Test results "borderline"

I had a blood test done as I have suspected thyroid problems due to many of the symptoms such as weight gain, difficulty losing weight, tiredness, intolerance to cold, very cold hand and feet.

I went to see my doctor today and she told me my results were "slightly borderline" but mostly normal. I am unsure of what she tested apart from my TSH levels but when I asked her for the results and the range she said the range is 0.25 to 4 and my results are 4.25. To me that is not borderline but above normal and when I asked her what else could be causing my symptoms she had no other suggestions. I said to her that I was not convinced of the results and she agreed to refer me to an endocrinologist but that could take months and I would like to know what information anyone can tell me about my results. I don't know how high some people's levels are who test high enough for a doctor to suspect a problem, but my doctor has refused to give me any medication as she says unnecessary medication is detrimental. She also says that a lot of people who have hypothryroidism often don't show symptoms but have high levels of TSH.

Is there anything I can do to help with the symptoms until I can see an endocrinologist?

33 Replies

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  • I would assume she has tested your T4 too and hopefully your Free T4 (FT4) so I would call and ask. I would also ask if you have had your thyroid anti bodies tested and if not request that test. I would say that with your symptoms and result that you have a thyroid problem. Mine was 8.17 with >1000 anti bodies.

    In the meantime you could try taking some selenium to help with conversion from T4 to T3 and probably iron (depending if you had this done and it was not just on the low end of normal). Either way, get your results, have a look at some of the research on here and post it here for others to look at. Also take your temperature a few times a day and post those results too.

  • Yes I agree u need to do stuff yourself u could be disappointed with what the endo might do or say. So its best u get the idea & start now.

  • I asked her for the results and she only told me TSH. I forgot what the other things were I was supposed to be tested for. Does it make a difference having those results? I will try and call the surgery tomorrow and ask them for the other results, hopefully the receptionists will be competent enough to give me the full results instead of just saying, "Normal". I'm not sure what the other results would mean either.

    The thing that worries me is that even if I and others on this forum think my results warrant treatment, what if the doctor doesn't? Without a prescription I won't be able to take thyroxine will I? It worries me that people say that Doctors in the UK will only treat you if your levels are above 5. My condition may not be severe but I have definite symptoms and at one stage over Christmas I put on 12lbs in 9 days and then another 6lbs in 3 days. I was over eating but I'm still pretty sure that amount of weight gain is not normal.

  • You're right to be persistent. My first TSH was >116, it's now 0.54 but I don't feel a lot better. Check out the compare hospitals section on this site to see if you can find a decent endo, you can also try drfoster

    drfosterhealth.co.uk/

    don't do what I did and just go to the local one hoping he'll be ok without any recommendations, it was another 6 months of my life wasted and I still have to try and get a referral for a second opinion from the GP.

    Ask the secretary for the figures including the reference ranges, they are yours and you are entitled to them, they have no right to withhold that information.

    All the best

    Rose xx

  • If I read you right, it's you who have suspected you might be hypothyroid, so I'm guessing your Dr just tested your TSH, so that's the only result you have. You need to go back and ask for full tests of TSH, FT3, FT4 and antibodies to give a better picture. Good luck !

  • Yes I told the doctor I wanted to have my thyroid checked. I've called them for the results and all they tested was TSH and T4. The T4 is 14 with a range of 12-22 so that looks ok but I don't really know what it means. She said she is referring me to an endocrinologist to have further testing done. They probably don't test for anything else at my surgery.

    I also did a basal test this morning and that was fine but I'll test over the next few days too. I'm never cold when I wake up though. The heating comes on before I wake up and my room is small with the door shut. It's only when I get up that I feel cold.

    I don't know...maybe there isn't a problem with my thyroid, but I can't explain my symptoms.

  • Sorry Debthebee, for some reason most of my reply didn't post, so here goes again !

    Free T4, or FT4, which is what your Doc tested is usually 10-24 range, so your Dr is right. Good info on the main site @ thyroiduk.org.uk/tuk/pages/...

