I recently had a blood test which showed that my TSH was 0.27mU/L (0.35.5.5) and T4 was 11.3pmol (10-20). I'm waiting to hear back from my doctor, but does this show that there's potentially an issue with my thyroid? This is all new to me so I would appreciate some help, thank you.
Is this subclinical hyperthyroidism?: I recently... - Thyroid UK
Is this subclinical hyperthyroidism?
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Not enough testing to be useful
If anything low Ft4 suggests hypothyroid
are you male or female
Approx age
Are you in U.K.
For full Thyroid evaluation you need TSH, FT4 and FT3 tested
Also both TPO and TG thyroid antibodies tested at least once to see if your hypothyroidism is autoimmune
Very important to test vitamin D, folate, ferritin and B12 at least once year minimum
Low vitamin levels are extremely common when hypothyroid, especially with autoimmune thyroid disease
About 90% of primary hypothyroidism is autoimmune thyroid disease, usually diagnosed by high TPO and/or high TG 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.
Significant minority of Hashimoto’s patients only have high TG antibodies (thyroglobulin)
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
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
Post all about what time of day to test
healthunlocked.com/thyroidu...
Testing options and includes money off codes for private 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
Thanks SlowDragon! I am a woman and 27, UK. Folate, b12 and vitamin D are fine but ferritin is low. I didn't eat anything before my blood test and only drank water. I'll check out those links.
Hi 16yearsofpainsofar, welcome to the forum.
It doesn't show any sort of hyperthyroidism. But we don't really have enough information about you to know what it shows.
The TSH is low, yes, but on the other hand, the bottom of the range is too high. And if you were hyper it would be much lower than that.
Your FT4 is very low, but that doesn't mean much without an FT3 result. But, if you were hyper it would be way, way above the top of the range.
And we need to know the time of the blood draw, and whether you have any sort of thyroid diagnosis, and if you're taking anything for it. Interpreting thyroid blood test results is not as simple as it might seem.
Thanks greygoose. Dr was actually checking something else but included tsh and T4 in the blood test. T3 wasn't tested. No thyroid diagnosis so no meds. Blood test was in the afternoon but I hadn't eaten anything and only drank water. I just want to know what is wrong with me 😔
Well of course you do - don't we all!
So, a TSH tested in the afternoon is going to be low. It's best to test it before 9 am, when it's at its highest.
Given your very low FT4, I think it would be a good idea to get full thyroid testing privately:
TSH
FT4
FT3
TPO antibodies
Tg antibodies
vit D
vit B12
folate
ferritin
to get the full picture. You really can't tell very much from just a TSH and an FT4. And have the blood draw before 9 am. That will give you a better idea of what is going on.
That's good to know about the time of day! I think I will look into private testing so I get the full picture!
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looking at your other posts you have psoriasis and possibly endometriosis
Both are autoimmune and having one autoimmune disease makes others more likely……especially autoimmune thyroid disease also called Hashimoto’s
Hashimoto’s frequently starts after hormonal changes, eg pregnancy or menopause
Yes I'm no stranger to autoimmune diseases, unfortunately! I gave birth almost a year ago so that might've affected my thyroid?
Yes many of us with Hashimoto’s get diagnosed after pregnancy
That's very interesting. I'm definitely bringing this up when I speak to my Dr! I looked at the symptoms of Hashimoto's and I have many of these. I am underweight and don't gain weight so this doesn't align with Hashimoto's or maybe weight doesn't matter?
Medics tend to assume you can only be hypothyroid if you’re overweight
But significant minority of Hashimoto’s patients struggle to maintain weight, especially if also develop gluten intolerance (very common)
U.K. medics generally only call hashimoto’s autoimmune hypothyroid (and they almost always ignore the autoimmune aspect of disease)
Hashimoto’s frequently starts with transient hyperthyroid type results and symptoms before becoming increasingly hypothyroid
I can't tolerate gluten!! Stopped eating it in my teens as it made me swell up and I was in so much pain. That's why I didn't think I could have Hashimoto's because I'm underweight!
So it’s looking more and more likely that you do have Hashimoto’s ……or coeliac
Were you tested for coeliac before you cut gluten out?
No point testing now as you are already gluten free
No I stopped eating it before I could have the test. This was 10 years ago so I don't fancy eating gluten again to have the test done. I wish the Dr had told me this back then.
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Low ferritin
Heavy or prolonged or frequent periods will lead to low iron and ferritin ask for full iron panel testing for Anaemia
cks.nice.org.uk/topics/anae...
