Bit new to all this so please bear with. 2 months ago my TSH was 3.8 so no T4 was done. Having lots of Hypo symptoms (both my mum and her mum were hypo so I’m familiar with the signs) but GP said all ok.
Scroll forward 2 months and my TSH is 0.1 and T4 is 15 (within normal I know) but my Hypo symptoms are still there including hoarse voice, hair dropping etc. My weight has dropped a bit but that’s probably through worry!
Do they fluctuate like this before deciding what side, hypo or hyper? What should I ask GP to do, as it seems they need a push these days 🙁
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Could you add reference ranges for your results (as these can vary between laboratories)
What dose of Levothyroxine are you taking?
I would ask for key thyroid vitamins to be tested (ferritin, folate, B12 and vit D) as these support thyroid health. It would also be useful to know FT3 levels for a complete picture of your thyroid health. If GP unable to do this, look to do this privately, as many (myself included) do.
Have you ever had thyroid antibodies tested to confirm an autoimmune condition, aka Hashimotos?
Even though your TSH has fallen under 1, this does not indicate hyperthyroidism. It is possible to have ‘hyper like’ symptoms with hypothyroidism.
Interestingly, my results from 2 months ago showed my ferritin at 57.
I’m not on any medication at the moment but my symptoms are all over the place so I’m wondering if I should ask for antibody tests to rule out Hashimotos.
I’m to do a repeat blood test in 1 month and have booked it for 08:20 having read invaluable advice on here. It’s just that everything’s a fight with the GP and my energy level is rubbish at best!
Autoimmune hypothyroid disease- Hashimoto’s frequently starts with slightly hyper phase….this is not true hyperthyroid….but caused by excess thyroid hormone being released as cells are breaking down
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
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
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)
NHS only tests TG antibodies if TPO are high
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)
Essential to test vitamin D, folate, ferritin and B12
Lower vitamin levels more common as we get older
For good conversion of Ft4 (levothyroxine) to Ft3 (active hormone) we must maintain GOOD vitamin levels
What vitamin supplements are you taking
Also VERY important to test TSH, Ft4 and Ft3 together
What is reason for your hypothyroidism
Autoimmune?
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
IMPORTANT......once you start on vitamin B complex, or any supplements containing biotin, remember to stop these 5-7 days before ALL BLOOD TESTS , as biotin can falsely affect test results
In week before blood test, when you stop vitamin B complex, you might want to consider taking a separate folate supplement (eg Jarrow methyl folate 400mcg) and continue separate B12
Post discussing how biotin can affect test results
Thank you so much for all this info. I’ve ordered a Blue Horizon test kit so I can get a better picture hopefully. Having symptoms at odds with results is confusing but your explanation of a possibly slightly hyper phase makes sense.
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went from under to overactive? Or just over medicated? 
Free T4
Over Medicated & Under Medicated....and Tinnitus 
Am I over-medicated?
Low TSH level
