Thyroid blood test results

[Daytripper68]

Hello,

I was hoping someone would be able to help me with my recent blood test results please:

Serum TSH level - 6.53 (normal range 0.35 to 4.94)

Serum free T4 level - 9.2 (normal range 9.0 to 19.1)

Serum free T3 level - 4.2 (normal range 2.4 to 6.0)

Thyroid peroxidase ABS - > 1000.0 iu/mL (normal range 0 to 5.5)

I had the same tests last month and the T4 was higher at 19.9 and TSH was 0.01. I was told at this point that I had subclinical hyperthyroidism but shouldn’t be experiencing any symptoms. However, I have been getting lots of joint pain and other symptoms such as hair loss, bouts of anxiety and depression and burning skin sensations. It’s probably also worth noting that I did have a baby four months ago.

I also recently had full blood count done and a few of my results were low such as white blood cells, lymphocytes, and haematocrit, whereas my MCHC result was slightly high. Potassium also came back as slightly low. Could any of this be related to my thyroid?

Also had coagulation screen and have prolonged APTT of 38.1s. Normal range is 26.4 to 35.9. I had bloods taken for lupus coagulation but have to repeat the test so haven’t got any results for that yet.

I have no idea what any of this means but am suffering quite badly with the joint pain at the moment. If anyone could offer any insight it would be much appreciated!

Thanks 🙂

[Jazzw]

Are you on any thyroid medication?

You have autoimmune thyroiditis (often referred to here as Hashimoto’s or just “Hashi’s”). So your immune system is attacking your thyroid, that’s why you’re swinging between having symptoms of overactive and currently, under active thyroid. It’s quite common to have issues after childbirth. It may settle down—it may not.

[Daytripper68 in reply to Jazzw]

Thank you for your reply and for the information.

No I’m not currently on any medication. I have a doctor’s appointment booked but it’s not for a couple of weeks yet so was just hoping to get some information on this in the meantime as have been feeling quite unwell!

[greygoose]

Hi Daytripper68, welcome to the forum.

So, what does it all mean? Well...

Thyroid peroxidase ABS - > 1000.0 iu/mL (normal range 0 to 5.5)

These high antibodies are saying that you have Autoimmune Thyroid Disease - aka Hashi's.

It often happens that women who have just had a baby develop Hashi's. Unfortunately, despite seeing it over and over again, doctors haven't a clue what it's all about.

Hashi's is an autoimmune disease where the immune system attacks and slowly destroys the thyroid, mistaking it for the enemy. It often starts out with a false 'hyper' phase - hence your results for last month - no, you didn't have subclinical hyperthyroidism, you were having what we call a Hashi's 'hyper' swing.

Now, the swing has swung the other way and you are very hypo:

Serum TSH level - 6.53 (normal range 0.35 to 4.94)

TSH - Thyroid Stimulating Hormone - is a pituitary hormone. When the pituitary senses that there's not enough thyroid hormone in the blood, it increases its output of TSH to stimulate the thyroid to make more hormone. But, your thyroid has been damaged by the Hashi's and cannot comply. So, the TSH will just keep getting higher. A 'normal' (euthyroid) TSH is around 1, so you can see that yours is pretty high.

Serum free T4 level - 9.2 (normal range 9.0 to 19.1)

T4 is basically a thyroid storage hormone, which doesn't do very much until it is converted into the active hormone, T3. Your FT4 is very, very low - which is why your TSH is high.

Serum free T3 level - 4.2 (normal range 2.4 to 6.0)

Your T3 is OK at 50% through the range. But it's doubtful that that will last. Sooner or later, it will drop.

But in any case, with your over-range TSH, very low FT4 and very high TPO antibodies, you should be put on thyroid hormone replacement straight away.

[Daytripper68 in reply to greygoose]

Thank you so much for the information! That’s really helpful.

I got the impression that my GP didn’t really know much about it all when I got my first set of results last month. She mentioned writing to the endocrinologist for advice and said I may need a referral.

I was quite confused by the test results so thanks again for taking the time to explain them 🙂

[greygoose in reply to Daytripper68]

I don't suppose your GP knows anything about it at all. None of them do. They just don't learn much about thyroid in med school - nothing factual or helpful, anyway. And endos don't know much more because they're mainly diabetes specialists.

[SlowDragon Administrator]

Request GP test vitamin D, folate, B12 and ferritin

These are often low with Hashimoto’s

You also need coeliac blood test at diagnosis of Hashimoto’s

GP will most likely want to retest thyroid again in another 6-8 weeks before starting you on levothyroxine

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

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.

In U.K. medics hardly ever refer to autoimmune thyroid disease as Hashimoto’s (or Ord’s thyroiditis)

For good conversion of Ft4 (levothyroxine) to Ft3 (active hormone) we must maintain GOOD vitamin levels

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

Monitor My Health also now offer thyroid and vitamin testing, plus cholesterol and HBA1C for £65

(Doesn’t include thyroid antibodies)

monitormyhealth.org.uk/full...

10% off code here

thyroiduk.org/testing/priva...

[Hidden]

Your TSH is much too high because of your hypothyroidism, so it's not surprising that you're ill. T3 should be at least 5.2

[Daytripper68]

Thanks everyone for the helpful replies. I didn’t think my T4 or T3 were bad as they were still in the normal range, though only just for T4.

I suppose this could be what’s causing the joint pain and other symptoms I’ve been having then.

Does it usually affect other things such as white blood cell count/lymphocytes etc? I’m wondering if this is due to something else going on.