hi I’m new to this site and new to hyperthyroidism
These were my results TSH 0.03 Serum-free T4 15 serum -free T3 6.3
Trab negative
I’ve not seen an endocrinologist yet I am awaiting an appointment
I’m not on any new medication either but I do take propranolol (for migraines)
I only have mild symptoms (which I’m not even sure they are related)!
I’m 59 (f)
Anyone give me advise please
welcome to the forum
Next step is to get further testing done, ideally BEFORE any consultation
Has GP tested vitamin D, folate, ferritin or B12
How much propranolol are you taking.
How long on this dose
What vitamin supplements are you taking, if any
For full Thyroid evaluation you need TSH, FT4 and FT3 tested
Also both TPO and TG thyroid antibodies tested at least once for autoimmune hypothyroidism - also called Hashimoto’s
Hashimoto’s frequently starts with temporary hyperthyroid type symptoms and mildly raised Ft4 and/or Ft3
Very important to test vitamin D, folate, ferritin and B12
Low vitamin levels are extremely common with autoimmune thyroid disease
propranolol tends to lower magnesium levels
Propranolol can significantly affect uptake and conversion of Ft4 to Ft3
However you must NEVER stop propranolol suddenly. It must be weened off very very slowly
Hashimoto’s
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)
ALWAYS test 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
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...
Medichecks and BH also offer private blood draw at clinic near you, or private nurse to your own home…..for an extra fee
Only do private testing early Monday or Tuesday morning.
Tips on how to do DIY finger prick test
support.medichecks.com/hc/e...
IMPORTANT......If you are taking vitamin B complex, or any supplements containing biotin, remember to stop these 3-5 days before ALL BLOOD TESTS , as biotin can falsely affect test results
endocrinenews.endocrine.org...
In days 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 if last test result serum B12 was below 500 or active B12 (private test) under 70
I’ve not seen an endocrinologist yet I am awaiting an appointment
if this is for NHS referral likely an extremely long wait and/or referral may be refused
Thank you for all the information
It’s a lot to take in but thanks for taking the time to reply
It appears that I have a lot of research and reading
By the way I’ve been on propranolol for years (as far back as I can remember)
I take vitamin D , flaxseed and Magnesium
Thanks again
Headache and migraines common hypothyroid symptoms
Propranolol will skew your test results making it difficult to interpret
Other indicators for being hypothyroid are high cholesterol and/or reduced kidney function
Propranolol
pubmed.ncbi.nlm.nih.gov/168...
rejuvagencenter.com/hypothy...
escardio.org/Journals/E-Jou...
labtestsonline.org.uk/tests...
Drugs that may decrease PTH include cimetidine and propranolol.
Hello Karen and welcome -
Do you have the ranges there please for the T3 and T4 results ?
Can you see any other antibody blood tests - looking like a TPO or TgAb ?
The TRab is the Thyroid Receptor antibody and is a negative meaning that you do not have Graves Disease - an Auto Immune Disease known to cause hyperthyroidism.
T3 range 3.8 - 6.0
T4 range 7.8 - 21
TSH range 0.35 - 4.7
thyroid receptor antibody 1.1
Ok thanks -
So TSH under the range -
Your T4 is in the range at around 54% with your T3 just over range at around 114% :
These results are referred to as being inverted - as generally the T3 tracks just behind the T4 result in percentage terms.
Usually a TRab under 1 is classed as a negative - and a reading between 1 and 1.50 generally considered borderline :
Are further antibody blood tests being run - eg TPO / TgAB ?
What symptoms are you dealing with and do you have any other health issues apart from the migraines.?
Considering you are taking Propranolol - this tends to slow the rate at which T4 converts to T3 -
and commonly prescribed after a such a blood test as you have presented with - so I am a little confused too :
I’ve had no other tests and as far as up to today they haven’t requested any either
They have just referred me to an Endo
It’s good to know I’m not the only one confused 🤣
Think I’m better waiting to hear from the Endo and just being patient
My symptoms are aching neck sore/dry throat and buzzing in ears (this isn’t constant) just things I’ve noticed and headaches too (no migraines)
Thanks for your help
Well yes but no but - you came on here to dispel your confusion not to add to it !!
