Odd comments on blood test - anyone able to help?

[gjm1904]

Hi everyone,

I wondered if anyone had had anything similar to this noted on a blood test result. I’ve attached a picture below. It’s saying about ‘euthyroid’ and it being rare to then have a normal TSH. I googled ‘euthyroid’ and it means an abnormal thyroid test when patient isn’t diagnosed with thyroid issue. The TSH level listed is normal though but I’m wondering if there was more tested that isn’t being shown on this print out I requested.

For a bit of background info. I have suspected hypothyroidism for years, it runs in my family and I have all the symptoms. Did a private test last month that came back subclinical but gp is reluctant to do anything. This test I’m talking about here is from last October when they did a blood test when I was having issues with being lightheaded and exhaustion.

Has anyone else seen this sort of comment before?

[SlowDragon Administrator]

previous post

healthunlocked.com/thyroidu...

What else was tested

What time was test done

[gjm1904 in reply to SlowDragon]

I’m not sure what else was tested, I asked the doctors for a copy of my last thyroid test and this is what they gave me. I found it a bit weird that they’ve limited it and now the comment doesn’t make much sense. It was done about 11am I think.

I find it weird that they are so restrictive on giving me my test results.

[SlowDragon Administrator in reply to gjm1904]

If that’s an old test TSH is frequently all that’s tested

Have you seen/contacted GP for new full thyroid including thyroid antibodies and vitamin testing

[helvella Administrator Thyroid UK]

That text is, I am sure, an automated comment.

We have had those exact words posted here - over eight years ago:

Serium tsh level 2.50 mIU/L (0.35-4.94)

Along with the comment

Euthyroid or adequate replacement. Rarely, patients with pituitary/hypothalamic hypothyroidism can have a normal tsh.

healthunlocked.com/thyroidu...

(Might well have been posted several times but if posted as an image, cannot easily be searched. And once I found a single other instance, I thought it should be enough to demonstrate that the comment is nothing special.)

The word "euthyroid" means, quite literally, "good thyroid". And is used by medics to cover everyone who in their opinions, and any tests done, are deemed not to have a thyroid issue.

With your TSH result, it is unlikely any further tests would have been performed. They often use a cascade or reflex approach: If TSH is too high or low, do FT4 otherwise stop.

[tattybogle]

'Comment' is just a general comment to aid GP's with intepretation of the lab results ~ it is not specific to you.

in this case it means:

" ~ IF this patient is not taking any thyroid hormone replacement the TSH of 1.59 is euthyroid / in range / normal) ~ ie. this result does not indicated a thyroid problem.

~ IF this patient is taking thyroid hormone replacement the TSH of 1.59 indicates 'adequate' replacement ( ie. the dose of Levo is enough to get the TSH back into ref range). *note 'adequate' does not necessarily mean 'the best dose for the individual' , it simply means their TSH is 'somewhere back in ref range' .

~ Reminder , in patients with hypothyroidism caused by pituitary or hypothalamus problem (central /secondary/ tertiary hypothyroidism which is relatively rare) ~ a normal / in range TSH result does not rule out hypothyroidism , because their TSH doesn't tell the truth ( so if this is the case their fT4 would need to be tested ) "

[tattybogle in reply to tattybogle]

"I googled ‘euthyroid’ and it means an abnormal thyroid test when patient isn’t diagnosed with thyroid issue. "

Google must be having an off day ..

Euthyroid means "not having any thyroid problem" , or " thyroid results within the 'normal' reference range ".

[tattybogle in reply to tattybogle]

Is this the old test from October 2021 that you "thought looked at the high end" ?

TSH of 1.59 was fine ...( TSH level around 1 / under 2 is where it is for the vast majority of healthy people ) so no sign of thyroid problem from that test.

[gjm1904 in reply to tattybogle]

haha yeah it must have, It was the first thing that came up when I typed it in and so it made me question what it was saying.

[PurpleNails Administrator]

Euthyroid is thyroid in “normal” range.  

Abnormal is hypo or hyper. 

The comment is an automated “prompt” for doctors.  

So the comment is saying if TSH is normal it means thyroid levels (FT4 & FT3)  should also be functioning normally or replacement is adequate. 

 It acknowledges patients with central / secondary hypothyroidism can have a normal TSH with very low levels.  

TSH is unreliable for other reasons too,  such as HPT axis down regulation, fluctuating levels, antibodies interference, low nutrients lowering TSH, daytime rhythm, monthly cycle….likely more. 

So the comment doesn’t cover enough scenarios.  I’m not sure it’s a helpful comment because if it normal & someone does have hidden hypothyroid levels what can be done about it? 

Someone on replacement would rarely feel well with a TSH at the top of reference range as it means levels are likely low. 

This could all be resolved by focusing on FT4 & FT3 levels but doctors are taught to focus on TSH.