Help with results undetectable tsh : hi I posted... - Thyroid UK

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Help with results undetectable tsh

Victoria27 profile image
13 Replies

hi I posted the other week about having a tsh of 0.008 a few weeks ago but it was an at home test. I’ve had them repeated through the doctors and these were the results:

Tsh 0.001 (0.49-5.2)

Free t4 11.4 (11.5-22.7)

Free t3 5.6 (3.5-6.5)

It doesn’t make sense to be hyper while my t4 is low. I’ve been off levothyroxine for 10 years nearly after I was put on it when I was 18 when my tsh was just under 7. After stopping it after 5 years my tsh and t4 have been normal (tsh around 2). But I’m thinking something must be off. I had a course of steroids a month ago so surely this wouldn’t still affect my tsh now?

All my other routine bloods were normal except an elevated bilirubin level but I can’t see any connection there.

Any thoughts would be appreciated. Thanks

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Victoria27
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greygoose profile image
greygoose

You're not hyper, you're hypo. Your Frees are still quite low.

It's not having a low TSH that makes you hyper, it's very high FT4/3.

What time of day was the blood draw for this test?

Victoria27 profile image
Victoria27 in reply togreygoose

9.30. Sorry yes I thought one should be low and one should be high not both low. I’m trying to conceive so really didn’t want my results to be hypo

greygoose profile image
greygoose in reply toVictoria27

It's like a seesaw: the lower the Frees are, the higher the TSH, and vice versa. But it's the TSH that follows the levels of the Frees, not the other way round. All the TSH does is tell the thyroid that it needs to make more hormone, and when the thyroid responds, the TSH drops. TSH has nothing to do with conception or anything much else.

I’m thinking something must be off. I had a course of steroids a month ago so surely this wouldn’t still affect my tsh now?

Well, it could, because the TSH moves very slowly. But, you are showing hypo because your FT4 is so low, and a low FT4 is not good when trying to conceive.

On the other hand, your FT3 is 70% through the range, so that might also account for the very low TSH. But that in itself is not normal. Normal is having the FT3 slightly lower than the FT4 at around 50% through the range for both of them.

So, why did you stop the levo all those years ago? Are you taking anything at the moment? Have you ever had any antibodies tested?

Victoria27 profile image
Victoria27 in reply togreygoose

Thanks for explaining it. I didn’t just want the dr to stick with “Subclinical hyperthyroidism” and leave me when I could need treatment so needed to understand it better myself.

A different dr reviewed my bloods one day and decided I shouldn’t have ever been on Levo as I was too young and I had no antibodies so stopped it and retested my tsh 3 months and 6 months later and it was around 1-2. It was probably irresponsible looking back but I didn’t know better and haven’t had it retested since until now.

greygoose profile image
greygoose in reply toVictoria27

It was irresponsible of that doctor! Of course you didn't know any better, why would you? But he should have. Too young indeed! Some people are born with hypothyroidism.

Anyway, you now have another idiot doctor who thinks you can be hyper with practically not T4 in your blood! In no way do those results suggest hyperthyroidism, subclinical or otherwise. But he should recognise that your results are not 'normal'. There's something wrong, and his job is to find out what. And, the first thing he should do is test antibodies. Just because you didn't have them when you were younger doesn't mean you don't have them now. And, if they still come back negative, the next step is to get an ultrasound of the thyroid to see if there's any damage. You need that FT4 higher if you're hoping to conceive.

Victoria27 profile image
Victoria27 in reply togreygoose

Yes I’m realising this now and wishing I’d done more but I can’t change the past. I only got these results yesterday but if they don’t phone me on Monday I’ll be making an appointment- I just need to do some research myself so I know what to go into the appointment with so they can’t tell me again it’s Subclinical hyper when they’re obviously ignoring the t4 result.

Thanks for taking the time to reply it’s making me understand it more.

greygoose profile image
greygoose in reply toVictoria27

You're welcome. :) And if you have any other questions, don't hesitate to ask. Good luck! x

Victoria27 profile image
Victoria27 in reply togreygoose

My gp have got in touch saying they want me to repeat bloods in 8 weeks and aren’t too concerned as my tsh isn’t high. Is it worth pushing to see if I can get my antibodies tested or is that more something that’s done when tsh comes back as high? Thanks in advance

greygoose profile image
greygoose in reply toVictoria27

Well, antibodies should have been tested when you were first diagnosed. But, I think you have more chance of getting high results when your TSH is low, rather than high, because antibodies fluctuate all the time, but tend to be highest when the thyroid is under attack. And at that time the TSH will be low because of the extra thyroid hormones leaking into the blood. So, yes, push! :)

Victoria27 profile image
Victoria27 in reply togreygoose

Thank you I will do then i just wasn’t sure if it wouldn’t be worth it because I keep reading about high tsh and antibodies. Thanks for your help

greygoose profile image
greygoose in reply toVictoria27

There's no direct connection between the two, so I wouldn't worry about that. You do need to know. :)

SlowDragon profile image
SlowDragonAdministrator

well you need thyroid antibodies and vitamin D, folate, B12 and ferritin levels tested

Low thyroid hormones leads to low vitamin levels and low vitamin levels tends to lower TSH

What vitamin supplements are you taking

Remember to stop taking any supplements that contain biotin 5-7 days before all blood tests as biotin can falsely affect results

What was reason for steroids?

Steroids can lower TSH

Recommended that all thyroid blood tests early morning, ideally just before 9am, only drink water between waking and 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

thyroiduk.org/testing/

Medichecks Thyroid plus BOTH TPO and TG antibodies and vitamins

medichecks.com/products/adv...

Blue Horizon Thyroid Premium Gold includes BOTH TPO and TG 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

support.medichecks.com/hc/e...

Medichecks and BH also offer private blood draw at clinic near you, or private nurse to your own home…..for an extra fee

Victoria27 profile image
Victoria27 in reply toSlowDragon

I’m currently taking folic acid 400mcg and vit d 400units as recommended by fertility specialist. I was on prednisolone for my previous ivf round embryo transfer but stopped as it was unsuccessful. But either way it wouldn’t affect my t4 would it and that’s still low/slightly out of range.

I’ll speak to them Monday if they’ll test the vitamin levels but I can easily order one online. Although will it be accurate if I’m already taking folic and vit d (albeit in a low dose)

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