Low TSH Low Normal FT4: Suppressed Pituitary

[Lorenza2]

I had a baby a year ago (11/13) and recovered really well at first after a natural birth and no apparent complications. I started eating healthily and walking an hour a day after my 6 week check in January. I lost weight and was getting fitter again. I started taking the oestrogen based Yasmin pill in February.

By March my energy started to leave me and my daily walks became harder and harder. In April I began to feel tired and easily stressed out, emotional and depressed. My baby was a good sleeper and I was eating quite healthily and taking daily exercise as well as being 'on the go' with a baby. I started to gain weight despite all of this.

I thought that this was being a Mummy but then in conversation with friends with babies a similar age I noticed they were feeling well, losing weight and generally in a better place than me so I went to the doctors.

They ran blood tests and rang me to tell me I had low iron, so I did the usual iron boosting things and assumed that was what was making me tired.

A month later when I took my son to the doctors I asked for a print out of my results as I wanted to know what my chlosterol was as my husband's is high. (Perfect btw) I was still feeling tired and as I looked through the results I noticed that my TSH was very low at 0.60 so I thought that meant I was borderline hypothyroid. I then consulted Dr Google and discovered it meant you were to be more Hyper than Hypo.

I was still feeling pretty grotty so I went back to the doctors to draw this to their attention. The doctor was dismissive and made me feel like a hypochondriac and told me that they don't test the thyroid more than once every 3 months.

As I was gradually feeling worse over the next few weeks I returned for another blood test on 1st September. It took a month for me to get my results and my thyroid function was down at 10.3 and I was deficient in Vit D and low normal B12.

I went back to the doctors and was given a Vit D supplement and another blood test results as follows:

C Reactive Protein: 18

TSH: 0.53

FT4: 10.2

Follicle Stimulating Hormone: 1.7

Lutenising Hormone 1.0

Prolactin: 207

Intrinsic factor Antibody: 2.5

The Dr mithered for nearly 2 weeks saying she wanted to get a T3 reading and couldn't get the lab to do it and she couldn't get the lab to do it. She scared me by saying that the most likely cause was a pituitary tumour.

Another set of bloods was run on 17/10 with results as follows:

TSH: 0.38

FT4: 11.3

Follicle Stimulating Hormone: 5.9

Lutenising Hormone: 3.3

Prolactin: 267

Cortisol: 297

I found those results quite reassuring as I am not going to slip into a coma whilst looking after my baby which was a concern! They were taken at 9am.

As much as I am reassured I am also confused about the contradictory TSH and if I should be concerned. I am feeling increasingly tired and would like to feel better. I have a referral to an endocrinologist that I am waiting on, but this could take months and i would like to put my mind at rest. My doctor is useless so thoughts would be appreciated.

[Clutter]

Lorenza, If there is any pituitary dysfunction the TSH result is worthless and only FT4 and FT3 should be taken into account. Your GP should write on the bloods request that FT4 and FT3 are essential as she is investigating secondary hypothyroidism (hypopituitarism) and, if necessary, should phone the lab to insist they do the FT3 test she has requested.

Pituitary tumours are relatively common and are almost always benign.

Your FT4 is low but I can't see how low without the lab ref range (the figures in brackets after your results). Low FT4 inevitably means that you will be low in the active hormone T3 which is why you are fatigued and have hypothyroid symptoms. Your thyroid is probably healthy but isn't receiving sufficient stimulus from your pituitary gland to produce enough thyroid hormone. It's likely that you will need thyroid hormone replacement unless the pituitary dysfunction can be corrected.

Low levels of ferritin, vitamin D, B12 and folate are common prior to getting a diagnosis of primary and secondary hypothyroidism. If you post all your above blood test results with the lab ref ranges on the Healthunlocked Thyroid UK forum members there are knowledgeable and will help interpret your results and advise.

[Lorenza2]

Thank you so much for your reply that is so reassuringly simple! The results are repeated below and any further clarity or comments are very welcome.

Sept 1st

C Reactive Protein: 18 (0-10)

TSH: 0.53 (0.50-5.00)

FT4: 10.2 (10 - 25)

Follicle Stimulating Hormone: 1.7

Lutenising Hormone 1.0

Prolactin: 207 (64 - 395)

Intrinsic factor Antibody: 2.5 (0-6)

Another set of bloods was run on 17/10 with results as follows:

TSH: 0.38 (0.50 - 5.00)

FT4: 11.3 (10 - 25)

Follicle Stimulating Hormone: 5.9

Lutenising Hormone: 3.3

Prolactin: 267 (64 - 395)

Cortisol: 297 (125-630)

NB I haven't included the ranges for the follicle and lutenising as they are complex and variant on different stages in a cycle and I was on the pill for the first test and not for the second test.

Out of interest Clutter, are you a physician? You sound very authoritative!

[Clutter in reply to Lorenza2]

Lorenza, no I'm not medically trained but I know a bit about thyroid because of researching to solve my own thyroid issues. I don't know much about the other blood results other than I think negative Intrinsic Factor antibodies rule out pernicious anaemia as a reason for low B12 (it's not a very accurate test by all accounts) and your high CRP indicates inflammation somewhere in your body, but it can also be high if you had a cold at the time of the test, so may need repeating in a few weeks.

You'll get more help if you cut and paste your post onto TUK where some members are very clued up on FSH, LH, Prolactin and cortisol.

ps use the orange Reply tab under the post you are responding to and the member will be sent an email alert.