I’ve been having symptoms of hypothyroidism for many years but tests always came back in range. Recently the symptoms have gotten worse and I decided to get a full thyroid test done privately.
Female- 62 ( mother also had hypothyroidism)
Total T4 101 (59-154)
TSH 7.28 (0.27- 4.2)
Free Thyroxine 13.5 (12.0-22.0)
Free T3 4.5 (3.1-6.8)
Thyroid Peroxidase ab’s <9.0 (0-34)
Thyroglobulin Antibody 20.3. ( 0-115)
Took these to the GP as TSH was high and she wants me to wait to have a further blood test in a months time. She thinks it might be a false reading as I had a PE in April 2021 and this might have affected the result and said that they did a test while I was in hospital which was normal. She also said as the other numbers were in range, she wasn’t convinced that there was a problem. I am really confused as I thought I finally had an answer for all these awful symptoms which is having a massive impact on my life. Does the higher TSH level mean I have a thyroid problem or would it need some of the other numbers to also be high to have a diagnosis? Any advice would be much appreciated . Thanks in advance
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Gypsy7018
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Hi Gypsy7018 Yes...The high TSH by itself could indicate hypothyroidism.
If the fT4 is still in range then they call it 'sub-clinical' hypothyroidism.. (but if symptoms are causing a problem, at the GP's discretion you can still be treated with Levothyroxine even while fT4 is in range ..... and your fT4 is rather low even though it's still in range)
However ... they can't start lifelong treatment for hypothyroidism until they are sure...... just one 'over range' TSH result is not enough to consider treatment ..it could be a 'one off' that would improve by itself... so they do need to repeat it a few weeks later to rule that out ( NHS guidelines say " 2 over range TSH results 3 months apart" )
if your Thyroid Peroxidase antibodies (TPOab )were over range that would help re-assure them that the decision to treat was correct even at the 'sub-clinical ' stage.. because raised TPOab indicate immune system has attacked the thyroid . so they know it is likely to be damaged. and that ultimately it is likely to get worse and end up with TSH over range AND fT4 under range . at which point they would treat anyway.
Because your TPOab are in range , your GP will not be so sure as to the cause of any thyroid problem .... but regardless of antibodies , they would still need to do a repeat TSH test to make sure it had stayed over range. and wasn't just due to something else causing TSH to be high for a short time then going back to normal .
So don't despair ...... the wait for a second test IS necessary (and GP could have said come back in 3 months!).... So asking you to wait for a second test in a month doesn't mean you don't have hypothyroidism .. and it doesn't mean they won't diagnose or treat you.
People can be treated by NHS GP's for 'sub-clinical' hypothyroidism (even while fT4 is still in range) .. and having positive TPOab isn't a strict requirement for treatment .. it just helps them feel more confident to start treatment .
At next test request they include testing vitamin D, folate, ferritin and B12 as well as thyroid levels
Low vitamin levels are extremely common when hypothyroid
As tattybogle says……before starting what’s likely a lifelong replacement of thyroid hormones, it’s important to do at least 2 separate tests, ideally 6-8 weeks apart before diagnosis of hypothyroidism
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