Help!!

[Sincity34]

My tsh is 6.06 and T4 is 11 but my doctor says I am normal!!! I feel anything but normal. I have made an appointment with a private Endo next week but can anyone tell me what my chances are of getting medication?

[PurpleNails Administrator]

Are you - as of yet - not diagnosed with thyroid condition? If you currently take replacement hormone how much do you take?

Is this the only thyroid test you had? What is the FT4 range. Ranges vary between labs. It is very low by most ranges we see. If may just be in range, which is why dr says not necessary to medicate.

For full thyroid test you need TSH, FT4 & FT3. Thyroid antibodies TG & TPO. Also important to test vitamin D, folate, ferritin & B12.

Ensure you have a complete set of test prior to private appointment so you have all the information you need. Private blood test options are available.

When you test. For consistent results test 1st thing in morning before eating except water & avoid supplements with biotin a week before draw. (Delay any levo dose, until after draw). Was this how the last test was done?

[Sincity34 in reply to PurpleNails]

Not yet diagnosed or medicated. Tpo 0.68, ft4 is 11, tsh is 6.06. my nhs doctor says I'm not bad enough to be medicated despite being symptomatic and won't test me again for a year. This is why I have made a private appointment to get a second opinion.

[PurpleNails Administrator in reply to Sincity34]

Each result will have a lab reference interval for a expected healthy range

EG

FT4 11 (8 - xx) or

FT4 11 (12 - xx)

TPO 0.68 will have a (0 - 34) or >34 as an example of the lab limit.

Dependant on the range, one might shown a result within range the other below.

Above range TSH with within range FT4 is sub clinical and treatment wouldn’t not be offered until FT4 below range or TSH above 10. If 1st test with TSH above range GP should be retesting in 6 - 8 weeks.

If TPO positive some GP will offer treatment early on as decline of thyroid inevitable. Many do not show positive TPO levels but may be TGab positive.

[SlowDragon Administrator in reply to Sincity34]

Thyroid levels should be retested 6-8 weeks after first abnormal test results…..not waiting a year

There are two antibodies linked to autoimmune thyroid disease

TPO and TG (thyroglobulin)

NHS only tests TG antibodies if TPO are high

Significant minority of autoimmune thyroid patients only have high TG antibodies

You will need to test privately to check

Also 20% of autoimmune thyroid patients never have raised thyroid antibodies. An ultrasound scan of thyroid can be helpful if both antibodies are negative

Is there any autoimmune disease in your close family

[Sincity34 in reply to SlowDragon]

Yes my mum and sister have hashimotos. I did have my tsh done back in September and it was 4.2 and my ft4 was 11 then.

[SlowDragon Administrator in reply to Sincity34]

Were both tests done early morning?

Have you had vitamin levels tested

What vitamin supplements are you currently taking

What’s your diet like …..are you gluten free, vegetarian, vegan or on dairy free diet

[Sincity34 in reply to SlowDragon]

No both afternoon. I take Q10, multivitamin, Vit D,5htp, pregnenolone, milk thistle and dandelion. My diet is ok I don't eat much as any thing over 1000 cals causes weight gain. Not any special diet.

[SlowDragon Administrator in reply to Sincity34]

So if had tested early morning TSH would have been higher

Test before 9am ideally

How much vitamin D are you currently taking

[SlowDragon Administrator in reply to Sincity34]

Which multivitamin exactly

Remember to stop taking any supplements that contain biotin a week before all blood tests as biotin can falsely affect test results

[SlowDragon Administrator]

Was this the first abnormal test with TSH over 5

Always test thyroid levels as early as possible in morning to get highest TSH

You need 2nd thyroid test 6-8 weeks after this

See flow chart on top of page 2

gp-update.co.uk/Latest-Upda...

About 90% of primary hypothyroidism is autoimmune thyroid disease, also called Hashimoto’s, usually diagnosed by high thyroid antibodies

Just testing TSH and Ft4 is inadequate

you need thyroid antibodies tested,

TSH, Ft4 and Ft3 tested together

Plus vitamin D, folate, ferritin and B12 tested

Low vitamin levels are extremely common when hypothyroid, especially with autoimmune thyroid disease

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.

In U.K. medics never call it Hashimoto’s, just autoimmune thyroid disease (and they usually ignore the autoimmune aspect)

Recommended on here that all thyroid blood tests should ideally be done as early as possible in morning

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

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

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...

Suggest you reschedule consultation until got full thyroid and vitamin testing otherwise first appointment is waste of time and money

[Sincity34 in reply to SlowDragon]

The consultation won't cost me it's on my work health insurance. I would rather get my blood tests through the consultant as I won't have to pay. And yes it was my first test above 5. As stated above it was 4.2 in September.

[SlowDragon Administrator in reply to Sincity34]

If September test had been early morning likely would have been over 5

[SlowDragon Administrator in reply to Sincity34]

Don’t be surprised if endocrinologist doesn’t test everything recommended, especially if a diabetes specialist

[SlowDragon Administrator]

Approx how old are you….thyroid often plays up around menopause

Are you in the U.K.

Most endocrinologists are diabetes specialists

Email Thyroid U.K. for list of recommended thyroid specialist endocrinologists and doctors

[e-mail]

[Sincity34]

48. On HRT that doesn't really work! This Endo seems good she is a professer and thyroid is listed as one of her specialisms.

[SlowDragon Administrator in reply to Sincity34]

Get the list from thyroid U.K…..see if this Professor is on there

[Sparklingsunshine]

Hi

I was diagnosed finally in June 2020. That was my second over range TSH result, mine were never that high, think it was 7.2 or something but I'd had two slightly below range FT4 results and I was symptomatic.

I'd long suspectect thyroid issues as I have fibromyalgia which has a lot of similarities and my previous TSH results were always high normal. I don't have autoimmune thyroid disease. Think mine might be menopause related. Hope you get sorted and start to feel better.