Help understanding test results

[mrsm68]

I have not been diagnosed with any thyroid problems at all but have suspected something was not right for a few years.

My eyebrows have fallen out completely, pubic hair has a bald strip down the middle and I have no hair under my arms at all. I have just been looking back at my test results over the last few years and would really appreciate it if anyone can tell me if they see anything suspicious or worth investigating.

Thank you in advance to anyone that can shed any light on whether this all looks normal. I realise that there are other things that would need testing but I just wanted an experienced opinion.

Both TSH and Free T4 levels seem to be increasing.

Please note: The reference ranges change from the March 2019 result onwards and I have only had one antibody test.

Here goes:

Dec 2016

TSH 1.66 mU/L Range: 0.35 - 5.5 mU/L

Free T4 10.3 pmo/L Range : 10.0 - 19.8 pmo/L

June 2016

Thyroid Peroxidase Antibody

28 iu/ml Range: 0.0 - 60.0

June 2017

TSH 2.06 mU/L Range: 0.35 - 5.5 mU/L

Free T4 10.6 pmol/L Range : 10.0 - 19.8 pmo/L

Jan 2018

TSH 2.06 mU/L Range: 0.35 - 5.5 mU/L

Free T4 11.8 pmol/L Range : 10.0 - 19.8 pmo/L

Mar 2019

TSH 2.01 miu/L Range: 0.27 - 4.2 miu/L

Free T4 13.2 pmol/L Range : 12.0 - 22.0 pmo/L

Jan 2020

TSH 3.10 miu/L Range: 0.27 - 4.2 miu/L

Free T4 13.7 pmol/L Range : 12.0 - 22.0 pmo/L

Aug 2022

TSH 2.10 miu/L Range: 0.27 - 4.2 miu/L

Free T4 13.2 pmol/L Range : 12.0 - 22.0 pmo/L

[SeasideSusie Remembering]

mrsm68

Dec 2016

Free T4 10.3 pmo/L Range : 10.0 - 19.8 pmo/L = 3.06% through range

.

June 2017

Free T4 10.6 pmol/L Range : 10.0 - 19.8 pmo/L = 6.12% through range

.

Jan 2018

Free T4 11.8 pmol/L Range : 10.0 - 19.8 pmo/L = 18.37% through range

.

Mar 2019

Free T4 13.2 pmol/L Range : 12.0 - 22.0 pmo/L = 12% through range

.

Jan 2020

Free T4 13.7 pmol/L Range : 12.0 - 22.0 pmo/L = 17% through range

.

Aug 2022

Free T4 13.2 pmol/L Range : 12.0 - 22.0 pmo/L = 12% through range

.

Here is ThyroidUK's list of signs/symptoms of hypothyroidism:

thyroiduk.org/wp-content/up...

Do you have any of these symptoms?

If so, then the fact that your FT4 has always been very low may possibly suggest Central Hypothyroidism.

With Central Hypothyroidism the TSH can be low, normal or slightly raised, and the FT4 will be low. There will be a fine low between low and below range and the diagnostic procedure may mean below range, it is not really clear.

TSH is a pituitary hormone, the pituitary checks to see if there is enough thyroid hormone, if not it sends a message to the thyroid to produce some. That message is TSH (Thyroid Stimulating Hormone). If there is enough hormone then there's no need for the pituitary to send the message to the thyroid so TSH remains low.

In Primary Hypothyroidism, which is where the thyroid fails, the TSH will be high.

However, with Central Hypothyroidism the signal isn't getting through for whatever reason so the message isn't getting through to the thyroid to produce hormone, hence low FT4. It could be due to a problem with the pituitary (Secondary Hypothyroidism) or the hypothalamus (Tertiary Hypothyroidism).

As Central Hypothyroidism isn't as common as Primary Hypothyroidism it's likely that your GP hasn't come across it before.

Your GP can look at BMJ Best Practice for information - here is something you can read without needing to be subscribed:

bestpractice.bmj.com/topics...

and another article which explains it:

ncbi.nlm.nih.gov/pmc/articl...

and another here:

endocrinologyadvisor.com/ho...

and another one:

academic.oup.com/jcem/artic...

You could do some more research, print out anything that may help and show your GP.

You may need to be referred to an endocrinologist. If so then please make absolutely sure that it is a thyroid specialist that you see. Most endos are diabetes specialists and know little about the thyroid gland (they like to think they do and very often end up making us much more unwell that we were before seeing them). You can email ThyroidUK at

[e-mail]

for the list of thyroid friendly endos. Then ask on the forum for feedback on any that you can get to. Then if your GP refers you, make sure it is to one recommended here. It's no guarantee that they will understand Central Hypothyroidism but it's better than seeing a diabetes specialist. You could also ask on the forum if anyone has been successful in getting a diagnosis of Central Hypothyroidism, possibly in your area which you'll have to mention of course.

I am not medically trained and I am not diagnosing, I am just pointing out the possibility

[SlowDragon Administrator]

You need BOTH thyroid antibodies tested

Also test vitamin D, folate, ferritin and B12

Always test thyroid levels early morning, ideally before 9am

Are you vegetarian or vegan

Gluten free or dairy free

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

About 90% of primary hypothyroidism is autoimmune thyroid disease, usually diagnosed by high thyroid antibodies

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.

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

Significant minority of Hashimoto’s patients only have high TG antibodies

20% of autoimmune thyroid patients never have high thyroid antibodies and ultrasound scan of thyroid can get diagnosis

In U.K. medics hardly ever refer to autoimmune thyroid disease as Hashimoto’s (or Ord’s thyroiditis)

Recommended on here that all thyroid blood tests early morning, ideally before 9am

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 and money off codes

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...

Symptoms of hypothyroidism

thyroiduk.org/wp-content/up...