid to have low vitamin levels
Low vitamin levels are also much more common as we get older
Is he currently taking any vitamin supplements?
Thyroid levels should be retested 6-8 weeks after first abnormal thyroid results
Do you know the reason for hemi thyroidectomy?
For full Thyroid evaluation he needs TSH, FT4 and FT3 plus both TPO and TG thyroid antibodies tested.
Very important to test vitamin D, folate, ferritin and B12 at least once year minimum
Test vitamin D twice year if supplementing
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...
NHS easy postal kit vitamin D test £29 via
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.
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...
Thank you for your advice slowdragon. I do not know the reason for his thyroidectomy. I have asked him to join healthunlocked.com. I hope he does, as I believe he will need quite a bit of support and I am not sure if he would be comfortable in providing me all his health details as more detailed information will be required for all of you to assess his health situation.
Wishing everyone at Healthunlocked.com a very blessed and peaceful New Year. You are all God Sent.
Thank you so much for all your advice, He has decided to see an Endo privately as speed is of the essence.
Vast majority of endocrinologists are diabetes specialists and useless for thyroid
Email Thyroid UK for list of recommended thyroid specialist endocrinologists...
NHS and Private
tukadmin@thyroiduk.org
Currently an extremely long wait on NHS….often around a year
We ALWAYS recommend getting FULL thyroid and vitamin testing done BEFORE booking any consultation
A) if vitamin levels are low, need to improve low levels by supplementing first then retest thyroid in 2-3 months to see if improved.
B) without full testing before consultation the appointment is waste of time
C) extremely important to test early morning before eating or drinking anything other than water……not after a consultation
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