    My girlfriend has symptoms, like zero libido, previous thyroid surgery, weight gain, loss of eyebroe hair, phobias and feeling cold and hugging a hot water bottle when others are peeling layers off and she had tests and hers were a little more 'normal' than yours and was dismissed as well despite the symptoms.

    It really is a minefield to understand the condition, but at least your Doc is clued up and has referred you, so good luck and hope you get a diagnosis and treatment !

  • Hi Alfiecat,

    Ranges differ quite a lot in different parts of the country.

    Where I am in Essex, the new FT4 range is 6.3 - 14 and the TSH is 0.3 - 6.0! I thought things might get better, but it's becoming worse. Wishful thinking.

  • I have just been looking on the web for information on T4 levels and most places have said a normal level of T4 would be between 4 and 11! How can my doctor's range be so high???

  • Free T4, or FT4, which is what your Doc tested is usually 10-24 range

  • Deb,

    Be very careful - I think you are misunderstanding what you are seeing.

    Most of the places on the web are not in the UK. And some countries use different units for some tests. They even vary within some countries.

    Free T4

    ======

    In the UK we use units of pmol/L with typical range something like 10 to 23. The other unit you might see is ng/dl in which a typical range would be 0.8 to 1.5.

    Total T4

    ======

    But the numbers you quote appear more likely to be Total T4 with a typical range of 4 to 11 µg/dL (or 60 to 160 nmol/L).

    Total T4 and Free T4 are *very* different tests, measuring different things and with potentially hugely different interpretations.

    You might care to look here:

    thyroiduk.org.uk/tuk/pages/...

    or here:

    gpnotebook.co.uk/simplepage...

    After all, your own GP might well look there himself. (It is possible that you need to register in order to access that site - if so, it is free.)

    Rod

  • I meant also to say that Total T4 is relatively rarely performed in the UK - far more common is Free T4. When you see just T4 test mentioned in the UK, it will almost certainly be Free T4.

  • Ok so that's normal, but I don't really know what it means anyway or which is supposed to be indicative of a thyroid problem. All I want is a solution to my symptoms and I cannot think of anything else.

  • The higher your TSH and the lower your FT4 results, the higher the suspicion of hypothyroid. I'm no expert and many others know a lot more than I do on this forum, but that's the basics. All I know is what I've read on the web and in Dr Barry Peatfield's book, 'Your Thyroid and how to keep it healthy'. Really good luck and keep smiling !

  • I wouldn't say my doctor is clued up at all. She initially told me the results were slightly borderline but all they would do would be to re-test me in 3 months as my levels may be slightly elevated for another reason or the lab results may be wrong. I had to push her for an explanation of my symptoms and then she said all she could do was refer me for more testing and refused any medication.

  • The doc is not keeping up with current knowledge...... Take in the press release from last year from the society for endocrinology..... A tsh of over 4 is putting you at a greater risk of heart problems...... endocrinology.org/press/pre...

    If your Thyroid Stimulating Hormone TSH is raised, but the t4 is normal it means that the thyroid is managing to make the right amount of hormones but is having to be pushed very hard to do so.... This is normally the first sign of thyroid failure.

    Ask for a thyroid antibody test to ascertain whether you have Hashimotos disease or not... This is the most common reason for thyroid failure.

    Nel

  • I agree with you, but they are the doctors with the degree who are we to argue with them you know? Even though they seem to know nothing about this subject! I will send her the article but I don't really think it will make much difference.

    I will request an antibody test as well as a trial in the meantime.

    Thank you for the information :)

  • The doctor may have a degree but they are GENERAL practitioners. The amount of time they spend on endocrinology probably amounts to less than a day, over the whole course. The doc is not a specialist. You should also tell your doctor that he can do a Continuing Professional Development unit in thyroid , through pulse magazine. ( I did it and got 10 /10) Here's the link...http://www.pulsetoday.co.uk/story.asp?sectioncode=50&

    storycode=4126143.

