TSH reflex to free T4

[Justwannabemeagain]

I'm not sure I understand this test. My TSH reflex to free T4 is .83 But my TSH is 1.8. I have been have all sorts of problems that my Doctor can't figure out. Daily chest pain and palpitations. Pressure and ringing in the ears, abdominal pain, tingling in the face, low bp and heart rate. I used to take BP meds for High BP now I don't. My heart rate used to be in 80s now its in the 60s, and justva few days ago i started have a hoarse voice and a cough..This all started in Sept when my T4 dropped from 4.6 to .83. Can anyone tell me what these numbers mean and if this is the route of my problems?

[PurpleNails Administrator]

Please add ranges

You also need and ft3 plus vitamin D, folate, ferritin and B12 tested.

[tattybogle]

Just to clarify :

"TSH reflex to T4" is not a different test to "TSH" (Thyroid Stimulating Hormone)

it is basically a code meaning "Please test the TSH ... and ONLY IF the TSH is HIGH/LOW ... THEN test the fT4"

[Jaydee1507 Administrator]

I think you're probably a bit confused about what test is what and it's difficult to understand. Can you get a print out of your results, with ranges that would make it clearer?

[Justwannabemeagain in reply to Jaydee1507]

THS

Test

[Jaydee1507 Administrator in reply to Justwannabemeagain]

That's an improvement although we do need the range of the test as this varies from lab to lab. Your TSH is higher than it should be for the average person so if you are on Levo then you need an increase.

There should also be numbers for FT4 and possibly FT3?

[Justwannabemeagain in reply to Jaydee1507]

I only had two types of tests TSH And TSH REFLEX T4

[Jaydee1507 Administrator in reply to Justwannabemeagain]

There is no test called TSH reflex T4. Get a proper print out of the results and post them here. They should also show the ranges the lab uses - usually in brackets after the number.

[tattybogle in reply to Jaydee1507]

as explained in reply above "TSh reflex T4" is a testing protocol .. ie. it is an instruction to the lab machine/ technician to run a TSH test and then test fT4 IF the TSH is over or under range , if the TSH is in range then fT4 is not done.

[tattybogle in reply to tattybogle]

note .. the latest TSH is from December ... it is now 0.82 ie not too high anymore.

[Jaydee1507 Administrator in reply to tattybogle]

Right, I'm with you now. Anyway though a range for the test would be mighty useful.

I've read a few replies to her previous post and realised she has been kept on 25cgs Levo for 2 years.

She needs a new doctor and a dose increase.

[tattybogle in reply to Jaydee1507]

.... which may be very tricky to get at the moment since current TSH is 0.82 this is probably 'just in range' bottom of TSH range usually 0.4 ish ( Edit range is 0.4 - 4.2)

we need to find out what the fT4 was ~ if it was actually done ~may not have been done since 0.82 is in rage.

[Justwannabemeagain in reply to Jaydee1507]

Yes

[Jaydee1507 Administrator in reply to Justwannabemeagain]

Just wondering if you've done anything different this time for the TSH test? It actually looks OK in this latest test but the previous test not so much.

Get yourself another doctor who will do a FULL thyroid panel of TSH, FT4 and FT3. You need ALL those results, along with the range of each test to bring back here.

You likely need more thyroid hormone and maybe just having an autoimmune 'swing' at the moment.

[tattybogle in reply to Justwannabemeagain]

just a heads up, you should remove this image now ,as your name and date of birth is visible .

It shows the TSH range is [0.4 -4.2] so i've copied that here .

[Justwannabemeagain in reply to tattybogle]

Thanks but I don't know how to remove it

[PurpleNails Administrator in reply to Justwannabemeagain]

go to more & delete.

Deleting

[Justwannabemeagain in reply to PurpleNails]

Thank you

[helvella Administrator Thyroid UK in reply to Justwannabemeagain]

Image removed by admin as it showed personal information.

[SlowDragon Administrator]

previous post here

healthunlocked.com/thyroidu...

Been left on just 25mcg levothyroxine for approx 2 years

See different doctor and request FULL thyroid and vitamin testing

[Justwannabemeagain]

TSH REFLEX

Test

[Lalatoot]

Here's a simple sum. 2 + ? + ? = ?

What's the answer?

We don't know because we don't have all the numbers.

It is the same with your problem. You have a part of the sum but not the rest of the numbers.

TSH only tells you that your pituitary gland is stimulating your thyroid to produce thyroid hormones. It doesn't tell you what the level of thyroid hormones are or whether those levels equal feeling well.

As you have symptoms I would suggest that you need to look at all parts of the sum. So test free t4 and free t3 as well as TSH . Testing folate, ferritin, b12 and vit d can also be beneficial to seeing the big picture as you need good levels of all of these for your body to use thyroid hormones efficiently.

Once you've got all these results then you are looking and considering all the information available rather than just 1 tiny part of the bigger picture.

[Justwannabemeagain in reply to Lalatoot]

These are the only numbers I have.

[Justwannabemeagain in reply to Lalatoot]

I will have to call my pc and tell them I need more blood work

[Jaydee1507 Administrator in reply to Justwannabemeagain]

Do the test at 9am or as close as possible to then as thats when TSH is highest. Also take that days Levo AFTER the test.

[JAmanda]

it sounds like you may be under medicated but the only way to really see is to test tsh, t4 and t3 (first thing in am, before taking Levo and a week after stopping taking any b vitamins with biotin in). I use Medichecks but there’s other services. I pay for the blood to be drawn at my local hospital.

[Batty1]

Where are you located in the US? Depending on where you live you can actually pay for your own set of thyroid labs (TSH, FT4 , FT3, T4 ) and then post those results here.

[Justwannabemeagain]

I made a call to my GP today asking for theses test. I have not heard back yet