Was the weight loss intentional - or part of the reason you went to the doctor ?
I have Graves Disease and found the most well rounded of all I researched that of Elaine Moore's books and her now archived website :-
web.archive.org/web/2024122...
The other Auto Immune Disease that can cause thyroid issues is that of Hashimoto's and many forum members find the research and suggestions of Dr Izabella Wentz worth following and she writes as :- thyroidpharmacist.com
Your symptoms read as thyroiditis - of which there can be several causes :-
Weight loss ?
I thought I saw it listed on your Profile page -
just press the Profile icon on the task bar along from where the Alert icon sits and this takes you back to everything you have ever written on this open patient to patient forum ?
I want to loose weight as I’ve gained weight I didn’t go to the doctors because I lost weight
I actually went to doctors for a routine blood test and they decided to do a full blood count and profile
Ok then - apologies - maybe try and edit your Profile page - though thinking on- maybe this little summary has a mind of its own.
Huh ? Not understanding what you mean. Please explain
On your Profile page under Health Interests - it reads as overactive thyroid - hyperthyroidism, healthy eating and weight loss :
and I read this to mean you were also experiencing weight loss - but this is not true and the opposite a more true summary of your current health status.
Ok fair enough - sorry
Oh don't worry - no need to apologise -
I've a feeling this Health interest summary sometimes has a mind of it's own -
We are to help and the fact that you haven't lost any weight is also of interest -
as with TRab - you can have Blocking or Stimulating antibodies - at any given time -
so even being classed as ' hyperthyroid ' doesn't necessarily mean you automatically lose weight.
Ok thanks for your help
TSH 0.03
Serum-free T4 15 (7.8-21) 54.55%
serum -free T3 6.3 (3.8 - 6.0)
Hi Karen-321, welcome to the forum.
Well, pretty certain you're not hyper, not with an FT4 only 54.55% through the range. And your FT3 is only slightly over-range. But some doctors see a low TSH and have a knee-jerk panic reaction and start waffling on about hyperthyroidism.
But what time of day was the blood draw for this test? TSH varies throughout the day, and is lowest around midday. It's highest before 9 am. So, we have to take that into consideration. So, what you really need is to do new labs under ideal conditions to get a clearer picture of what's going on. 
Thanks for the reply
I had the test mid afternoon and more tests is just quite difficult
I have been referred to an Endo and will have to be patient
But thank you
So, your TSH would have been pretty low at that time - lower than it would have been before 9 am.
I understand the NHS is pretty mean with testing, only doing the bare minimum. But you can test privately, you know, if you so wish.
I will deffo consider doing so if I’m still waiting for the Endo
Thank you
You're welcome.
Sorry but can you read my last message
You are very knowledgeable and I appreciate you
Thanks
Your TPO antibodies were 1? That's negative and not indicative of Hashi's.
But, there are two Hashi's antibodies. The other one is Thyroglobulin antibody, which the NHS doesn't test. But if that is high, it would mean you have Hashi's. So if you can get that tested it would be a good idea.
Something has caused a rise in FT3, which has caused TSH to drop. Sometimes hyper levels are transient & you may see levels drop. So testing other thyroid antibodies might be good step. (TPO & TG)
I had similar results some years before being diagnosed with a toxic / hot nodule. This is where a nodule autonomously over function. I had a visible left sided swelling, but at over 5cm it isn't that noticeable, many doctors said it looked fine. So smaller nodules can easily go unnoticed.
Levels can build very slowly often leading by FT3.
I also had migraines but wasn’t given propranolol until diagnosed hyper, & was unwell when the propranolol abruptly stopped. Propranolol tends to lower FT3.
If antibodies are negative & levels remain elevated ask for a thyroid scan.
Thank you
Could a kind person explain my results please.
Thyroid peroxidase antibodies 
CONFUSED. NEWLY DIAGNOSED UNDERACTIVE THYROID
T3 only / weight gain/blood results 