    The doctor will be working to what he thinks are gudelines published by the BTA and RCP. However, in the UK we actually have NO official gudelines and if we did, the doctor is not bound to follow them. If he quotes guidelines at you, remind him that guidelines are not a substitute for clinical judgement.

    We have every right to argue with the doctors when it comes to our own health. They are supposed to work with us, not just dictate. If your doctor is ancapable of taking this on board, find a new one.

    Nel.

  • pulsetoday.co.uk/story.asp?...

    Sorry here is the correct pulse link...

    Nel.

  • Hi Deb

    I am taking a trial of thyroxin 25mg, with

    TSH 3.1 (0.35 - 4.94)

    T4 11.0 (9 - 19.1)

    T3 3.91 (3.6 - 6.5)

    also elevated TPO

    GP agreed to this trial after a 'heated' debate with me in tears saying to him that he obviously didn't care about my health and was I to remain ill until we hit the magic number of over 5.

    Why do we have to fight for the right to be well.

  • I am very glad you got him to agree to it. Symptoms may not be severe, but as you say, why do we have to wait until they are to get treated?! Yes I am losing weight on an extreme diet but I am losing it at the rate of someone on a regular healthy diet doing exercise. Before this diet I was on a calorie controlled one doing 2 hours of exercise a day and losing minimal amounts of weight - like less than a pound a week! I am on an extreme diet as well as doing exercise and when I don't diet I put on so much weight. And what if my digestive problems that no one can seem to find the cause for is because my thryoid is not performing at its optimum ability??

    I am going to try write the doctor a letter with the article that NellyB mentioned above but I don't have much hope she will agree to a trial. My doctor refused because she said it could be detrimental if it is not needed and because she is the doctor how can you argue with them and expect them to agree?

    I don't really know what to do but I guess I will just try this. It is possible it's not my thyroid but the doctor has no other answers for me and if a small dose is not going to harm me then why not?!

    How did you get on with the medication by the way?

  • it was a locum GP who gave me the trial of thyroxin, my own GP refused as all tests were in range, apart from high TPO. First he said, it's my age, then, you have CFS and ME, I've been so tired and so so cold it makes me cry, which caused rows as I have the heating on all the time and won't go out. lol 2 wheat bags and a fluffy hotwater bottle I take everywhere. Hardly any eye brows left now and have carpal tunnel in my right hand.

    I'm due to see the doctor this week as I've had another blood test. My fear is that if I don't see the locum my GP will stop the medication.

    Got results today and all are within range, so I don't know what happens next :-(

  • Have been trying to post a question with latest results but it won't submit

  • When you say within range are they lower than your last test? How long have you been taking the medication and have you been feeling better?

  • I also don't have symptoms like yours apart from being cold, but I've usually got a dressing gown on me over my clothes. I never wanted to use heating so I've always tried to wrap myself up extra warm but even with socks and slippers on my feet are still freezing unless I'm doing exercise. Once I'm stationary for a while my hands and feet freeze and I get very cold again. I'm also prone to overheating and when I do I sweat excessively...more than I've ever seen anyone sweat when just doing nothing but in a hot place. I'm not currently working but when I was I would always complain about being cold and it was really uncomfortable but then put a heater too near me and it was too hot!

  • Currently on a trial of 25mg levo given to me by a LOCUM gp - 6 weeks on, the blood test results are

    TSH 1.4 (0.35-4.94)

    T4 12.0 (9.0-19.1)

    T3 4.35 (3.6-6.5)

    I don't know if they are good or not Deb, they are lower, but I've read TSH should be 1 or lower to feel well. Don't really have any idea where T3 or T4 should be. I still have brain 'fog', still tired, but not napped in afternoon for a couple of weeks now. Still have pins and needles in hands and feet and throbbing body, lots of aches and pains. I'm not so cold - I've actually been out today. Wooohooo and best bit I don't have to take laxatives.

    I've felt so rubbish that the amount of weight I've put on even with going to slimming club has stopping bothering me. Altho come the summer it probably will.

