Normal Blood Test but Still Hypothyroid Symptoms?

[Emj001]

Hello,

I recently had some blood tests done which showed:

TSH 1.26 milliunit/L - Range: 0.3-4.2

Free T4 12.1 pmol/L - Range: 9 - 23

My question is can I be within range and have hypo symptoms? I've got some leg/ankle oedema and feel quite tired often. I've had a lot of hair loss and been emotionally frazzled. My endo thinks that my T4 is too low and wants me to reduce the Levothyroxine I'm taking.

Anyone experience anything similar?

Thanks, Elide

[Buddy195 Administrator]

Are you sure your endocrinologist said your T4 was too low? It’s extremely low in the range. What dosage of Levothyroxine are you taking? Ideally we need to see FT3 blood tests, plus key thyroid vitamins (ferritin, folate, B12 and Vitamin D) to offer you better advice.

Most GPS and even some endocrinologists don’t routinely test FT3 and some only test FT4 if TSH is not in range. That’s why so many forum members test privately for TSH, FT3, FT4, thyroid antibodies and key vitamins. Many members use Medichecks or Blue Horizon

healthunlocked.com/redirect...thyroiduk.org/help-and-supp...

I recommend testing thyroid levels and key vitamins privately, then posting results on the forum for advice & next steps.

[Emj001 in reply to Buddy195]

Hi Buddy, sorry I don’t follow? Yes he said my tsh is too low in the range and he wants it higher so I should reduce my T4. Presently I ranks about 60mcg but I feel like rubbish. What is an optimum tsh ?

My ferritin is 25 and my B12 is above normal reference range.

[Buddy195 Administrator in reply to Emj001]

In your post your wrote ‘My endo thinks that my T4 is too low’ whereas I think you meant TSH.

Your TSH is absolutely not too low. Most people feel best with TSH of one or below. Unfortunately some endocrinologists are diabetes specialists and have little knowledge of the thyroid.

Please supply the ranges for any vitamin tests you have had, as these can vary between laboratories.

[Emj001 in reply to Buddy195]

Yes sorry it's TSH!

[humanbean]

You might find this link of interest :

healthunlocked.com/thyroidu...

The two pictures in it come from here :

web.archive.org/web/2004060...

eje.org/content/143/5/639.f...

There is absolutely no reason for your TSH to be any higher than it currently is, and it would be quite safe for it to be lower than it is. I'm guessing your doctor assumes optimal TSH is mid-range, which is not true.

Your Free T4 is only 22% through the range. Many of us only feel well when Free T4 is about 60% - 80% through the range. Knowing your Free T3 would also be useful, because Free T4 and Free T3 should be looked at together.

According to patients TSH is really the least important of the three thyroid tests, and Free T3 is the most important, but doctors think only TSH is important, which leaves so many of us under-medicated.

[Emj001 in reply to humanbean]

Thanks for these links. The chart was so interesting!

[tattybogle]

"TSH 1.26 milliunit/L - Range: 0.3-4.2

Free T4 12.1 pmol/L - Range: 9 - 23

My endo thinks that my T4 is too low and wants me to reduce the Levothyroxine I'm taking."

"Yes he said my tsh is too low in the range and he wants it higher so I should reduce my T4".

Somebody is confused here ..

if Endo really thinks TSH of 1.26 is too low, then he is the one who is confused.

TSH of about 1 is where healthy people have it ~ TSH of around 1 is NEVER too low for anyone. See this graph : healthunlocked.com/thyroidu...

Lowering your does of levo will lower your fT4 result ,, but that is already pretty low .. (too low for most people) and that low level of fT4 is probably what is responsible for your hypothyroid symptoms . lowering it anymore will almost certainly make you feel worse .

The right thing to do for someone who has those results on Levo, who still has hypothyroid symptoms, is to RAISE the dose of Levo a little bit ...which will RAISE the fT4 level ~and that will LOWER the TSH a bit ... but as long as the TSH is still within the reference range (ie more than 0.3 at that lab ) then there is absolutely no problem. with the TSH being a bit less than 1 .

if your endo has really said a TSH of 1.26 is 'too low' , then your Endo needs to read this list of references : healthunlocked.com/thyroidu... my-list-of-references-recommending-gp-s-keep-tsh-lower-

all recommend that for optimal treatment GP's keep TSH between 0.4 / 0.5 ish and 2/ 2.5 ish in patients on levo .... which means the they have no concerns at all with TSH as low as 0.4/0.5

[tattybogle]

you ( and your endo !) may find this explanation helpful : healthunlocked.com/thyroidu...