Advise on TSH and FT4 results

[WalterFred]

Hi All,

Last week, I had a liver fibroscan, and the nurse informed me I had no scarring. However, he noted that there is a lot of fat (CAP score 307).

The nurse took some blood samples, including TSH and free T4, as well as vitamin D, iron, transferrin, transferrin saturation, and ferritin.

I already have the TSH and FT4 results, which are: TSH - 0.65 (0.35 - 4.94 mIU/L) and FT4 - 12.6 ( 9 - 19.1 pmol/L).

The results for the other tests were vitamin D - 50 (50 - 200 nmol/L), iron - 21 (12 - 31 umol/L), Transferrin - 3.03 (1.74 - 3.64 g/L), transferrin saturation - 27 (20 - 50 %), ferritin 88 (30 - 300 ug/L).

Although these results are within normal ranges, both my mother and uncle had thyroid nodules, and I'm wondering if I need any further tests as I seem to suffer from symptoms associated with thyroid issues, such as exhaustion, cold intolerance, anxiety, insomnia, dry skin, etc.

I would be interested in others thoughts on these results and whether I should have more detailed thyroid tests.

[TiggerMe]

Welcome aboard

You are very low in Vit D which makes you feel awful, aim to get your level up to 100-125, this can be done quite quickly with a loading dose for a few weeks if well tolerated and then drop back to a maintenance dose.... grassrootshealth.net/projec...

Have you had any results for B12 and folate? Iron is ok

Your fT4 is on the low side but I'd look at improving your vits and mins before retesting with a full thyroid panel to see where your fT3 level is and go from there

[WalterFred in reply to TiggerMe]

Thanks for the reply, they didnt test for B12 or folate so maybe I will ask to get these tested as well and then get the full Thyroid panel test in a few months.

[DippyDame]

Yes... you need to include FT3 in your tests

Your vit D at 50 nmol/L is far too low ....should be 110 -150 nmol/L

Optimal ferritin level for thyroid function is 90-110ug/L

Being in "normal range" means nothing...we aim to find the exact point within the reference range where symptoms are relieved...

You have hypothyroid symptoms.....you require replacement thyroid hormone(s)

Fatty liver can be a hypothyroid symptom, not necessarily an alcohol issue

Was your cholesterol checked it's probably raised for the same reason....avoid statins if you can/ correct thyroid medication. See link below. My cholesterol dropped when my Frees were corrected.

thyroiduk.org/related-condi...

Full thyroid test...

TSH, FT4, FT3, vit D, vit B12, folate ferritin and thyroid antibodies TPO and Tg

I suspect your FT3 is low....you may need to test privately

thyroiduk.org/testing/priva...

[WalterFred]

Thanks for the info, I am taking statins but they didnt test for cholesterol levels.

The reason for all the tests was because 6 months ago I had an episode of acute pancreatitis and because I was a drinker they referred me to a liver specialist who I am seeing next week.

I stopped drinking after the acute pancreatitis episode and it looks like I have a fatty liver, but as you say, this may not be alcohol related.

Hopefully the liver consultant will pick up on the thyroid levels and get the other tests done for me.

[SlowDragon Administrator]

Hopefully the liver consultant will pick up on the thyroid levels and get the other tests done for me.

Better to get full testing done BEFORE consultation

For full Thyroid evaluation you need TSH, FT4 and FT3 tested

Also both TPO and TG thyroid antibodies tested at least once for autoimmune thyroid disease

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

B vitamins often lower as we get older and alcohol lowers B vitamins

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

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

[WalterFred]

Very interesting post SlowDragon, it looks like I need a lot of other tests doing, and will probably need to get them done privately.

My blood tests last week were taken at about 2pm which may be when TSH is at its lowest, so its a good idea to have them tested again early morning.

What I dont understand fully is whether I may have hyperthyroidism or hypothyroidism. My guess was hyperthyroidism because the TSH is only just above the minimum and the T4 is in the low end of acceptable. However I guess more testing is needed.

My main symptoms are joint/muscle pain, exhaustion, anxiety, cold intolerance & insomnia. Whether these are Thyroid related or something else, I dont know.

I'm now dosing with 25,000 iu of Vitamin D for 3 days followed by 6000 iu maintenance dose. Also B vitamins.

[gabkad]

Have you looked up the symptoms of fatty liver? That might be the most obvious reason you feel unwell.