Tsh 4.02 and t4 15.7

[poppppy]

Hi I am just wondering if these results would be considered hypothyroidism if we used same parameters as USA etc . I thought I heard this before on this site. This result is a friends from 3 years ago .should someone euthyroid have tsh below 1 ? And so could they have been in first stages of hypothyroidism 3 years ago with these results . Therefore is it worth having bloods done again now . If you get my drift Thank you for advice and help 🙏

[HealthStarDust]

If you search for any of greygoose responses, they will always say that it’s the FT3 that’s the most important!

What I can share is while I have now been diagnosed, I had all the the same symptoms and worse almost a decade ago and the tests came back as within range for TSH and T4. TSH was around 1.

I now understand that many things effect tests such as time of day etc. And, I often now wonder could I have gotten treatment earlier if someone had tested my FT3 and gone by my symptoms alone?

The diagnosis and treatment of thyroid disease is a bit cruel.

Anyway, to answer your question, to use other countries parameters then yes, that result would indicate subclinical hypothyroidism but I am making assumptions about that range used and how some countries diagnose based on number of tests etc.

It will be interesting to see other responses as I’m curious how.

[poppppy in reply to HealthStarDust]

Thank you for yr reply . Totally agree with how bad the system are at diagnosis and treatment . I had tsh above 7 and they told me I was depressed . It was only when I pushed for antibody tests that I got their apology from gp . As antibody result proved I was auto immune thyroiditis. And ultra sound scan showed total atrophy .My niece had terrible struggle getting them to higher her dose of thyroxine.

Qnd yes it was the amazing folk on this site who told me about t3 and mine was abnormal even when t4 and tsh back in range . So I am now on liothyronine only and feel much better than I did

Thank you for your response

[greygoose]

A euthyroid (normal) TSH is around 1 - no matter what the range they put on it, a TSH is always a TSH. At 2 it shows that your thyroid is struggling. And at 3 you are technically hypo. I have no idea about how they do things in the US, but there are some countries that will diagnose at over 3.

The NHS, however, who absolutely hates diagnosing anyone with hypo, require it to get much, much higher before they will deigne to diagnose - and even then they try to make excuses not to.

And it's probably that same hatred of diagnosing that stops them testing FT4 and FT3! If they went by the FT3 they would have to diagnose too many people, and that would be expensive. But, due to the education doctors are given in most countries, the majority of doctors don't even know what T3 is - and several have admitted that to me. So, they probably wouldn't be able to diagnose by the FT3, anyway. And, as they have little idea what hypos symptoms are - being non-specific makes it too difficult for the poor darlings - they rarely take them into consideration either before or after diagnosis.

Where FT4 and FT3 are concerned, ranges vary from lab to lab according to the machine they're using and the local population - which is not a good way to set a range when doctors are going to treat the top level like the Berlin Wall: impenitratable! Ranges are only a rough guide at best, not cast-iron limits. Perhaps this article would interest you:

The normal range: it is not normal and it is not a range

ncbi.nlm.nih.gov/pmc/articl...

So, with a TSH of 4, your friend appears to be hypo, and should continue testing. But impossible to comment on the FT4 without the range.

[poppppy in reply to greygoose]

Thank you so much for this answer . Can I ask further on this please. If someone then is showing they are hypo via their tsh but free t4 and free t3 are in normal range does it mean one should be having thyroxine supplemented at this stage in a perfect world . Or not as at this stage they are managing to make enough on their own .

Or do u think if someone has a raised tsh of 4 and a normal t4 it would be probably impossible that they had a normal free t3 .

I think what I am getting at is if the NHS refuses to treat my friend with these levels should they start thyroxine themselves. As in a perfect world would they be started on it. Or should they try gluten free dairy free thyroid protocols to see if they can reduce their antibodies .

Also do u think people should push for antibody testing . It was my antibody results that convinced my nhs doc to take me seriously .

I will get them to push for t3 test. I got my go to do mine in the end after talking to yourself and your colleagues. And found I needed t3 liothyronine . So thank you again

[greygoose]

If someone then is showing they are hypo via their tsh but free t4 and free t3 are in normal range does it mean one should be having thyroxine supplemented at this stage in a perfect world .

In a perfect world, it would depend on the individual case:

- where their FT4 was in the range

- their level of FT3

- how they feel/symptoms, etc.

I'm not sure that it's always a good idea to intervene at that point. If they start on thyroid hormone replacement, their TSH will drop, so their thyroid will make less and less hormone until it finally 'goes to sleep'. So, starting on thyroid hormone replacement will not necessarily improve matters straight away. It could be argued that the sooner you start, the sooner you will get to your optimal dose, but it's also wise sometimes to leave well alone. I don't think you can make a one-rule-fits-all in these cases.

Or do u think if someone has a raised tsh of 4 and a normal t4 it would be probably impossible that they had a normal free t3 .

Not impossible at all. It could even be that the FT3 is higher in-range than the FT4, because that's what the thyroid does when it's failing: makes more T3 than T4.

Once you get on thyroid hormone replacement, it then depends on how well you convert. And you need to convert extra well because you will no-longer have that extra bit of T3 that a healthy thyroid makes. That's the difficult part. But, if you have a healthy, working gland, and you are a poor converter, the thyroid should make up the short-fall.

I think what I am getting at is if the NHS refuses to treat my friend with these levels should they start thyroxine themselves. As in a perfect world would they be started on it.

If they do that, then it will make it all the more difficult to get a diagnosis. And that could lead to complications in the future when seeking help for other health matters. If push come to shove, then yes, you have to take matters into your own hands - plenty do - but if it were me, I'd hold off for as long as possible. I do self-treat and know how difficult it can be.

Or should they try gluten free dairy free thyroid protocols to see if they can reduce their antibodies .

No, they should try gluten-free after having been tested for Coeliac, to see if it helps lessen their symptoms. There's nothing to be gained by reducing antibodies, they aren't doing any harm. Antibodies are the result of the disease, not the cause. Even if it were possible to reduce them - which I sincerely doubt - it wouldn't affect the progression, nor the outcome, of Hashi's. The Hashi's would still be there and run its course.

Same goes for dairy-free.

Also do u think people should push for antibody testing .

Oh, absolutely, yes! And not just to be taken seriously but to understand why levels are going to fluctuate even on the same dose, once you are medicated. Not knowing if you have Hashi's is like groping around in the dark, wondering why you can't get your dose right.