Can this be the start of hypothyroidism?

[poppppy]

My friend , who has no diagnosis of thyroid issues, had had bloods done by a functional medicine practitioner and was told their free t3 and free t4 are suboptimal and "need to be observed for any further deterioration ." The results they were given are as follows( ranges given in brackets );

Tsh 1.5 (02.7 to 4.2 )

Free t4 13.9 ( 12 to 22)

Free t3 3.2 ( 3.1 to 6.8)

Thyroglobulin antibodies 18.2 ( 0 to 115)

Thyroid peroxidase antibodies 10 ( 0 to 34 )

Can I ask you all Is there any significance in the t4 and t3 being low end of normal ? Or are they just that " normal " .

Any answers very welcome . And thankyou so much in advance for you time and knowledge . Greatly appreciated

[Buddy195 Administrator]

When medics say ‘within range’ or ‘normal’ this may not be the same as ‘optimal’ when one feels most well. TSH should always be under 2, with most members reporting that they feel best when TSH is under 1. However, it is extremely difficult to get any treatment via GP until TSH is significantly elevated.

Does your friend have any adverse symptoms or a family history of thyroid issues?

Has your friend had key thyroid vitamins tested (folate, ferritin, B12 and vit D), as having these optimal supports thyroid health.

[poppppy in reply to Buddy195]

Thank you . Yes my friend had the above tests I will ask her for the results thank you so much for your swift reply . Very kind of you

[poppppy in reply to Buddy195]

Hi my friend had the following results . Thank you so much for your help in this Iron 16.9 ( 10 to 30 )

Ferritin 55 ( 30 to 264 )

Active b12 73.9 ( 37.5 to 188)

Folate 13.2 ( >7)

Vitamin D 91 ( 50 to 250)

Thank you again for any further advice on this in advance . Greatly appreciated

[Buddy195 Administrator in reply to poppppy]

I like my levels to be:

Vitamin D (100-150nmol/L)

Vitamin B12 (Total B12 at top of range or for Active B12 100 or above)

Folate (at least half way through range)

Ferritin (half way through range) Although some point to 90-110ug as optimal.

Personally, I would try a good B Complex (eg Thorne Basic B or Ingennus) to improve and balance B vitamins. I would also try to include more iron rich foods into my diet, perhaps look at dailyiron.net for suggestions. SlowDragon regularly posts with suggestions on improving key vitamins

[FallingInReverse]

Is that the correct TSH range? Is the decimal point off?

Any symptoms? At all?

And has she had any vitamins tested?

[poppppy in reply to FallingInReverse]

Sorry its 0.27 . Thank you for pointing it out . And yes had vitamins tested . Will get her results. Dont think she has any symptoms . She had erythromelalgia diagnosed and chronic back problem . Thank you for your reply

[greygoose]

Her frees are very low, and certainly look hypo-ish. But the TSH doesn't correspond to the Free levels, which would make it difficult to get a diagnosis from a conventional doctor. But, what time of day was the blood draw for this test? Is this the first thyroid test she's every had?

[poppppy in reply to greygoose]

Thank you so much. The time of day was 1 pm approximately and this was her first test . Do you mind if I get back to you if she has any further questions . I respect your answers so much . You helped me in the past . So thank you

[greygoose in reply to poppppy]

Ok, so her TSH was at it's lowest point, which is not a good time to test. If she has another test it would be better before 9 am and fasting. And she should do another test in a few months time because you cannot tell much definitively based on just one test.

I do not mind being asked questions, no. And if I can I will answer them.

[poppppy in reply to greygoose]

Thank you so much

[Singoutloud]

It's too early to say for definite but the results might be pointing to a pituitary gland or hypothalamus issue that causes central or secondary hypothyroidism. I expect the reason the lab have stated the need for observation is to monitor if future results are consistently low or if this test is just a one off.

[poppppy in reply to Singoutloud]

Thank you so much for your reply . I will pass your answer on to her . Would you mind if I ask you further about the points you have raised thank you . No worries if you are too busy . You have been very helpful thank you

[poppppy in reply to Singoutloud]

Hi can I ask what is it about the results that make it look more like a pituitary gland or hypothalamus issue etc. Could you explain it more . So sorry to ask . Is there any further tests my friend should ask for to check for this also . And what would be the symptoms for these issues and diseases . Thank you in advance for your help and advice

[Singoutloud in reply to poppppy]

Sorry, only just noticed your replies. I only tend to dip in & out occasionally these days. I'm no expert I'm afraid but it has always stuck with me, from my own years of reading about thyroid issues, that if TSH and both frees are low it could be that the pituitary gland is not producing enough thyroid stimulating hormone (TSH) to encourage the thyroid to produce more ft4 & Ft3. That's the extent of my knowledge I'm afraid, I'm not sure how to go about getting it diagnosed but I believe the treatment would still be the same as for primary hypothyroidism. Happy to be corrected if wrong on this. If you search previous posts for secondary or central hypothyroidism you may find info from other members that have spoken about their journey.

[poppppy in reply to Singoutloud]

Thank you so much for your reply and I will check other posts like you said . So thank you you have been very helpful

[Beingreal99]

Sge may wantbto test b12 snd d3 and iron panel hence if low normal you will feel like the symptoms of hypothyroidism, extremely common low f3 and b12 and you Wang to be optimal not just low normal to be symptoms free,

[poppppy in reply to Beingreal99]

Thank you very much for your reply . Will pass it on so thank you