hi I had planned to travel for a procedure but was advised after I sent my results that I wouldn’t be able to have it done my F3 & F4 are normal but my TSH is TSH level"
5.49 mO/_ (0.27 - 4.2) "High"
Can anyone explain this to me please. level"
5.49 mO/_ (0.27 - 4.2) "High"
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Einaling
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TSH is the pituitary hormone that controls the thyroid, telling it to make more or less thyroid hormone.
Normally, a slight rise in TSH - Thyroid Stimulating Hormone - will stimulate the thyroid to make more T4 and T3 (thyroid hormones) and the TSH will stay pretty steady around 1. Your thyroid is not responding very well, so it is taking an abnormal amout of TSH to get your thyroid to make 'normal' amounts of T4 and T3, so you are therefore what we call 'hypothyroid'.
That said, you haven't told us what your FT4 and FT3 are. They might not be 'normal' at all. Just being within the so-called 'normal' range doesn't automatically make them 'normal' - or euthyroid. Euthyroid FT4s and FT3 are around mid-range.
You don't say where you live, nor where you're hoping to have your surgery, but different countries have different procedures. In the UK, for example, where the NHS really, really doesn't like diagnosing hypo, they will wait for your TSH to reach 10 before they will treat. But other countries will treat as soon as the TSH goes over-range, and yet other countries when it gets to 3. Sounds like the country you wish to go to treats as soon as it goes over-range. But whether you will get treatment in your home country depends on their thyroid policy. But, you do need treatment for an under-active thyroid because it would not be safe to have surgery whilst hypo.
But it's not below range, it's above range, and it's telling you you have an under-active thyroid - hypothyroidism. But I cannot possibly tell you what your doctor will say, that depends on so many things.
OK, I see. Sorry, I was thinking about something else and didn't check who I was talking to.
Well, despite what uneducated doctors think, you cannot draw any conclusions about anything based on one single thyroid blood test. You need the three to interpret together. So, possibilities of a below-range TSH:
- If you also have extremely high FT4 and FT3 then you probably have Graves' and need antibodies tested.
- If you have FT4/3 levels over-range but not excessively so, you could be in the throws of a Hashi's 'hyper' swing, and need antibodies tested. Or, if on thyroid hormone replacement, it could mean you're over-medicated.
- If you have FT4/3 anywhere within the range but with belowj-range TSH, it just means that the pituitary is satisfied with the levels of thyroid hormone, even though the rest of the body may still be hypo.
Once TSH gets below 1 it is a very poor indicator of thyroid status due to the fact that the pituitary gets served first when there is thyroid hormone available, so is satisfied with the levels and stops making TSH - which is understandable. If you don't need it, why make it? But, the pituitary can only measure what's in the blood and has no idea how well all the other cells in the body are faring. So, it's possible to have a low TSH but still be hypo. Something that doctors just cannot get their heads round!
Ellie-Louise profile imageEllie-Louise in reply to greygoose
27 days ago
Would you know about those results if I posted them for you?
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greygoose profile imagegreygoose in reply to Ellie-Louise
27 days ago
Not much, no, but if they're only slightly out of range, you GP is going to say it's nothing to worry about, anyway. That's what was said to me.
But, I'm not the only one reading posts. Bet there are plenty of people on here that know about liver testing. It's not uncommon to have liver problems when you're hypo.
Apart from stopping the Carbi, I have no idea what you can do. But, I'm not advising you to do that without the support of a doctor. If I were you, I'd do as PurpleNails suggests and go and see your GP.
How long have you taken carbimazole? Were you started on 5mg ? Or has it been reduced over time.
What was cause of hyper. As doesn’t seem you need carbimazole now. That depends on your history. If you have confirmed Graves antibodies doctors tend to leave people on a low dose of carbimazole for around 18 months. but some find they need half pill or dose every other day.
If you don’t have continuous hyper carbimazole wasn’t necessary.
I suspect you were given low dose carbimazole due to a time which showed low TSH. That’s now risen. Speak to your doctor suggest you stop it for 6 weeks and retest levels.
Ask if the cause was ever recorded because Graves does not usually follow this pattern. Remaining on carbimazole for long is also not common although it is becoming a popular choice, myself included. Has other treatments been suggested?
See if thyroid antibodies can be tested or has been previously.
Thyroid Peroxidase (TPO) and Thyroglobulin (Tg) for Hashimoto's (can start with transient hyperthyroidism but ultimately results in under active)
To be honest it’s so confusing for me, I’ve never been given any information or level of results. I’m either just told to take whatever I’m given and practically left to work it out, I’m trying to get a new Gp but it’s a nightmare at the min. I will try and talk to him again, if I even get a chance to say anything.
If he saying it’s fine you will need to stand your ground & say the TSH is over range, the FT4 is low in range & has lots of room to rise before it’s hyper or over range, & was there a FT3 result? You also have symptoms so not all is fine.
I have found my GP not helpful on thyroid issues. I have to follow up and point out previous notes & instructions from specialists.
I am doing a private test tomorrow, I stopped the carbi myself because Dr still reckons all is fine! I know I probably shouldn’t but had to try something.
Welcome to the group. If you could complete your profile it helps members understand your thyroid journey so far and be able to advise you better. Click on your image icon to start. Fill out the free text box at the top.
Can we have a bit of context with this?
Are you already diagnosed as hypothyroid or not?
If your TSH result is above range then you either need more thyroid hormone or you are showing signs of hypothyroidism.
I see that PurpleNails has now responded to you and given recommendations about your Carbimazole.
Your TSH is now too high so likely you don't need the carbimazole anymore.
It's really important to check your vitamin levels with a thyroid condition as vitamin absorption is reduced by low stomach acid.
Obviously you already get B12 injections but even for that to work well you need all your other vitamins at OPTIMAL levels, not just 'in range'.
Have you recently or could you ask your GP to test levels of ferritin, folate, B12 & D3? Private tests are available, see link for companies offering private blood tests & discount codes, some offer a blood draw service at an extra cost. thyroiduk.org/help-and-supp...
There is also a new company offering walk in (includes free blood draw) & mail order blood tests in London, Kent, Sussex & Surrey areas. Check to see if there is a blood test company near you. onedaytests.com/products/ul...
Only do private tests on a Monday or Tuesday to avoid postal delays.
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