  • Ok well so far it sounds like the meds have helped. 1.4 is still a lot better than your previous results but I think the doctor should let you continue until you get below 1. I think if you explain that as a result of the medication your symptoms have improved that should shut him up. Since you are already taking the stuff they shouldn't be allowed to just stop it if it's helping...I'm not an expert so I don't know if you stop taking the stuff when you reach a good level or if you're supposed to continue for a while. But push your doctor to keep at it. What would be the point in taking you off medication that is helping?! Have you been able to lose weight with the meds?

  • Alas no weight loss yet :-( weird thing is, I wasn't fussed about eating before starting the meds, so dieting was a doddle, although if I lost a pound I'd put it back on the next week. Now I have an appetite, specially for chocolate which isn't like me, I've never been a chocolate person.

    You mentioned overheating - I get that! I don't sleep well either, wake up alot with either being cold or sweating, or just turning over in bed wakes me. lol no wonder I'm tired during the day. I don't work now either.

  • Have you had a lot of trouble with your weight? I have had it for the longest time, but recently it has gotten worse. I used to be able to maintain my weight and still eat junk food on occasion (even though I was still overweight and had difficulty losing it) but now I just put on unless I'm on a diet. Weird that the medication has made you crave chocolate...I've never had a healthy relationship with food. A little bit of junk in moderation is not something I've ever been able to do, which is why I would only have it like once a week but then have a lot of it.

    I have episodes were I don't sleep well and also used to get night sweats regularly but those seem to have stopped. I don't think I get good quality sleep though, otherwise I'm sure I wouldn't still feel tired after 8 hours sleep! I'm not so tired these days that I need a sleep in the afternoon, but when I was doing 2 hours of exercise a day it was absolutely exhausting me. Even though that is a lot of exercise, I'm sure it's not supposed to exhaust you that much.

    Have you done the basal body test? Mine was normal but I don't know if having the heating on will affect that.

  • Yes I used to take my temp every morning, before getting out of bed, still under the duvet, it ranged from 35 to 36.1. I even began to take it when I was having a heat surge to see if it was just all in my head, still didn't get above 36.4 Sadly I can't do alot of exercise, I was recently diagnosed with osteoarthritis in my feet, after spending 2 years back and forth to docs wanting to know why my feet hurt so much. The pains in my feet make it difficult to walk sometimes.

    God I'm falling apart lol

    Thyroxin must be doing something - I'm not down in the dumps about my body falling apart

  • Were you very cold when you woke up? And did you have the heating on? I'm not really cold until I get up. It's odd how your symptoms are worse than mine but your TSH is lower...I suppose there have to be other indications.

    Gosh sorry to hear of the problems with your feet. That sounds quite unpleasant!

  • Deb, heating comes on about 5am. I don't need to sleep in pj's, dressing gown and two pair of socks now :-)

    My sister says she didn't have any symptoms besides being abit tired - she put that down to her age. But her GP tested thyroid as when she had her yearly check ( her gp unit does well woman checks) cholesterol level had rocketed for no apparent reason. I think her TSH was around 7 when diagnosed

  • I've been doing a lot more research and many of these symptoms are also found in sufferers of Candida. A lot of people on the Thyroid UK site said the Thyroxine helped some symptoms but they still had other problems and I wonder if for a lot of people there could be a combination of thryoid problems as well as Candida. It makes logical sense...for example if your thyroid slows down and all other processes slow down then your body can stop producing good bacteria as quickly surely? This can then lead to an overgrowth of bad bacteria, especially in people who have taken antibiotics for a long period of time.

    Many doctors nowadays still do not believe that Candida is a real disease, so a lot of people go undiagnosed. There's also a doctor called William Crook who wrote a book called "The yeast connection" and in it he suggests that there could be a link between the 2 diseases and Candida can actually lead to Hypothyroidism or vice versa. A lot of the symptoms are the same and there are tests you can do. Here's a link in case you're interested, but I found this very useful: yeastconnection.com/yeast.h...

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