Blood Results (Low FT4, Normal TSH) - Warrants ... - Thyroid UK

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Blood Results (Low FT4, Normal TSH) - Warrants GP Review?

BeeHappi23 profile image
8 Replies

Hi everyone,

I’m new to this group, and hope it’s ok to post this here.

Sorry, I tried to keep it brief, but it’s much longer than I planned!🙂

I’m a female in my mid 30’s and have long struggled with a range of symptoms (fatigue, poor quality sleep, digestive issues, headaches, depression/anxiety, and foggy thinking - amongst others!).

I’ve often attributed them to factors like shift work, not exercising enough, not having a good enough diet, and just not looking after myself well enough etc.

Over the past year I’ve made a real effort to:

- Exercise more

- Eat a balanced, healthy diet

- Drink more water

- Reduce caffeine and alcohol consumption

- Take a multivitamin every day

Despite being consistent with this for 8-10 months, I don’t feel any better.

A first degree relative has also been diagnosed with multiple health conditions in the past year, so I decided to get some private blood tests through Monitor My Health, thinking they would all likely come back ok.

Bloods were taken at 11:00 after decaf coffee and water only.

My results are:

TSH - 2.51 mu/L (0.27 - 4.2 mU/L)

FT4 - 11 pmol/L (12 - 22 pmol/L)

FT3 - 4.6 pmol/L (3.1 - 6.8 pmol/L)

Ferritin - 66 ug/L (no range given, but stated “Normal”)

Transferrin Saturation - 13% (no range given, but stated “Low”)

Active B12 - 70 pmol/L (no range given, but states “Normal”)

Folate - 4.4 ug/L (no range given, but stated “Normal”)

I’m still awaiting vitamin D results, but wouldn’t be surprised if this was low as in 2018 it was 9.6 ng/ml (treated with high dose Vitamin D for 6 weeks, then never rechecked by GP).

Do these warrant contacting my GP for review?

I just can’t see them being very amenable to discussing with me, as they’re mostly in range (and I haven’t got very far with discussing my symptoms/concerns with them previously).

Or should I perhaps repeat them myself in 8 weeks (at 09:00, fasted) and then go from there?

Thank you very very much. 😊

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8 Replies
greygoose profile image
greygoose

Hi BeeHappi23, welcome to the forum. :)

Well, your results may be 'in-range', but that doesn't mean they're 'normal'. Your TSH is too high, and shows that your thyroid is struggling. Your FT4 is below-range, which should be cause for concern, and your FT3 is under-mid range. However, your FT3 is higher in its range than the FT4, which is another sign that your thyroid is struggling - normally it's the other way round.

Your ferritin is low, as is your folate, and B12 would be better if it were higher. More signs of a struggling thyroid.

However, doctors only tend to look at the TSH, and as yours is in-range, they will tell you there's no problem. They do not know enough about thyroid to read the signs. So, probably best to wait and retest before confronting your GP. Most doctors do not like private tests and want to do their own. And, of course, they only test the minimum - they wouldn't know what T3 was, anyway!

Did you not get your antibodies tested?

BeeHappi23 profile image
BeeHappi23 in reply to greygoose

Hi greygoose 👋

Thank you for your detailed reply, I really really appreciate it.

No I didn’t have my TPO tested as I’ve been very much under the assumption that this must all be “just normal for me/all in my head/everyone must feel this way” and thought my blood results would likely all come back ok.

I’m a little surprised, but also almost relieved, that they have come back showing something isn’t quite right, as I’ve been diligent with improving my lifestyle for the past year and don’t seem to be getting anywhere! Which has been so frustrating.

Think I’ll look to repeat all bloods in the new year, with TPO added too 😊

Sparklingsunshine profile image
Sparklingsunshine in reply to BeeHappi23

Welcome, there is a condition called central hypothyroidism where you can have a normal or slightly elevated TSH but low levels of FT4 which yours is, your FT3 is holding up at the moment.

Its also known as secondary hypo. Its not common, or at least not commonly diagnosed and I know little about it and I strongly suspect your GP won't either. It normally needs a good Endo to get it diagnosed.

The treatment is the same as primary hypothyroidism, ie lifelong thyroid replacement but the cause is different in that its not autoimmune like Hashimotos, but a problem with the pituitary gland and/ or the hypothalamus. It has the same signs and symptoms as traditional hypothyroidism, fatigue, feeling cold, weight gain, dry skin etc.

If you retest in the new year try and make sure you test before or close to 9am, and drink nothing but water before you test. Not even a decaff I'm afraid. And check if the multi vitamin you take has high levels of biotin in it.

Biotin can mess with the accuracy of the thyroid blood test. And follow Greygoose's suggestion of improving low ferritin and folate levels, as these can make you feel dire.

Its possible that testing when TSH levels are among their highest at 9am and allowing 8 weeks after your first test might be enough to tip you over into the NHS we'll treat you range, or show if it was a fluke or if there's a trend showing a problem.

BeeHappi23 profile image
BeeHappi23 in reply to Sparklingsunshine

Hi Sparklingsunshine,

Thank you for your reply, I do appreciate it.

I had seen about central/secondary hypothyroidism when I had a little google.

This is interesting because my relative’s health conditions mostly relate to neuroendocrine cells, which of course the pituitary, adrenals and parathyroid are also composed of. They think there is a genetic component causing my relative issues, but we don’t know for certain yet, so this might be a point for me to discuss with them at some point too.

Thank you for the advice for when I re-test, I’ll make sure to skip the decaf!

Thanks so much again 😊

BeeHappi23 profile image
BeeHappi23

Also…

If anyone has advice on additional supplements for the B12/ferritin/folate/transferrin saturation - I’m all ears!

My daily multivitamin doesn’t seem to be enough (attached photo of what I currently take daily)

Multivitamin
greygoose profile image
greygoose in reply to BeeHappi23

We do not recommend multi-vits on here, for many reasons, and that is a pretty bad one. It contains iron, which is probably going to block the absorption of just about everything else. But, even if it didn’t, there’s not enough of anything to help a deficiency. So, pretty much a waste of time and money taking that. Far, far better to take just what you need according to your blood test results.

If you take B12 and folate, you also need to take a B complex because all the Bs work together and need to be kept balanced.

If you take iron, you need to take it at least two hours away from everything (four hours from thyroid hormones) except vit C. But it is essential to take it with vit C to help absorption and avoid constipation.

If you take vit D, you also need to take magnesium and vit K2-MK7 because they work together.

Zinc and copper should be tested before supplementing. If you are hypo, you probably have one high and the other low. Usually it is zinc that is low, so taking more copper is not a good idea.

There are many other things that could be said about supplementing nutrients, it's not as simple as it may at first sound. But, if you are considering taking something, just check on here that it's ther right type/amount and what it should be taken with.

BeeHappi23 profile image
BeeHappi23 in reply to greygoose

Hi greygoose,

Thank you so much for your detailed response, it’s really appreciated.

And now you’ve laid it out like that it makes sense of course to not be taking a multivitamin with a little of everything, and actually focusing on what I need.

I think I’ll need to go away and do some reading and investigate into the supplement side of things, but thank you so much for your replies, they’re really helpful 😊

greygoose profile image
greygoose in reply to BeeHappi23

You're welcome. :)

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