Low tsh, high ft4 and ft3 - is it hyperthyroidism? - Thyroid UK

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Low tsh, high ft4 and ft3 - is it hyperthyroidism?

ScarboroughFair profile image
11 Replies

Had blood test yesterday and GP appointment for Tuesday to discuss but wonder if anyone can understand these results

TSH 0.02 (0.27-4.2)

FT4 33 (11.1-22) [edited, in original I had 3.3 which is why I was confused]

FT3 10.7 (3.1-6.8)

This is all new to me and trying to get my head round it. Had expected I might have underactive thyroid based on symptoms (very tired, itchy dry skin, depressed) but this seems to point to over active

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ScarboroughFair profile image
ScarboroughFair
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11 Replies
PurpleNails profile image
PurpleNailsAdministrator

Welcome to forum.

Is the FT4 & FT3 result switched round or is it correct?

Do you take Levo or Lio & with an existing diagnosis or is this the first time you had abnormal results?

What is the doctor planning to do next?

ScarboroughFair profile image
ScarboroughFair in reply to PurpleNails

Hi PurpleNails,

I was only tested yesterday but got my results in the afternoon. Never been tested for thyroid function before so not on medication or chatted with my GP yet, seeing her on Tuesday so will see what she makes of it.

The TS4 and TS3 seem contradictory!

PurpleNails profile image
PurpleNailsAdministrator in reply to ScarboroughFair

Your thyroid levels are quite high, and TSH is a pituitary hormone which signal thyroid produce (thyroid stimulating hormone) as your levels rise your TSH drops.

Hyper can be transient, but can also be continuous.

1st steps thyroid antibody testing. This will show if this has an autoimmune cause.

Types of antibodies:

TPOab (Thyroid Peroxidase antibodies)

TGab (Thyroglobulin antibodies) TPO & TG “autoimmune” - Hashimoto’s (also present with Graves)

TRab (TSH receptor antibodies - measures stimulating, neural & blocking antibodies)

TSI (Thyroid-Stimulating Immunoglobulin) Graves

GP can test TPO sometimes TG, specialist can organise TRab / TSI.

Graves is most common cause of continuous hyper.

GP may suggest beta blockers & or anti thyroid medication while you wait for referral to endocrinology.

Either way repeat thyroid function should be taking again to see what levels are doing.

Hyper & hypo symtoms do have an overlap & can be non typical. I had elevated thyroid level from a nodule that was missed for many years. I also thought I was likely to have hypo. Very Low energy. I did gain weight which isn’t classic.

Ask GP to test folate, ferritin, B12, Vitamin D & screen for gluten issue. These are common with thyroid issues. GP may say can’t/won’t test all in which case there are private options.

ScarboroughFair profile image
ScarboroughFair in reply to PurpleNails

My vit D is below range but not by much. GP has put coeliac screen on too but results aren’t back for a few weeks. Don’t have any of those symptoms though.

Just got off phone with GP, she’s a bit nonplussed and speaking to endocrinology for advice. She’s calling back later so will mention the antibody testing and having a repeat test of thyroid.

I’ve now given up coffee which is a painful thing to do!

PurpleNails profile image
PurpleNailsAdministrator in reply to ScarboroughFair

Have you been given loading doses of D3? lots of posts about low vitamin D. many need a maintenance dose all year round.

Many self test to monitor levels & alter dose. Important co factors for vitamin D is magnesium & K2. K2 directs calcium to bones & teeth where needed and away from vessels where you don’t.

Good your doctor agreed to test for coeliac. Have you been or will be tested for B12, Folate & ferritin?

If Doctor liaising with endocrinology they may start you on carbimazole (anti thyroid) & beta blocker such as carbimazole while a referral it made.

Really it would be best if all thyroid antibodies could be tested early on, but often it is delayed as a specialist need to arrange TRab or TSI antibody tests.

ScarboroughFair profile image
ScarboroughFair in reply to PurpleNails

I have b12 deficiency so take tablets after the initial injections, and b12, ferritin etc all look ok. Vit D is 43 (50-99,999) so hope daily tablets will bump it up.

Getting antibody and repeat thyroid blood test Thursday, then seeing GP Friday. I think this is all new to her but she’s had advice from endo and is doing exactly what you suggested so that’s hopeful.

Thanks for your advice, it’s helpful

ScarboroughFair profile image
ScarboroughFair in reply to PurpleNails

Ah I just double checked and the TS4 is 33 not 3.3!!! So not confusing at all, I wrote it down wrong

PurpleNails profile image
PurpleNailsAdministrator in reply to ScarboroughFair

You may not know, but you do have option to edit your own posts (if you wish).

At the bottom on each post there is - blue “reply” icon - heart / like button - “report” in blue writing - end button is “more” with a v arrow.

You go to more v & select edit.

ScarboroughFair profile image
ScarboroughFair in reply to PurpleNails

Thank you, I will!

humanbean profile image
humanbean

As has been mentioned by PurpleNails hyperthyroidism (overactive thyroid) can be transient or continuous.

If transient (for example, in early stage Hashimoto's Thyroiditis, also called autoimmune thyroiditis or autoimmune thyroid disease - but there are other causes) it is likely that your immune system is attacking your thyroid. As thyroid cells are damaged, then destroyed, the cells release any thyroid hormones they contain into the bloodstream and will therefore raise the levels of T4 and T3.

Over time the thyroid gets more and more damaged and eventually the thyroid can't produce sufficient thyroid hormones for people to feel healthy. This is how many people become hypothyroid and develop an underactive thyroid.

If hyperthyroidism is continuous then this has several possible causes :

nhs.uk/conditions/overactiv...

One of the most common causes for hyperthyroidism is Graves' Disease, another autoimmune condition, but it acts, not by damaging the thyroid cells, but by stimulating the thyroid to over-produce thyroid hormones.

In your case I would suspect that you are most likely to be heading for hypothyroidism. Your T4 and T3 are more like the results we would see in early stage Hashimoto's Thyroiditis rather than what would be expected in hyperthyroidism. People who have hyperthyroidism often have levels of T4 of 40 or 50 or more, and levels of T3 that are similar.

ScarboroughFair profile image
ScarboroughFair

Thank you humanbean, it helps going into the GP with some understanding of what it all means. Like PurpleNails mentioned about their experience I’ve also actually put on weight (I reckon a stone in the last year) so really felt confused about the results.

This new GP at the practice seems good and immediately put me forward for a full blood work so hopefully will help me get to the bottom of it.

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