Dear all, my 13 year old hormonal daughter has been very tired but also struggles to sleep. Her T4 level is 12 (range 11-22) , TSH 2.29 (range 0.27-4.20). To me this seems very low?
Her ferritin level is 36 (range 13.00-150).
Thyroid issues run in the family. My mother is under active and I had graves thyrotoxocosis and had to have a thyroidectomy. I also suffer with ferritin and was under the impression that optimal is at least 50 and anything under should have an iron infusion - irrespective of whether your iron levels are ok.
Please can you let me know your thoughts as GP says normal no action required but I don’t trust him.
Thank you
Written by
JemimahR
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For full Thyroid evaluation you and your daughter need 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
Low vitamin levels are extremely common, especially with autoimmune thyroid disease
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)
Request/insist GP test vitamins and antibodies
Ferritin is bordering on deficient
Is she vegetarian or vegan
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). 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. Request coeliac blood test BEFORE considering trial on strictly gluten free diet
I also suffer with ferritin and was under the impression that optimal is at least 50 and anything under should have an iron infusion - irrespective of whether your iron levels are ok.
I'm not sure where you've heard that but I understand that it's not easy to get an iron infusion.
Her ferritin level is very low and anything below 30ug/L confirms iron deficiency according to NICE:
In all people, a serum ferritin level of less than 30 micrograms/L confirms the diagnosis of iron deficiency.
As she's above that level it might be difficult to persuade her GP to do anything but I'd try and get an iron panel done, this will include Serum Iron, Transferrin Saturation, Total Iron Binding Capacity as well as Ferritin and this would show if she has iron deficiency. A full blood count would be useful too as this would show if she has anaemia.
Has she had thyroid tests before and has she had very low/below range FT4 before? If so then there is a possibility it may suggest Central Hypothyroidism which is where the problem lies with the pituitary or the hypothalamus and it can't send the signal to tell the thyroid to make hormone so FT4 stays low. I don't know whether FT4 just scraping into range at 9.09% through range would be considered to be suggestive of Central Hypothyroidism and as it's not very common her GP may not have heard of it. Perhaps something her GP can look into and maybe contact a thyroid specialist (not an endo who is a diabetes specialist but a proper thyroid specialist who are probably as rare as hens' teeth).
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