is this TSH Low (0.37)?: hi, my GP said this TSH... - Thyroid UK

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is this TSH Low (0.37)?

Tangawizi profile image
9 Replies

hi, my GP said this TSH of 0.37 is normal. everything I have read says that it is low....is it low enough to indicate hyperthyroidism?my symptoms are more hypothyroidism...severe fatigue, brain fog,weight gain. sore glands, gravely voice

fatigue/brain fog has been for years. I have had a scan in the past which showed my thyroid is enlarged with nodules...but not considered significant

I am desperate for answers and to feel normal again

TIA

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Tangawizi
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pennyannie profile image
pennyannie

Hello Tangawizi :

I presume you are not taking any thyroid hormone replacement medication.

Your TSH is in the range and though low it will not be seen as needing further investigation.

Ideally we really need to see a Free T3 and Free T4 result and range alongside this TSH reading along with readings for thyroid antibodies to say anything of any substance.

Looking back I think I read of nodules, if these are thyroid nodules a scan could be useful to ascertain of these are growing and affecting your thyroid function.

You are right in that as cats do suffer with hyperthyroidism and as with cats we too should always be offered a full thyroid panel run when we e feel the thyroid is not functioning normally.

Many of us are forced to run these blood tests for ourselves as a TSH seen in isolation when the patient clearly has thyroid malfunction symptoms is insufficient.

SlowDragon profile image
SlowDragonAdministrator

Strongly recommend getting full thyroid and vitamin testing redone

Test results from 6 years ago showed B12, folate and ferritin all far far too low and borderline deficient

healthunlocked.com/thyroidu...

When were vitamin levels last tested

What vitamin supplements are you taking

For full Thyroid evaluation you need TSH, FT4 and FT3 tested 

Also both TPO and TG thyroid antibodies tested at least once 

Very important to test vitamin D, folate, ferritin and B12 at least once year minimum

About 90% of primary hypothyroidism is autoimmune thyroid disease, usually diagnosed by high 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.

Low vitamin levels are extremely common when hypothyroid, especially with autoimmune thyroid disease (Hashimoto’s or Ord’s thyroiditis)

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)

Recommended on here that all thyroid blood tests early morning, ideally just before 9am (and if/when on levothyroxine last dose levothyroxine 24 hours before 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

List of private testing options and money off codes

thyroiduk.org/getting-a-dia...

Medichecks Thyroid plus antibodies and vitamins

medichecks.com/products/adv...

Blue Horizon Thyroid Premium Gold includes antibodies, cortisol and vitamins

bluehorizonbloodtests.co.uk...

Just Thyroid includes BOTH TPO and TG antibodies -£49

randoxhealth.com/at-home/Th...

If you can get GP to test vitamins and antibodies then cheapest option for just TSH, FT4 and FT3

£29 (via NHS private service ) and 10% off down to £26.10 if go on thyroid uk for code

thyroiduk.org/getting-a-dia...

monitormyhealth.org.uk/

Monitor My Health also now offer thyroid and vitamin testing, plus cholesterol and HBA1C for £65 

(Doesn’t include thyroid antibodies) 

monitormyhealth.org.uk/full...

10% off code here 

thyroiduk.org/getting-a-dia...

NHS easy postal kit vitamin D test £29 via

vitamindtest.org.uk

Only do private testing early Monday or Tuesday morning. 

Link about thyroid blood tests

thyroiduk.org/getting-a-dia...

Link about Hashimoto’s

thyroiduk.org/hypothyroid-b...

Symptoms of hypothyroidism 

thyroiduk.org/wp-content/up...

Tangawizi profile image
Tangawizi in reply toSlowDragon

wow, thanks! I think I'll get private T3 and T4 just for peace of mind. GP did test B12 and ferritin...B12 normal but ferritin 33 which is still considered normal but I haven't had a period for 5 years so should be higher really. I have had chronic low ferritin and anaemia for a long time, despite supplements...is one of the reasons that I had a hysterectomy. have also had low vit D a few times, so I regularly take a supplement. any other vitamins that should be tested?

SlowDragon profile image
SlowDragonAdministrator in reply toTangawizi

Ferritin is all but deficient and NOT normal

Anaemia is prime cause of fatigue

Please add vitamin D, folate and B12 results

cks.nice.org.uk/topics/anae...

Serum ferritin level is the biochemical test, which most reliably correlates with relative total body iron stores. In all people, a serum ferritin level of less than 30 micrograms/L confirms the diagnosis of iron deficiency.

Never supplement iron without doing full iron panel test for anaemia first and retest 3-4 times a year if self supplementing. It’s possible to have low ferritin but high iron 

Medichecks iron panel test 

medichecks.com/products/iro...

Look at increasing iron rich foods in diet 

Eating iron rich foods like liver or liver pate once a week plus other red meat, pumpkin seeds and dark chocolate, plus daily orange juice or other vitamin C rich drink can help improve iron absorption

List of iron rich foods

dailyiron.net

Links about iron and ferritin

irondisorders.org/too-littl...

davidg170.sg-host.com/wp-co...

Great in-depth article on low ferritin 

oatext.com/iron-deficiency-...

drhedberg.com/ferritin-hypo...

This is interesting because I have noticed that many patients with Hashimoto’s disease and hypothyroidism, start to feel worse when their ferritin drops below 80 and usually there is hair loss when it drops below 50.

healthunlocked.com/thyroidu...

Thyroid disease is as much about optimising vitamins as thyroid hormones

healthunlocked.com/thyroidu...

restartmed.com/hypothyroidi...

