Can some help with understanding these result please?

[Tinal25]

I have not been feeling to good lately and doctor sent me for bloods. Theses are the result. She said she not worried about them. Im not on medication and im 30 weeks pregnant. What do you make of theses ?

[SeasideSusie Remembering]

Tinal25

Your TPO antibodies are negative and do not suggest autoimmune thyroid disease.

Is this the only test that was done?

If you think you have symptoms of thyroid disease you will need TSH, FT4 and FT3 testing, it would also be worth testing key nutrients - Vit D, B12, Folate and Ferritin - and Thyroglobulin (Tg) antibodies as even though your TPO antibodies are negative it is possible that your g antibodies could be positive.

[Tinal25 in reply to SeasideSusie]

theses are my other results and the docter said my vitamin d is low and my protein.

[SlowDragon Administrator]

welcome to the forum

Congratulations on your pregnancy

Are you diagnosed as having thyroid disease?

Are you currently taking any replacement thyroid hormones?

This photo only shows one test result

Test for TPO thyroid antibodies - result is negative

Have you had TSH, Ft4 and Ft3 tested

Or vitamin D, folate, ferritin and B12 levels tested?

[Tinal25 in reply to SlowDragon]

thanks theses are my other results. My vitamin d and protein low.

[SlowDragon Administrator in reply to Tinal25]

Can you add vitamin D, folate, ferritin and B12 results

Are you on levothyroxine?

[SlowDragon Administrator in reply to Tinal25]

I removed image in both replies as it showed your name and personal details

[Tinal25]

im not on levothyroxine. My docters not gave me the reading for these.

[Tinal25]

i have put another picture up and cropped it.

Results

[Maggie0652]

your t4 is really low there. With that low TSH, I would expect to see a much higher t4 result - it’s only 18.94% through the lab range. I wouldn’t feel well if mine was less than 75%.

What time of day was the test done? Did you fast for it?

I think you need to point out to the doctor how very low your t4 ( thyroid hormone) is, and that your TSH (pituitary hormone) is not representative of the actual thyroid hormone level!

[Tinal25 in reply to Maggie0652]

Yes i fast has i had a few other test alkng with this. It was round 9.25 in the morning. Also my vitamin and protien low. She said the results are not to worry about. Will pregnancy do this?

[Maggie0652 in reply to Tinal25]

as I’ve said in my other comment, TSH and t4 should not both be low. Ask for an urgent referral to the endocrinologist. TSH is not a thyroid hormone. Your actual thyroid hormone is very low. This is a problem with GPs who assume that everyone’s pituitary gland works perfectly - it’s not so. Read the article I’ve posted.

[Tinal25 in reply to Maggie0652]

thank you i will.

[Partner20 in reply to Maggie0652]

As the OP is in the final stages of pregnancy all hormone are likely to be disrupted. The TSH is the definitive reference for pregnancy, and this is currently at the correct level. Post-partum levels will, I am sure be checked, and any abnormalities then addressed. No endo referral would currently be accepted, for more reasons than one. A pregnant lady needs reassurance, too, not added worries, which you have most unfortunately and misguidedly given her here.

[Maggie0652 in reply to Partner20]

the TSH test was developed as a diagnostic tool for primary hypothyroidism.

These test results show that the usual culprit that causes primary hypothyroidism, autoimmunity, is not indicated.

In secondary hypothyroidism, TSH is low due to pituitary problems, and causes low thyroid hormones. This applies whether pregnant or not.

The reason, in pregnancy that t4 is always tested as well as TSH is precisely because TSH doesn’t tell the whole story.

It seems to me that it’s irresponsible to tell somebody who is concerned enough to ask for help, to completely ignore a possible issue and not to ask for further investigation.

I would say from personal experience, having been in that situation myself, that it’s better to investigate and put her mind at rest than tell her to ignore her concerns.

[Tinal25 in reply to Maggie0652]

i was confused had my docter said its slightly low overactive tyroid and she not worried but she wants me to tell my midwife snd antenatal care abouy results

[Maggie0652 in reply to Tinal25]

she’s saying that because the TSH is below range and she’s not considering the low t4.

In overactive thyroid the TSH (pituitary hormone) is below range and t4 (thyroid hormone) is over range - usually a lot over range.

Your t4 is very low so you’re not overactive. It looks like a pituitary problem, a fault in your pituitary gland, which doctors regularly miss because they only focus on primary hypothyroidism. Show your doctor and your midwife the article about pituitary disease and ask for it to be investigated

[Tinal25 in reply to Maggie0652]

thankf fornthe advise and i will show her. I had a few up and down result before pregnancy to.

.

[Maggie0652 in reply to Tinal25]

yes, your TSH is consistently low from the look of the results you’ve posted, which certainly supports the “secondary hypothyroidism” likelihood.

Diogenes posted a link to a research study recently done in Australia which also gives backup to the need to distrust TSH as a marker of thyroid status. It may require a few read throughs and highlight the main points, but if you print it off for the doctor and midwife, it may open their minds a little more. It does mention secondary hypothyroidism (pituitary disease).

frontiersin.org/articles/10...

[Maggie0652]

ask for an endocrinologist referral to investigate for secondary hypothyroidism. Those results are totally out of sync. Both TSH and t4 are low.

pituitary.org.uk/news/2017/...

[Tinal25 in reply to Maggie0652]

i have a read. Thank you

[Tinal25]

i had these done last year and didnt understand them either.

Results

[Maggie0652 in reply to Tinal25]

so there, your t4 is 30% through the range and TSH below range.

It astounds me that doctors are so blind to what’s right in front of them. Your t4 level has gone down significantly since that test but they’re so obsessed with TSH that they can’t see it.

Your b12 is way too low in that test too. You need to get it up to over 500.

[Tinal25 in reply to Maggie0652]

thank you

[Partner20 in reply to Tinal25]

All hormones flip like crazy during pregnancy, which is why hormone-related diagnoses are not made at this time. Post-partum thyroid checks will no doubt be done to determine where your levels have settled. Please don't worry about your current levels, as your TSH, which is the important consideration in pregnancy, is fine according to NICE guidelines. Pregnancy can cause many to feel unwell, not everyone bounces around happily!! Your GP ordered tests ti investigate possible causes for your symptoms which have not yet revealed anything concerning. Try to relax for the last few weeks, as stress will cause negativity, both mental and physical. I do hope all goes well. Good luck!🙂

[Tinal25 in reply to Partner20]

thank you

[helvella Administrator Thyroid UK in reply to Partner20]

which is the important consideration in pregnancy

Why do you consider TSH the important (overriding?) consideration?

And, given you do, why do you think a TSH below reference interval is fine?

(If that TSH level is regarded as fine, perhaps the reporting by the lab should identify they are using a pregnancy-specific reference interval?)

Do you have a link to the specific NICE guideline, please?