Serum ferritin level is the biochemical test, which most reliably correlates with relative total body iron stores. In all people, a serum ferritin level of less than 30 micrograms/L confirms the diagnosis of iron deficiency.
Never supplement iron without doing full iron panel test for anaemia first and retest 3-4 times a year if self supplementing.
It’s possible to have low ferritin but high iron
Test early morning, only water to drink between waking and test. Avoid high iron rich dinner night before test
Stop iron supplements 5-7 days before testing
Medichecks iron panel test
medichecks.com/products/iro...
Look at increasing iron rich foods in diet
Eating iron rich foods like liver or liver pate once a week plus other red meat, pumpkin seeds and dark chocolate, plus daily orange juice or other vitamin C rich drink can help improve iron absorption
List of iron rich foods
Links about iron and ferritin
irondisorders.org/too-littl...
davidg170.sg-host.com/wp-co...
Great in-depth article on low ferritin
oatext.com/iron-deficiency-...
drhedberg.com/ferritin-hypo...
This is interesting because I have noticed that many patients with Hashimoto’s disease and hypothyroidism, start to feel worse when their ferritin drops below 80 and usually there is hair loss when it drops below 50.
healthunlocked.com/thyroidu...
Posts discussing Three Arrows as very effective supplement
Great replies from @FallingInReverse
re ferritin and Three arrows
healthunlocked.com/thyroidu......
healthunlocked.com/thyroidu...
healthunlocked.com/thyroidu...
Great reply by @fallinginreverse
healthunlocked.com/thyroidu...
Iron patches
healthunlocked.com/thyroidu...
Thyroid disease is as much about optimising vitamins as thyroid hormones
healthunlocked.com/thyroidu...
restartmed.com/hypothyroidi...
Post discussing just how long it can take to raise low ferritin
healthunlocked.com/thyroidu...
Iron and thyroid link
healthunlocked.com/thyroidu...
Posts discussing why important to do full iron panel test
healthunlocked.com/thyroidu...
Good iron but low ferritin
healthunlocked.com/thyroidu...
healthunlocked.com/thyroidu...
Chicken livers if iron is good, but ferritin low
healthunlocked.com/thyroidu...
Shellfish and Mussels are excellent source of iron
healthline.com/nutrition/he...
Iron deficiency without anaemia
healthunlocked.com/thyroidu...
Ferritin over 100 to alleviate symptoms
healthunlocked.com/thyroidu...
healthunlocked.com/thyroidu...
Great research article discussing similar…..ferritin over 100 often necessary
ncbi.nlm.nih.gov/pmc/articl...
Low Iron implicated in hypothyroidism
healthunlocked.com/thyroidu...
Really interesting talk on YouTube, link in reply by Humanbean discussing both iron deficiency and towards end how inflammation can also be an issue
healthunlocked.com/thyroidu...
Inflammation affecting ferritin
healthunlocked.com/thyroidu...
Updated reference ranges for top of ferritin range depending upon age
healthunlocked.com/thyroidu...
Thank you for your incredible patience while you have been awaiting the outcome of our ferritin reference range review. We conducted this with Inuvi lab, which has now changed the reference ranges to the following:
Females 18 ≤ age < 40. 30 to 180
Females 40 ≤ age < 50. 30 to 207
Females 50 ≤ age < 60. 30 to 264l
Females Age ≥ 60. 30 to 332
Males 18 ≤ age < 40 30 to 442
Males Age ≥ 40 30 to 518
The lower limits of 30 are by the NICE threshold of <30 for iron deficiency. Our review of Medichecks data has determined the upper limits. This retrospective study used a large dataset of blood test results from 25,425 healthy participants aged 18 to 97 over seven years. This is the most extensive study on ferritin reference ranges, and we hope to achieve journal publication so that these ranges can be applied more widely.
Looks more like central hypothyroidism - where the hypothalamus or pituitary doesn't respond to low thyroid hormones by making TSH rise. Most GPs haven't a clue about central hypo (or anything except TSH). What time of day was test done? Have you ever had a head injury or whiplash? Have you had a problem with excess bleeding in childbirth?
Interesting! Never heard of central hypo. It was done in the afternoon (a couple of weeks ago) but I hadn't eaten anything beforehand. The GP is going to redo the test in the morning soon. I don't think I've ever had a head injury or whiplash. I tore during childbirth and since giving birth (nearly a year ago) I've been bleeding almost everyday. My periods have always been extremely heavy but now I'm bleeding all the time (heavy periods and heavy spotting between periods).