Help interpreting results: Told TSH levels norm... - Thyroid UK

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Help interpreting results: Told TSH levels normal when they're higher than the normal range

Lasagnebread profile image
6 Replies

Hi! A bit of background: I'm mid 30s & was diagnosed with subclinical hypothyroidism 2 years ago and my GP referred me to the consultant as I also developed a large goitre & have family history (my late Mum had hypothyroidism). Consultant told me I had Hashimotos & my TSH, T3, T4 & antibody levels were all over the place so I was tested for a few other things to try and make sense of it. Everything settled down eventually & I was discharged last month & told it was an episode of thyroiditis.

This month I saw my GP as I have developed really bad water retention in my legs & arms & feel absolutely dreadful. He sent me for some thorough bloods, I was told over the phone they were all normal but they've been put on the app and they don't look normal to me. I have made a follow up but it's not for another month.

Can anyone help me understand what might be going on here?

Results (sorry there are a lot!):

TSH - 11.16 (normal range 0.55 - 4.78)

T4 - 12.9 (normal range 11.5 - 22.7)

Serum Albium - 50 (normal range 35-50)

Serum Total Protein - 80 (normal range 60-80)

Serum ALT - 12 (normal range 10-49)

Total Alkaline phosphatase - 55 (normal range - 30-130)

Mchc - 310 (normal range 315-345)

Haematocrit - 0.473 (normal range 0.360 - 0.460)

RBC - 4.90 (normal range 4.10-5.10)

Haemoglobin - 143 (normal range 120-150)

HbA1c - 36 (no range given)

Hypochromasia 9% (no range given)

Erythrocyte Sedimentation Rate - 13 (normal range 0-12)

Serum cholesterol - 3.1 (no range)

LDL cholesterol - 3.0 (no range)

Non HDL cholesterol - 3.6 (no range)

Serum Ferratin - 8 (normal range 10-291)

Vit D - 49 (normal range above 49)

Serum Cortisol - 350 (normal range 145 - 619)

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Jaydee1507 profile image
Jaydee1507Administrator

Welcome to the group. If you could complete your profile it helps members understand your thyroid journey so far and be able to advise you better. Click on your image icon to start. Fill out the free text box at the top.

Indeed you are right your results are not normal. With a TSH over 10 your GP should be starting you on Levothyroxine, hopefully at a dose of 50mcgs. Especially as you already have a diagnosis of subclinical hypothyroidism and Hashimoto's there is no doubt that you should be treated.

You could try phoning and asking for a sooner appointment to get you started.

Many with autoimmune thyroid disease aka Hashimoto's benefit from a gluten free diet. A smaller percentage of those also need to remove dairy from their diet to feel well. These are intolerances and will not show up on any blood test.

When hypo we get low stomach acid which means we cannot absorb vitamins well from our food, regardless of a great diet. For thyroid hormone to work well we need OPTIMAL levels of vitamins.

Have you recently or could you ask your GP to test levels of ferritin, folate, B12 & D3? Private tests are available, see link for companies offering private blood tests & discount codes, some offer a blood draw service at an extra cost. thyroiduk.org/testing/priva...

There is also a new company offering walk in& mail order blood tests in London, Kent, Sussex & Surrey areas. Check to see if there is a blood test company near you. onedaytests.com/products/ul...

Only do private tests on a Monday or Tuesday to avoid postal delays.

It's ideal if you can always get the same brand of levo at every prescription. You can do this by getting GP to write the brand you prefer in the first line of the prescription. Many people find that different brands are not interchangeable.

Always take Levo on an empty stomach an hour away from food or caffeine containing drinks & other meds. Many people find taking it at bedtime works well for them.

Did you do the test as per the protocol recommended here? Recommended blood test protocol: Test at 9am (or as close as possible), fasting, last levo dose 24hrs before the blood draw & no biotin containing supplements for 3-7 days (Biotin can interfere with thyroid blood results as it is used in the testing process).

Testing like this gives consistency in your results and will show stable blood levels of hormone and highest TSH which varies throughout the day. Taking Levo/T3 just prior to blood draw can show a falsely elevated result and your GP/Endo might change your dose incorrectly as a result.

SlowDragon profile image
SlowDragonAdministrator

Low vitamin levels strongly linked to being hypothyroid.

Serum Ferritin - 8 (normal range 10-291)

Ferritin is deficient

GP should do full iron panel test 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

dailyiron.net

Request B12 and folate levels tested too

Also coeliac blood test if not been tested at diagnosis of Hashimoto’s

SlowDragon profile image
SlowDragonAdministrator

Vitamin D is insufficient but easier to self supplement than ask GP

How much vitamin D are you currently taking

NHS Guidelines on dose vitamin D required

ouh.nhs.uk/osteoporosis/use...

GP will often only prescribe to bring vitamin D levels to 50nmol.

Some areas will prescribe to bring levels to 75nmol or even 80nmol

leedsformulary.nhs.uk/docs/...

GP should advise on self supplementing if over 50nmol, but under 75nmol (but they rarely do)

mm.wirral.nhs.uk/document_u...

But with Hashimoto’s, improving to around 80nmol or 100nmol by self supplementing may be better

pubmed.ncbi.nlm.nih.gov/218...

vitamindsociety.org/pdf/Vit...

Once you Improve level, very likely you will need on going maintenance dose to keep it there.

Test twice yearly when supplementing

Can test via NHS private testing service

vitamindtest.org.uk

Vitamin D mouth spray by Better You is very effective as it avoids poor gut function.

There’s a version made that also contains vitamin K2 Mk7.

One spray = 1000iu

amazon.co.uk/BetterYou-Dlux...

It’s trial and error what dose we need, with thyroid issues we frequently need higher dose than average

Vitamin D may prevent Autoimmune disease

newscientist.com/article/23...

Web links about taking important cofactors - magnesium and Vit K2-MK7

Magnesium best taken in the afternoon or evening, but must be four hours away from levothyroxine

betterbones.com/bone-nutrit...

medicalnewstoday.com/articl...

livescience.com/61866-magne...

sciencedaily.com/releases/2...

Recipe ideas

bbc.co.uk/food/articles/mag...

Interesting article by Dr Malcolm Kendrick on magnesium

drmalcolmkendrick.org/categ...

Vitamin K2 mk7

betterbones.com/bone-nutrit...

healthline.com/nutrition/vi...

serenfach profile image
serenfach

I suspect your GP did not even look at the results, but if he did, get a new GP. This one is happy for you to be ill. With a TSH that high, he should have started you on Levo straight away, and looked at why other results are off.

Ask the Practice Manager to put the test results back in front of the GP. If they still dont do anything, see if you can change your GP or surgery. With those results you must feel dreadful. Sending a hug.

arTistapple profile image
arTistapple

These results are not subclinical. You look more like fully hypothyroid.

Lasagnebread profile image
Lasagnebread

Thank you for the replies. I think your right that the GP hasn't looked serenfach . I'm going to chase again on Monday as I'm really struggling. I've been getting strange painful sensations on random areas of my skin and even clothes touching hurts - I'm sure it's all linked and it's just impossible to do anything when I feel so unwell and sore.

Someone asked about my folate & B12. I'm on a 3 month course of prescription folate atm 5mg a day as my levels were very low and have an over the counter B12 spray that I take daily with this. My levels are normal for these two things at least! Folate is 416 (range 211-911) and B12 is 9.6 (normal range above 5.4)

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