posted earlier today about how to get my blood results and managed to find them! Now in the predicament of figuring out what is what
my TSH in Jan was 0.6, and this new one has come back at 0.87
T3 is 5.7 (range is 3.5 to 6.5 according to endo)
T4 is 15.4 (range is 10.9-21.4 according to endo)
TSH receptor antibodies has come back at less than 0.1
Does these seem normal and then this means something else is causing me to feel like I do? Or is there something else I can do? Considering going private but want to make sure it’s actually my thyroid and in turn worth the money I’d spend.
Thank you!
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hythyfo
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You'd need to add the ranges for these results for us to make sense of them, if it's fT3 3.1-6.8 and fT4 12-22 then you can see your levels are on the low side for fT4 but it all depends on the range your lab uses
my TSH in Jan was 0.6, and this new one has come back at 0.87
Irrelevant at that level. Doesn't tell you anything much.
T3 is 5.7 (from research this seems normal)
You cannot 'research' ranges because they vary from lab to lab. One of the most common ranges for FT3 is 3.1-6.8, which would give you a percentage of 70.27 through the range. So, for whom would that be 'normal'? Certain not for someone euthyroid - well, they wouldn't be euthyroid at that level. There's no such thing as 'normal' where thyroid blood test results are concerned, there's only what's right for you as an individual.
T4 is 15.4 (unsure if this is normal, to me it seems high)
Much the same reply as above. The most common range for FT4 is 12 -22, which would give you 34% though the range, which isn't 'normal' for anyone - much too low. Euthyroid is around 50%.
TSH receptor antibodies has come back at less than 0.
I think that's more than likely negative, but the question is: why did they test it? Did they test TPO and Tg antibodies? They would seem more relevant. Because looking at your FT3 and FT4 levels, what comes to mind is Hashi's.
So would my t3 at that range come across as okay? And then my t4 is actually low? I genuinely have no idea why she tested for that, she didn’t explain anything at all. I’d asked for t3 and t4 based on our last conversation and she made some snarky comments if I’d googled those🥲 I didn’t feel like I could have an open conversation with her about anything or ask any questions at all
Not a lot different to the numbers I came up with above. FT4 is still low, and FT3 is still high. Neither of them are 'normal'.
In someone with not thyroid problems (euthyroid), the FT4 would be around 50% through the range, with the FT3 slightly lower. And whilst it is possible to have a naturally low-ish FT4, it is not, by any stretch of the imagination, to have a euthyroid FT3 that high - so much higher than the FT4. And whilst I'm not usually interested in ratios, it's obvious to anyone that that ratio is all wrong.
So, the question is: why? And this, I imagine, is why in her ignorance, the endo tested for Graves'! Although it looks nothing like Graves' if you actually know what Graves' looks like. It look more like Hashi's.
Hashi's - aka Autoimmune Thyroiditis - is an autoimmune disease like Gravesr', except that with Graves' the thyroid hormone levels are always both very high - much higher than your FT3, which isn't even over-range. With Hashi's, levels jump around all over the place, and one can be very high whilst the other is very low.
What happens with Hashi's is that your immune system is slowly destroying your thyroid, and the dying cells are depositing their stock of thyroid hormone - T4 and/or T3 - into the blood, causing levels to rise haphazardly.
And, anyone who knows anything about thyroid would look at those results and test Hashi's antibodies: TPO antibodies and Tg antibodies. Seems your endo doesn't know anything about thyroid. But, that's what you should do next: get your Hashi's antibodies.
As for snarky remarks about Google, think I would have said 'pity you don't do a bit more googling, you might know something about thyroid'!
i have to respectfully disagree a bit, GG.... yes i do agree that the difference between fT3 and fT4 is a little bigger than you'd expect to see , and yes this does indicate a potential issue when looked at together with the symptoms...
but your reply could give the impression that no one 'healthy' has fT3 higher than fT4, and that healthy fT4 should be around 50% in everyone .....
the study from Ankrah-Tetteh et al found fT3 sat higher than fT4 in about half the healthy young people they looked at, and fT4 levels of significantly higher and lower than 50% were common.. yes it was only 10 people .. i really wish there was a bigger/ better study, but haven't yet found one.
i know you've seen a lot of thyroid results on here ,,,,, i'm not doubting your much longer experience and judgement , cos i know you are often right ....but how much experience do any of us really have of what is common in healthy people ?
unless we have a study showing the healthy set points for a much larger sample of people, i just don't think it's right to say so categorically that T3 wouldn't ever be higher than T4 , or that T4 should be around 50%.
