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how accurate is a tsh blood test? can you have normal results but still have thyroid problem?


could anyone tell me if you can have a normal tsh blood test .but still have a overactive thyroid?

i am 31 yrs old with no children .not on any medication .had always been fit and healthy but for the past few years have not felt right.

GP thought my symptoms might be because of a thyroid problem .had a bunch of blood tests .tsh and all the others come back normal. apart from elevated prolactin but told that's nothing .

i have been having elevated prolactin ever since 2005 when i received head injuries and whiplash in a car crash .told MRI was clear at the time. have no memory of the accident

i now seem to be caught up in a vicious cycle .i have all the symptoms of a overactive thyroid .but GP will not diagnose a thyroid problem on symptoms alone .he wants blood results to back this up .and will now not investigate any further.

not sure where i go from here. i might try going to another GP

just wondered what other people experience was when being diagnoses .

15 Replies

the TSH test is very inaccurate for many people and there is not only one standard way of being hypo or hyper (ie there is euthyroid hypometabolism, thyroid hormone resistance at cellular level, hashimotos, graves etc etc)

what are your symptoms? head injuries and whiplash can cause thyroid problems......other things too of course, not only thyroid problems.

have you had thyroid antibodies tested?


hi nobodydriving

my symptoms are

feeling hyper


irritable.nervousness, feeling tired

sweating .

heart palpitations

go between loose stools then constipation

weakness in arms and hands

menstrual cycle notice a big change. had always been as regular as clock work. but now length between periods have become very irregular. blood flow has also changed .become very light.

toe nail infection on both big toenails .not responding to any treatment .nail was growing back in multi layers and nails become loose.

redness on palms of hands(not there all the time)

i have not had thyroid antibodies tested , GP has never mention having that test

think i will go and see another GP and ask about that

thank you for replying


Hi what is your TSH level apparently lower the better I think it can be between O.2- 5.4 to be ok mine was always between 0.8-4.6 but 8 weeks ago my TSH was 17.16 which is really high but at that time I was also diagnosed with Pernicious Anemia which means my body doesn't absorb B12 which is important for your body.

Maybe you should have this checked and your Vit D have a full mot I did and this is when they discovered everything that was wrong with. I am now waiting to see an Endocrinologist.

I hope this helps and please let us know how things are going.

I always think that if you dont feel right then you must probably aren't right remember a womes intuition is always right


hi mummytina

my GP did not say what my tsh level was .only that its in normal range.

trying to have my medical records sent to me so i can go over what level it was. and for all the other blood test .receptionist was very snappy when i asked about it lol. but think everyone has the right to see there records.

going to ask about having full mot on blood test

was your GP helpful?or did you have to keep going back saying you think something wrong?

thank you for replying


I did see the doctor a few times before one GP was really good and listened to me instead of saying in a round about way that it was all in my head I'm so glad I persevered and now I'm seeing an endocrinologist which is hopefully the next step.

It is everyones right to have their blood test results and if you post them on here we will try and help decipher them, there are a lot of people on here who will help.

Good luck and keep percevering.



when i get my medical records i will post results on here .

hope you get on OK when you see endocrinologist

think i just need to keep persevering .


Please bear in mind that many GP's are unaware of symptoms/signs of thyroid gland problems and follow the guidelines by the BTA, nor do they know how best to treat patients. ThyroidUK have a list of private sympathetic doctors and it may be worthwhile consulting one of them.

This is an excerpt from Dr Lowe's site. He died earlier this year and was an Adviser to ThyroidUK but has lots of info. Some of the links are unavailable but you can gain a lot of info especially about menstrual problems:-

You can also have a variety of blood tests to see if your results are consistent with hypothyroidism. For example, you measure your cholesterol and LDL levels. These are high in many people who have wholesome diets and exercise regularly but are under-treated by thyroid hormone. You can have your erythropoietin measured. This is a protein that may be low when under-regulation by thyroid hormone has decreased the oxygen requirement of your tissues. And you can have your anti-thyroid antibody levels measured to see if they are high.

You notice that I didn’t include blood tests for your TSH, free T4, and free T3 levels. These tests are of limited value. They are meaningful only when they are way out of range. If they are in-range or close to in-range, they are useless in telling your whether you have enough thyroid hormone regulation. The only thing they tell us is the effect of the pituitary’s TSH on the thyroid gland, and the effect of the thyroid gland’s hormones on the pituitary. They tell us nothing whatever about the effects of thyroid hormone on the cells of any other body tissues. To infer from the levels of these hormones the thyroid or metabolic status of other tissues is not only indirect—it’s a wild and scientifically-unsound inference.



hi shaws

thanks for the link i will have a look at it

i was told by my GP that because my tsh is normal.then their could be nothing wrong with my thyroid

after reading what you wrote .i now realise their more to it than that

thank you for replying


This is another link re TSH



The TSH test is very accurate at measuring the levels of TSH in the blood but unfortunately it is meaningless in diagnosis of quite a significant number of patients. It only tells you how much TSH is in the blood stream and not how much of the various thyroid hormones are in the blood stream. T4 and T3 tests are more useful but even these don't really tell you what's going on. You can have really good levels of both T4 and T3 and still be hypo as the tests just tell you what's in your blood and not what's in your cells. If the thyroid hormones aren't getting into your cells properly they stay in your blood making it look like you are fine even though you are actually hypothyroid.

A good way to test if you need thyroid hormones is to take your temperature several times during the day. If it is consistently low, it is likely you are not making enough thyroid hormones or you are not able to use them in your cells for whatever reason. This used to be pretty much the only test for hypothyroidism.

Your list of symptoms certainly suggests hypothyroidism is a possibility.

I hope you get the treatment you need

Carolyn x


hi Carolyn

i will have a go at taking my temperature through out the day .

thank you for replying


You seem to have some awareness that elevated prolactin is associated with high TSH - which in the most regular situations might mean hypothyroidism. That is, TSH rises because of hypothyroidism. When TSH rises, the pituitary often enlarges (hyperplasia) and prolactin levels rise.

But in the context of possible pituitary damage involving, maybe, compression of the pituitary stalk - well, who knows? Perhaps your pituitary should be producing almost no TSH - but is producing too much TSH for the thyroid hormone levels you have, and also too much prolactin?

With even the possibility of pituitary damage,you really, really need both Free T4 and Free T3 levels,

Your symptoms are confusing - and could indicate alternation between hypothyroidism and hyperthyroidism. But do be aware that palpitations can occur in BOTH hypo and hyper - some people only get them when hypo, some when hyper.


hi helvella

i am going to book an appointment with another GP and ask about free t4 and free t3 levels

is it common to alternate between hypothyroidism and hyperthyroidism ?

thank you for replying


Is is common to alternate? Well, umm, people do quite often go through some alternation when they are deteriorating due to autoimmune thyroid disease (typically Hashimoto's).

Always remember though, that it doesn't matter two hoots if it is common or rare, if it is happening to YOU, it is what needs to be considered and looked at. :-)

Do, do, get your actual test results.


yep think i need to start being more assertive when i see GP

GP made it clear that because i did not tick all his boxes then there was nothing wrong. even turned his back saying is that all .

but every body is different .and symptoms are affecting me on a daily basis

i will chase up medical records


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