Is TSH enough?

[kushami36]

I am having various health problems, nothing pinned down yet. Is TSH enough to rule out thyroid problems?

I don’t have a family history or anything specifically pointing to thyroid. At one point TSH was slightly elevated, then it went back in range.

Sorry for the newbie question. I have tried finding this out but I’m so tired at the moment.

[Jaydee1507 Administrator]

Sometimes thyroid antibodies Thyroid peroxidase and Thyroglobulin can be raised and point towards autoimmune thyroid conditions.

Low free thyroid levels FT4 can also give an indication.

If someone has Hashimoto's or autoimmune hypothyroidism then TSH can fluctuate in and out of the range either way for years before official diagnosis.

Can you get private bloods to show TSH, FT4 & FT3, also the antibodies I mentioned?

When hypo we get low stomach acid which means we cannot absorb vitamins well from our food, regardless of a great diet. For thyroid hormone to work well we need OPTIMAL levels of vitamins. Have you recently or could you ask your GP to test levels of ferritin, folate, B12 & D3?

[kushami36 in reply to Jaydee1507]

Yes, I can order private blood tests if needed. I will see my endocrinologist soon. (I see her for something unrelated.) I will ask her to order the additional thyroid ones you suggested, and if she demurs, I will get them done privately just to set my mind at rest.

With the vitamins/minerals, my GP has ordered ferritin and I will get the others done privately.

Thank you so much for your help.

[SeasideSusie Remembering]

kushami36

Is TSH enough to rule out thyroid problems?

No.

One form of hypothyroidism is Central Hypothyroidism. This is where the problem lies with the pituitary or the hypothalamus rather than the thyroid, the feedback loop between the pituitary or hypothalamus and thyroid doesn't work so TSH doesn't rise to the high levels it does when it's the thyroid at fault. Central Hypothyroidism is diagnosed when TSH is normal, low or minimally elevated along with a low (below range) FT4. So just testing TSH can't rule out Central Hypothyroidism, this is why it's important to test at least FT4 as well.

[kushami36]

Thank you. I will get private tests if needed to make sure this possibility is covered too.

[SlowDragon Administrator]

Test early morning

TSH, Ft4 and Ft3 together plus Thyroid Peroxidase antibodies and Thyroglobulin antibodies

Vitamin D, folate, B12 and ferritin

[kushami36 in reply to SlowDragon]

Thank you.