Ankrah-tetteh et al 2008 study is here : (see fig. 1)
Tania Smith (thyroidpatientscanada author) has put these individuals TSH / fT4 / fT3 levels together on same image to make it easier to see how fT4 / fT3 / TSH relate to each other in the individuals .. her image is in my reply below to hythyfo
Not sure I was that categoric, to be honest. And I don't think I've given any sort of 'impression' at all. That certainly wasn't what I said. So, I don't really know what you're disagreeing with.
And, as is always the case, how can one be sure that these people in the Ankrah-Tetteh study weren't cooking thyroid problems. That's the problem with ranges, isn't it, there's no guarantee that the sample of people used to set the ranges were 100% thyroid-healthy. And, I was just going by the graphs that are usually quoted on here and said 'around' 50%. I even said: And whilst it is possible to have a naturally low-ish FT4... And, given the OP's symptoms, which clearly show something is not right, I can't help feeling you're being a bit nit-picky, here.
Also, I was speaking in general - which seems pretty obvious to me because I cannot possibly know the blood test results of everyone on the planet! And, in general, that's the way it is. Of course there are always exceptions, that goes without saying - well, I thought it did, anyway - but apparently not.
Not sure what you're trying to prove, here, tatty, but I don't feel it's very helpful to anyone. And not like you at all.
basically i am just trying to be a bit protective of hythyfo in any upcoming experiences with doctors ....
my concern, and reason for sticking my head over the parapet to discuss the point is that if we send someone with T3 @73% and fT4 @43% off to the doctors using the argument that this difference in %'s can't be normal/ healthy (without acknowledging that it could well be for some) ...or that it is abnormal to have T3 higher than T4 (when it almost certainly isn't)
..... then we are just setting them up to receive another hefty dose of "it's all in your head/ you are obsessed with your thyroid/ go away "
and this type of interaction with doctors is so damaging to the self esteem , especially if you're in your early 20's .... not to mention that they will write on your notes.. "health anxiety / obsessive" etc..... that it will just make it even harder to believe in yourself and be taken seriously if/when results do start to show a clearer picture.
So that's why i'm being cautious about the explanation of ' what is normal ?' that we give people who have more 'borderline' deranged results with sometimes mismatched symptoms ....my aim is to help them stand up more effectively to doctors by providing evidence that can be shown to doctors , and not send them in there defenceless ready to be shot down and belittled (again) ....., just that ...i'm not trying to prove a point.
if the difference was bigger ,ie. more like T3 85% to T4 20% , i would not have felt any need to query you reply , as that sort of difference is not found even in ankrah tetteh's study..... hythyfo would then have solid grounds to say it's clearly abnormal ,, and more to the point would have some evidence to put in front of a doctor to back it up.
I don't like ahkrah tetteh's study much either ,i totally take your point ... it's definitely not great evidence (too few people ,lack of detail on what they meant by healthy , screening for thyroid antibodies... ) but it does exist , and until i've found anything that disproves it , i find it difficult to totally ignore it .
(also tbh... i trust Tania's judgement so far when it comes to interpreting studies , . and if she thought it was a totally flawed study , she wouldn't rely on it to make her points and she uses it quite often) .
i desperately need a wee ,so posting this before checking for typo's...
Tatty I was only suggesting she see a doctor to get her antibodies tested, not that she jump into the lion's den! But, you're probably right, private testing would be a far better solution - if that's an option.
However, I remain in total disagreement with you about the high FT3. And in that graph below, pretty certain that guinea pig n° 6 had some sort of thyroid problem and consider the whole study nul and void because they didn't test antibodies. Which is a totally unforgivable omission!
thank you! Is this worth me then progressing down the private route because I genuinely don’t see myself getting anywhere with this endo, or I’ll have to wait months to be seen by gp, hopefully referred to endo, and then wait months to be seen by an endo? I couldn’t believe the comments because surely me researching is a good thing?🤣
Nooooooo! They don't like informed patients because it shows up their ignorance. The last thing they want is a mere patient telling them they're wrong? 🤣 They like patients that keep their mouths shut and do as they're told.
So, yes, chose your endo wisely - ask for recommendations, etc. And then ask that endo to test for Hashi's antibodies. If you do have Hashi's then your FT3 has probably been low at some point, upsetting the delicate hormonal balance of your body and causing symptoms.
