antibodies bloods within range but other result... - Thyroid UK

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antibodies bloods within range but other results atypical. Appointment with GP tomorrow. Can anyone offer help?

Carsey2411•

2 years ago•7 Replies

hi,

Thank you for all your help so far

My TPO was 30 (0-50)

And thyroid tests

TSH 0.35 mIU/L (0.35 - 4.94) 0.0%Free T4 (fT4) 11.1 pmol/L (9 - 19.10) 20.8%Free T3 (fT3) 3.8 pmol/L (2.4 - 6) 38.9%T4:T3 Ratio 2.921

Still indicative of secondary thyroid?

I have an appointment with the GP tomorrow not sure what to ask?

Thanks

Claire

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RegenallotmentAmbassador2 years ago

I’d ask for all vitamins and full iron panel to be tested. Low D, ferritin, B12, folate can all impact your health and have a knock on effect for thyroid function.

Are you already on Levothyroxine? Or and Liothyronine?

Other things you could test, gut health, any symptoms of SIBO or H. pylori? How about adrenal function? Knowing if you have high or low adrenaline and cortisol can help a lot with figuring out what to supplement and what needs to recover.

let us know how the appointment goes 👍

🌱

Carsey2411• in reply toRegenallotment2 years ago

Thanks. I’m not on thyroid medication. My ferritin is within range and ok. They will not test all of that on pt request.

RegenallotmentAmbassador• in reply toCarsey24112 years ago

What was your actual ferritin result and the range? In range isn’t the same as optimal.

Someone made the analogy of running a car with the oil at the bottom of the dipstick.

Optimal helps us hypos function properly. Most of my vits results were in range. D was just into insufficient. But by doubling them (still only part way through range) I’m so much better.

I don’t know what a pt request is. My surgery only run TSH and not much else. GP will say in range, so nothing to do, but experience from following advice here has shown me how important this has been to improving health.

I send off private testing to monitor my health, my GP accepts this as it’s an NHS lab. I source vits privately based on recommendations here.

Carsey2411• in reply toRegenallotment2 years ago

ferritin was 90 (30-250) I don’t eat red meat, well if I do it’s very very occasionally. I do eat lots of other foods high in iron though.

I also take a high dose of vitamin d and magnesium

tattybogle2 years ago

basically yes . you would not expect raised TPOab when central hypo is the issue.

Raised TPOab would indicate the immune system has been damaging the thyroid gland , causing it to be unable to produce enough T4/T3

With Central/ Secondary Hypothyroidism , there is nothing wrong with the thyroid gland itself, (and the immune system is not causing the problem .... so no antibodies are expected) The problem is that the pituitary is not producing an appropriate amount of TSH ( Thyroid Stimulating Hormone) ,and so the thyroid gland is just not being 'asked' to make enough T4/T3.

in Tertiary Hypothyroidism the issue is with the hypothalamus .. which produces TRH Thyrotropin Releasing Hormone ~ ( 'thyrotropin' is another name for TSH so it really means TSH Releasing Hormone )

Hypothalamus releases TRH >>>which tells pituitary to produce TSH >>> which tells thyroid to produce T4/T3 .

So .... if you get a problem with either the hypothalamus or the pituitary , then the thyroid is not asked to make enough T4/T3 and you end up hypo .

Has he mentioned treating you for hypothyroidism yet ?

He may not be willing to diagnose it as central/ secondary (or tertiary) hypo YET because your T4 is still in range.... most guidelines will say " low" T4 ( below range) .. rather than 'low in range' like yours is ..... and getting a diagnosis of central / secondary /tertiary hypo when fT4 is still in range can be extremely difficult.

Has the fT4 level been falling over the time you have been having thyroid tests done ?

Did you mention in an earlier post that you had another pituitary hormone that was also low ?

The pituitary connection might be something to discuss with GP, (i note you said he's previously said it's 'not a pituitary problem'.. but it seems odd to rule it out especially if there is another pituitary hormone level that is low.)

If he has discussed treating you for 'hypothyroidism' based on central /secondary hypo (low TSh / low T4) then BY DEFINITION it is a pituitary problem.

Carsey24112 years ago

thanks.

My LH serum was below range but has been within range but always low. My T4 has fallen from 12.4 I think in 2017 and my TSH was 0.88 then.

Dr did mention treating for hypo I think based on my T4, not TSH although he acknowledged it was low.

Dismissed pituitary and said it was not connected.