Hi everyone
I’m new here.
Can someone help me settle a bit of an argument around TSH & T4 levels please?
I have recently had a consultation with Newson health who tell me on 100mcg thyroxine my TSH should be <1.
My GP is denying that stating my TSH is normal at 2.5. My T4 is 18.0.
I have felt like I’m literally dying for 3 months. I’m about to start HRT.
Can anyone advise on this thyroid please? I’ve been taking Levo since 2018 and was increased from 75mcg to 100mcg in May.
Your fT4 is only mid range and adding HRT might drop that slightly lower... have you done a full thyroid panel to see how much you are converting to fT3?
Most of us feel better with a TSH of 1 or below, 2.5 is too high and your fT4 too low if you still feel unwell
I can’t get a GP to budge on this. They won’t do anything more that a TSH and T4.
I can’t get a GP to budge on this. They won’t do anything more that a TSH and T4.
which is completely useless
TSH over 2 strongly suggests you need dose INCREASE in Levo
Like thousands of U.K. patients you will need to test privately
Bloods should be retested 6-8 weeks after each dose change or brand change in levothyroxine
For full Thyroid evaluation you need TSH, FT4 and FT3 tested
Also both TPO and TG thyroid antibodies tested at least once
Very important to test vitamin D, folate, ferritin and B12 at least once year minimum
About 90% of primary hypothyroidism is autoimmune thyroid disease, usually diagnosed by high thyroid antibodies
Autoimmune thyroid disease with goitre is Hashimoto’s
Autoimmune thyroid disease without goitre is Ord’s thyroiditis.
Both are autoimmune and generally called Hashimoto’s.
Low vitamin levels are extremely common when hypothyroid, especially with autoimmune thyroid disease
20% of autoimmune thyroid patients never have high thyroid antibodies and ultrasound scan of thyroid can get diagnosis
In U.K. medics hardly ever refer to autoimmune thyroid disease as Hashimoto’s (or Ord’s thyroiditis)
Recommended that all thyroid blood tests early morning, ideally just before 9am, only drink water between waking and test and last dose levothyroxine 24 hours before test
This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip)
Private tests are available as NHS currently rarely tests Ft3 or all relevant vitamins
Testing options and includes money off codes for private testing
Medichecks Thyroid plus antibodies and vitamins
medichecks.com/products/adv...
Blue Horizon Thyroid Premium Gold includes antibodies, cortisol and vitamins
bluehorizonbloodtests.co.uk...
Only do private testing early Monday or Tuesday morning.
Link about thyroid blood tests
thyroiduk.org/testing/thyro...
Link about Hashimoto’s
thyroiduk.org/hypothyroid-b...
Symptoms of hypothyroidism
thyroiduk.org/signs-and-sym...
Tips on how to do DIY finger prick test
See detailed reply by SeasideSusie
healthunlocked.com/thyroidu...
Medichecks and BH also offer private blood draw at clinic near you, or private nurse to your own home…..for an extra fee
Welcome!
Neither of those " experts" is correct! So sorry that you are suffering at their hands.
Once replacement hormone is initiated TSH is no longer a reliable marker.....the TSH test was developed to diagnose hypothyroidism....nothing more. However it was tweaked as a "lazy" way to monitor dosing.....many are suffering as a result.
The most important result is FT3 ( the active thyroid hormone) followed by FT4 ( the storage hormone)
Basically...with no complications, T4 ( and some T3) is produced by the thyroid it then converts to T3 in various tissues of the body, that T3 is then transported to the nuclei of the cells where it attaches to T3 receptors, becomes active and goes on to fulfill it's function
If the system fails in any way hypothyroidism developes so firstly we need to establish conversion status which we can do by comparing FT4 and FT3 results.
High FT4 with low FT3 indicates poor conversion. this can sometimes be improved by optimising core nutrients vit D, vit B12, folate and ferritin.
So....a full thyroid test includes TSH, FT4, FT3, vit D, vit B12, folate, ferritin and thyroid antibodies TPO and Tg
For good health T3 must flood every cell in the body in a constant and adequate supply....i suspect your FT3 is low!
NHS test TSH and sometimes FT4 but rarely FT3 which, if low, is the cause of many many symptoms.....
To obtain full test results many of us resort to private testing
thyroiduk.org/testing/priva...
This should help
thyroiduk.org/if-you-are-hy...
i'd be inclined to refuse HRT until at least TSH, FT4 and FT3 are tested....HRT can affect thyroid hormone levels.
Do you have the reference range for your FT4 result....the numbers in brackets...withour ref ranges we can only guess as to your level of hormone because each lab's machine is callibrated to different ranges.
Ask your GP for further testing...or test privately...and come back with as much info as possible which will enable us to help you.
We are all here to help....just ask!
TSH should be under 2 as an absolute maximum when on levothyroxine
gponline.com/endocrinology-...
Graph showing median TSH in healthy population is 1-1.5
web.archive.org/web/2004060...
Comprehensive list of references for needing LOW TSH on levothyroxine
healthunlocked.com/thyroidu....
onlinelibrary.wiley.com/doi...
If symptoms of hypothyroidism persist despite normalisation of TSH, the dose of levothyroxine can be titrated further to place the TSH in the lower part of the reference range or even slightly below (i.e., TSH: 0.1–2.0 mU/L), but avoiding TSH < 0.1 mU/L. Use of alternate day dosing of different levothyroxine strengths may be needed to achieve this (e.g., 100 mcg for 4 days; 125 mcg for 3 days weekly).
It would be so much better if they just included an FT3 test as they used to do....FT3 stopped as routine in my area in 2002!
TSH is only a rough guide and is leaving many suffering.
Sorry SD on my soap box with this one!!
I haven’t had an NHS test in 10 years…..because they would only test TSH …..even by their own guidelines that’s wrong when TSH is suppressed
My GP was very happy to accept copies of private results
I wait to see what new GP and ICB area are like now I have moved house
Shocking isn't it
I told my Practice that it was a waste of time doing a thyroid test now because I'm on high dose T3 so TSH and FT4 are undetectable...self medicated because the NHS system can't treat me appropriately.
They don't even want to hear the words T3 now....and maybe learn something! They leave me to get on with it
The Practice team are all lovely people but T3 seems to scare the living daylights out of them
Bizarre!
Best of luck with your new GP
what are optimal levels on combined t4/t3 please?
Relevance of TSH vs T3/T4
TSH &T4 levels after total thyroidectomy
TSH and T4 numbers haven't budged
Tsh and t4 rising on treatment 