OK, so just seen below that you do, in fact have Hashi's! And that changes everything because the disease has not yet damaged your thyroid enough for it to show, so no doctor is going to do anything about it. There is no treatment or cure for Hashi's, the only thing that can be done is to replace the missing hormone when your thyroid becomes incapable of making enough for your needs. I realise you have symptoms but that is probably because of the fluctuating levels of hormone that you're experiencing at the moment.
So, you don't need a private endo at the moment. There's nothing he can do. But do your research for the future and find a good one ready for when you need one. In the meantime, do the occasional private test to keep an eye on thyroid hormone levels - most doctors will only test TSH. And get your nutrients tested: vit D, vit B12, folate and ferritin. These will more than likely be low and causing symptoms. So, optimising those could help enormously. When you've had them tested, post the results and ranges on here, and we can help you formulate a supplement plan.
hi , you mustn't assume the ranges used for your tests , you do need to know for sure what they are as it can make a big difference :
eg there is an fT4 test in use in at least 2 NHS areas that has a range of about [7.9-14] ish .
If your fT4 result was 15.4 [7.9-14 ] then that means the level of fT4 in your blood is high ... 123% ....quite a bit over range,
but if your result is 15.4 [12-22] then your result means the fT4 level in your blood is much lower ...34% through range...ie 'normal' but on the low side.
(there are also other rages in common use in NHS labs eg [9-21]ish or [11-26]ish )
if your fT4 / fT3/ TSH are all within range, then before spending money on seeing someone else , you need to be realistic about they are able to do for you at this stage ... the only options they have for treating abnormal thyroid hormone levels are:
1) to prescribe thyroid hormone to raise fT4 / fT3 levels if they are below range (or if TSH is consistently over range)
or
2) to prescribe 'antithyroid' drugs ( carbimazole) to lower your fT4 / fT3 production if your fT4 / fT3 are consistently too high .... this is not prescribed lightly as it does have the potential for serious side effects on liver function.
if your fT4 or fT3 are not CURRENTLY over range , then there is not a lot they can do AT THE MOMENT other than watch and wait and keep monitoring bloods at regular intervals to see if your fT4 / or fT3 levels are going to go higher or lower over time .. or are wildly swinging around.
TSH 0.87 (was 0.6 in Jan) .. on the face of it a very normal result for TSH
fT4: 15.4 [10.9 - 21.4] ......43 % through range
fT3: 5.7 [3.5 - 6.5] ............. 73 % through range
The only way to know whether these levels are 'normal for you ' is to observe what happens to them over time.
The difficulty doctors have at this point is that some people do have TSH / fT4 / fT3 levels like yours as their natural setpoint (when they are well) ....some people naturally have their fT3 slightly higher than their fT4 , while some other people naturally have fT4 a little bit higher than fT3.
unfortunately we don't know what your usual fT4 / fT3 levels are when you feel well. so we don't know if these current levels are usual for you or not.
The image below shows results taken from 10 healthy people.....some have T3 (pink) naturally sitting a little bit higher than fT4 (blue), while some have T3 naturally sitting a little bit lower than fT4.
So... the fact that your fT3 is higher than your fT4 does not necessarily mean there is any problem .. for example "person 10" has very similar levels to you as their 'usual/ healthy'
However if "person 3" (who has lower levels of fT3 as their usual), suddenly found thier fT3 up at 70% then you would expect them to feel some symptoms of 'too much thyroid hormone' ....
if fT3 at 70% is higher than your 'usual / healthy' , then yes it could explain some of your symptoms.
i'm really sorry this reply doesn't point a clear way forward .. i'm just trying to explain why it's not easy for any doctor (even a good one) to decide what to do with you at the moment and why they are all saying "go away / normal/ all in your head ".
honestly , i think your best plan is to wait 6-8 weeks and retest TSH / fT4 / fT3 /TPOab / TGab yourself so you have a better picture of what is happening to your thyroid levels over time before considering seeing anyone else about it ... private testing doesn't have to be expansive ..(Monitor My Health (an NHS lab) is only about £30 and Thyroid UK have a discount code)
if it helps any .... my daughter is 25 and is having some very similar issues, ie, anxiety /insomnia / no energy / losing weight / blood pressure and pulse a bit high .... TSH is 0.6 and fT4 is 80%.... but as we don't know what her 'usual' is as it's the first test she's ever had , and she had been under a lot of stress for a several months which is now gone and the insomnia is slowly improving ( and because the experience of yet another GP offering her antidepressants will do her head no good at all) ..... so we have decided to wait another couple of months while continuing healthy regime of stress reduction methods / trying to eat better / sleep hygiene etc to see if symptoms improve and then retest FT4 / fT3 / TSH / and thyroid antibodies.
