T4 question

[Edso57]

Hi

Haven’t had a blood test for a while but last private test for thyroid (Blue Horizon) showed a TSH of 0.38 (range 0.27 to 4.2) a Free T4 of 15.72 (so 33% of range 12 to 22) and a Free T3 of 4.4 (range 3.1 to 6.8). Test was taken first thing in the morning and after fasting. This was over 5 years ago ….

Lots of hypo symptoms, so I would welcome any comments ! (GP / NHS lab will only test TSH?!)

[fuchsia-pink]

It's a shame that your GP is so ill-informed ... Your TSH will tell her/him that everything is fine, and it clearly isn't. Most of us need our actual thyroid hormones in the top third (or higher) of the lab-range - and don't care what TSH shows once we are on thyroid meds, as this becomes pretty irrelevant.

So basically you need a dose increase - an extra 25 mcg a day of levo - but you may have a fight on your hands to get it x

[Edso57 in reply to fuchsia-pink]

Thanks for the reply but I’m not currently on any medication, GP won’t/ can’t (lab!) test T4 as TSH “in range”. T4 was lower end of range 5 years ago so would be interesting to know what it might be now ! I guess another private test is the only answer. Sigh ….

[fuchsia-pink in reply to Edso57]

Aah. Sorry. I'd see if the GP will test your thyroid antibodies then. Basically they won't start prescribing thyroid meds until TSH is waaaay over -range - unless (a) free T4 is under-range (and yours isn't) OR (b) antibodies are high. This then puts them on notice that you are likely to need medication at some point ... and they should then test TSH and free T4 to see when they think you should be started on levo

But if antibodies are normal, you'll need to look more widely to see what the issue is. I'd start with testing ferritin folate, vit D and B12 myself - post the results here and boost whatever needs boosting x

[Edso57 in reply to fuchsia-pink]

I supplement with high strength vitamin B12 (2500 mcg), vitamin D (4000 IU) , vitamin K2 and a B complex with methyl folate. Tests were all done after fasting first thing in the morning

[SlowDragon Administrator]

Obviously you need to get full thyroid and vitamin testing redone

Very important to test vitamins as well as thyroid

And to test thyroid antibodies

A test even a year ago would be too long ago

Always test as early as possible in morning before eating or drinking anything other than water to get highest TSH

What vitamin supplements are you currently taking, if any

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 at least once year minimum

Low vitamin levels are extremely common, especially with autoimmune thyroid disease (Hashimoto’s or Ord’s thyroiditis)

Autoimmune thyroid disease with goitre is Hashimoto’s

Autoimmune thyroid disease without goitre is Ord’s thyroiditis. Both are autoimmune and generally called Hashimoto’s.

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...

[Edso57 in reply to SlowDragon]

I supplement with high strength vitamin B12 (2500 mcg), vitamin D (4000 IU) , vitamin K2 and a B complex with methyl folate. Tests were all done after fasting first thing in the morning.

[SlowDragon Administrator in reply to Edso57]

So you should be testing vitamin D twice year

You could be taking too much

Test B12, folate and ferritin at least once a year

Remember to stop taking vitamin B complex a week before ALL blood tests as biotin can falsely affect test results

[SlowDragon Administrator in reply to Edso57]

NHS easy postal kit vitamin D test £29 via

vitamindtest.org.uk

Or here

monitormyhealth.org.uk/

[Edso57 in reply to SlowDragon]

Thank you. Btw, I only supplement vitamin D in winter, I get a lot of exposure to sunlight in summer months 😎

[Edso57]

With a low’ish TSH and a FT4 towards lower end of range (and *lots* of hypo symptoms) could this be central / secondary hypothyroidism?

[SlowDragon Administrator in reply to Edso57]

Or autoimmune thyroid disease….important to test thyroid antibodies

Low vitamin levels tend to lower TSH

Hence reason why important to regularly retest vitamin levels