Post discussing just how long it can take to raise low ferritin 

healthunlocked.com/thyroidu...

Iron and thyroid link

healthunlocked.com/thyroidu...

Excellent article on iron and thyroid 

cambridge.org/core/journals...

Posts discussing why important to do full iron panel test

healthunlocked.com/thyroidu...

healthunlocked.com/thyroidu...

Chicken livers if iron is good, but ferritin low

healthunlocked.com/thyroidu...

Shellfish and Mussels are excellent source of iron 

healthline.com/nutrition/he...

Heme iron v non heme

hsph.harvard.edu/nutritions...

Ferritin over 100 to alleviate symptoms 

healthunlocked.com/thyroidu...

Great research article discussing similar…..ferritin over 100 often necessary 

ncbi.nlm.nih.gov/pmc/articl...

Low Iron implicated in hypothyroidism 

healthunlocked.com/thyroidu...

Ferritin range on Medichecks 

healthunlocked.com/thyroidu...

healthunlocked.com/thyroidu...

We have received further information the lab about ferritin reference ranges. They confirm that they are sex dependent up to the age of 60, then beyond the age of 60 the reference range is the same for both sexes: 

Males 16-60: 30-400 ug/L

Female's: 16-60: 30-150

Both >60: 30-650 

The lower limit of 30 ug/L is in accordance with the updated NICE guidance and the upper limits are in accordance with guidance from the Association of Clinical Biochemists. ‘

Tangawizi profile image
Tangawizi in reply toSlowDragon

RBC 4.19 (3.8-5.3)

Haemoglobin=128 (120-150)

Haematocrit=0.397 (0.37-0.45)

MCV=94.7 (83-100)

MCH=30.5 (27-32)

MCHC=322 (310-350)

RBC distribution width=14.4 (11.5-15.5)

Vit B12=276 ng/L (180-900)

Ferritin=33 (33-400)

Folate=5.3 (2.5-19.5)

TSH=0.37 (0.27-4.2)

SlowDragon profile image
SlowDragonAdministrator in reply toTangawizi

No vitamin D result

Optimal vitamin D at least over 80nmol

Test twice yearly via NHS private testing service when supplementing 

vitamindtest.org.uk

when were these vitamin results from?

Optimal vitamin levels are

Serum B12 at least over 500

Folate at least over 10 and ideally over 15 minimum

Ferritin at least over 70

Clearly your vitamin levels are very poor and bordering on deficient

Low vitamin levels extremely common with thyroid disease

Low vitamin levels tend to lower TSH

Essential to test TSH, Ft4 and Ft3 together and both TPO and TG antibodies

Tangawizi profile image
Tangawizi in reply toSlowDragon

just see you found my old test results!! 😊 thankyou, I forgot I even posted! x

SlowDragon profile image
SlowDragonAdministrator

Full iron panel test is

TIBC = Total iron binding capacity

Serum Iron = self explanatory

Transferrin saturation = measures how much protein is saturated by iron

And

Ferritin

SlowDragon profile image
SlowDragonAdministrator

low iron/ferritin and B12

Are you vegetarian or vegan?

low B12

Do you have any Low B12 symptoms 

b12deficiency.info/signs-an...

methyl-life.com/blogs/defic...

If you do have symptoms of low B12 you need testing for Pernicious Anaemia via GP BEFORE starting on any B12 supplement or separate vitamin B complex

With serum B12 result below 500, (Or active B12 below 70) recommended to be taking a daily separate B12 supplement initially and after 2 weeks add in a daily vitamin B Complex as well

Then once your serum B12 is over 500 (or Active B12 level has reached 70), you may be able to reduce then stop the B12 and just carry on with the B Complex.

If Vegetarian or vegan likely to need ongoing separate B12 few times a week 

B12 drops very effective

healthunlocked.com/thyroidu...

B12 sublingual lozenges 

amazon.co.uk/Jarrow-Methylc...

cytoplan.co.uk/shop-by-prod...

B12 range in U.K. is too wide

Interesting that in this research B12 below 400 is considered inadequate 

healthunlocked.com/thyroidu...

Vitamin B complex

supplementing a good quality daily vitamin B complex, one with folate in (not folic acid) 

This can help keep all B vitamins in balance and will help improve B12 levels too

Difference between folate and folic acid 

healthline.com/nutrition/fo...

Many thyroid patients have MTHFR gene variation and can have trouble processing folic acid.

thyroidpharmacist.com/artic...

B vitamins best taken after breakfast

Thorne Basic B recommended vitamin B complex that contains folate, but they are large capsules. (You can tip powder out if can’t swallow capsule) 

Thorne currently difficult to find at reasonable price, should be around £20-£25. iherb.com often have in stock. Or eBay

If you want to try a different brand in the meantime, one with virtually identical doses of the ingredients, and bioavailable too, then take a look at Vitablossom Liposomal B Complex. Amazon sometimes has it branded Vitablossom but it's also available there branded as Yipmai, it's the same supplement

amazon.co.uk/Yipmai-Liposom...

or available as Vitablossom brand here

hempoutlet.co.uk/vitablosso... &description=true

Or 

Igennus Vitamin B complex. Nice small tablets. Full dose is 2 tablets per day. Most people are fine with just single tablet 

igennus.com/products/super-...

IMPORTANT......If you are taking vitamin B complex, or any supplements containing biotin, remember to stop these 7 days before ALL BLOOD TESTS , as biotin can falsely affect test results

endo.confex.com/endo/2016en...

endocrinenews.endocrine.org...

In week before blood test, when you stop vitamin B complex, you might want to consider taking a separate methyl folate supplement and continue separate B12

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