Thank you! I’ll order one of those tests in a month or two and see what it comes back at. It’s frustrating as I’ve only had TSH done before I felt ‘ill’ and between then and now it had dropped 0.6 to 0.65, and the most recent one is 0.87
Frustrating as doctors argue that you’re too young to be ill! I’ve tried literally everything I can with food, sleep etc. it’s genuinely affecting my MH now but feel like I can’t mention that to the doctors as that’ll be used against me!
2 possible reasons why you might have T3 that is 'too high for you as an individual' and causing your symptoms are :
hashimoto's/ autoimmune hypothyroidism.... which as GG has explained can initially lead to levels of T4 / T3/ TSH going all over the place for a while (often seeming to be inconsistent with each other), until it get's bad enough to show a clearer picture of rising TSh with lowering T4 levels. Testing TPOab and TGab will give you a clue if hashimoto's is the cause.
or.....
some people develop thyroid nodules that can overproduce T3 ( called 'hot' nodules) you would need some sort of thyroid scan to tell if your higher T3 level was due to a hot nodule. An ultrasound scan can see a nodule , but cannot tell you if it's 'hot' or not.... endocinologist would need to arrange a thyroid uptake scan to see if that was the case,, but i think it unlikely they would be willing to do that at this point unless your T3 was higher or over range and /or your TSH was below range.
My TPOab was 44, which from what my mum explained is slightly higher than the 0-30 normal range. Got a massive family history of thyroid cancer/hashis/graves so it’s frustrating that it’s not been taken seriously. I genuinely don’t think I’ll get anywhere with the endo that I’ve seen now, I’m back to square 1 with the NHS or I’ll have to go private
just noticed you do already have a TPOab result (thyroid peroxidase antibodies ):
TPOab was 44
can you find the range for that ? (some TPOab ranges are 'less than 34 is normal' ,, but there are others eg 'less than 50 is normal' )
bear in mind in hashimoto's it's common to have TPOab in the hundreds, and even thousands. so even if your result is technically over range , 44 might be viewed by most GP's as a bit borderline/ inconclusive
Yeah they said the range was 0-30. It’s ever so slightly elevated compared to my mums that came back at 3000 which is why I kind of figured that it may not be hashis
Your experience with that arsewipe of an endo doing a proper number on your mental health is exactly what i'm hoping to protect my daughter from., and why i suggested she didn't take it any further with the NHS just yet.
Once you realise that there is nothing they can actually do with your CURRENT results other than watch and wait and then maybe some further testing.... and that the NHS will probably only do half arsed testing of 'just TSH' , or 'TSH/ T4 without fT3', then in my opinion you may as well stay away from them just for the time being while you watch and wait and gather some proper evidence of what your TSH/ fT4 / fT3 are doing for yourself.
(using MonitorMyHealth is a good idea because it is an NHS lab that runs the tests so it's harder for a GP to say your private results are unreliable)
That way you are at least looking after your mental health. even if there's not an obvious way to fix the physical just yet.
She has just managed to enjoy a long weekend with some friends despite having not enough energy , and is feeling good about herself, and positive about continuing to do stuff that she knows is good for her for a few more weeks. like trying to eat more, avoid / manage stress, and being patient for a bit longer while we gather more evidence of what is happening ... and as a result is feeling in control of what decisions she's making about her health . and is not being made to feel like a hypochondriac.... because frankly whether or not she has a thyroid problem developing ,i know that being made to fee like a silly hypochondriac is definitely going to be very bad for her .
umm.... if your GP has these results then ask GP reception for a printout of these results .... ranges will usually be on there ...
if GP does not have these results , then i'd ask someone at where ever you had the blood drawn which lab they use , then contact the lab directly to ask for ref ranges.
Forgive my lack of technical input here. I’m sorry if the bickering has confused you. Each of those members was ‘correct’ in their opinions. I think it’s important though not to get too hung up on number crunching or we’re in danger of becoming as bad as the doctors we criticise.
Your bloods look fine to me and are similar to mine. If you feel good at your current levels, then celebrate that and don’t over analyse.
There’s no ‘normal’ in the thyroid world. Optimal for what we aim for.
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