T3 and T4 results: Hi looking for some advice... - Thyroid UK

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T3 and T4 results

sash779 profile image
13 Replies

Hi looking for some advice from those with personal experience please.

GP tested TSH and found "within normal range" so couldn't check T4 and T3. As my Mum and Aunty have Hypothyroidism they advised to get a private blood test. Results below.

Has anyone experienced symptoms with the same "in range" results?

TIA

Biochemistry

Magnesium 0.94 0.7 - 1.0 mmol/L

Hormones

Cortisol (Random) 276.0 6am - 10am 166 - 507 nmol/L New range

Thyroid Function

TSH 2.47 0.27 - 4.20 mU/L New range & unit

T4 Total 80.3 66 - 181 nmol/L

Free T4 13.8 12.0 - 22.0 pmol/L

Free T3 4.09 3.1 - 6.8 pmol/L New range

Immunology

Anti-Thyroidperoxidase abs <9.0 <34 IU/mL New units

Anti-Thyroglobulin Abs 15 <115 IU/mL New units

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sash779 profile image
sash779
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13 Replies
pennyannie profile image
pennyannie

Hello Sash and welcome to the forum :

Are you already diagnosed - if so, what is the cause of your hypothyroidism and if taking T4 thyroid hormone replacement what dose are you prescribed ?

What symptoms are you referring to and ' in range ' doesn't mean you will be symptom free :

sash779 profile image
sash779 in reply topennyannie

Not yet diagnosed or medicated.

Roughly I'm exhausted all the time, don't feel refreshed on waking, random pains, very much not myself according to friends and family. Going to look at the symptom checker posted below next.

pennyannie profile image
pennyannie in reply tosash779

Ok then -

Your T4 is low in the range at just under 14 % through it's range -

and T4 is needed in good supply as it needs to be converted in your body into T3 which is the active hormone needed to run all your bodily functions from your physicality through to your mental, emotional, psychological and spiritual well being, your inner central heating system and your metabolism.

Your T3 is just above 27 % through it's range and over working as basically your thyroid is struggling to function at a level that gives you a sense of well being.

It's generally accepted that hypothyroid symptoms can be experienced once the TSH starts rising above 3 but unfortunately the NHS does not start prescribing T4 - Levothyroxne - until you have a TSH over 10 on 2 blood tests a couple of months apart.

Had your antibodies been over range I believe an NHS doctor has some leeway and can commence T4 prescriptions earlier than waiting for the TSH to rise to over 10.

Maybe you could ask for a referral to an endocrinologist as your T4 is too low in the range to support easily a decent level of T3 and your T3 and T4 results inverted as generally we see a T3 as a percentage of a T4 reading.

Thyroid UK - thyroiduk.org - is the charity who supports this patient to patient forum and you can find a list of hypothyroid symptoms on the website to tick and stay focused on when you discuss your thyroid health issue again with your doctor.

If you email admin @ thyroiduk.org they hold a list of recommemed endocrinologists and thyroid specialist - both NHS and Private - as you might find this useful for referral purposes.

P.S. Just out of interest - what did the Medichecks doctor suggest ?

FoxyTed profile image
FoxyTed in reply tosash779

Hi Sash, I’m the same, life at a standstill. I’m waiting on Endo doing HIS tests and wouldn’t go by my private tests. It’s a disgrace re the thyroid diagnosis and the waiting and waiting. People on here are very knowledgable! Get well soon….us ALL

Suvi8901 profile image
Suvi8901

“GP tested TSH and found "within normal range" so couldn't check T4 and T3. …”

-=-=-=

Sorry but your GP is talking nonsense! Of course you can check for T3 and T4 hormones. Too lazy to order up further lab based blood tests???? One wonders!

If he/she is ignorant and arrogant , the GP should AT LEAST refer you on to a consultant NHS endocrinologist. SIMPLES! Get him or her to write that letter!

BW

Jaydee1507 profile image
Jaydee1507Administrator in reply toSuvi8901

Its extremely common that the NHS only tests TSH. Its not a decision made by the GP or an ommission in having requested but a refusal by the lab to test. Hence members here are foced to pay for private blood tests to know where their thyroid health is.

Suvi8901 profile image
Suvi8901 in reply toJaydee1507

Then that GP should at least refer you on to a consultant NHS endocrinologist for an expert opinion?! GPs are not endocrinologists .

I suffer primary hypothyroidism, lupus, lupus nephritis, SLE, DLE, SCLE, vasculitis, type 1 diabetes etc etc.

ALL my AI diseases and medications were consultant diagnosed and prescribed. ALL my repeat meds are signed off by my GP regularly with blood tests done at 3/4 monthly intervals. T3, T4 plus TSH. NO fuss!

Repeat!

Your GP must refer you on to a consultant specialist. Labs have different “normals” for “ in range “ and take their cue from expert docs!👆

THE NHS CONSULTANT doc should have a say in what I see as blatant patient obstruction!

sash779 profile image
sash779 in reply toSuvi8901

Hiya Unfortunately for my GP he can't order further tests if TSH is normal, and they won't test T3 an dT4 until TSH done. So I paid for the above from Blue Horizon.

Suvi8901 profile image
Suvi8901 in reply tosash779

Then that GP should at least refer you on to a consultant NHS endocrinologist for an expert opinion?! GPs are not endocrinologists .

I suffer primary hypothyroidism, lupus, lupus nephritis, SLE, DLE, SCLE, vasculitis, type 1 diabetes etc etc.

ALL my AI diseases and medications were consultant diagnosed and prescribed. ALL my repeat meds are signed off by my GP regularly with blood tests done at 3/4 monthly intervals. T3, T4 plus TSH. NO fuss!

Repeat! Your GP must refer you on to a consultant specialist. Labs have different “normals” for “ in range “ and take their cue from expert docs!👆

THE NHS CONSULTANT doc should have a say in what I see as blatant patient obstruction!

DippyDame profile image
DippyDame

Welcome....

Good grief will this madness never end!

Reliance on TSH is not enough!

"Normal" is not a diagnosis....it just means the results are within the ref range.

What we aim for is the specific point within the range where symptoms are relieved.

TSH is a pituitary hormone, not a thyroid hormone. It reflects the overall free hormones in the serum but it does not show the level of each - ie FT3 and FT4

FT3 followed by FT4 are the important results

T3 is the active thyroid hormone and for good health it should flood every cell in the body by way of a constant and adequate supply

Low cellular T3 = poor health

Your private tests show both Frees are low and therefore unlikely to be adequate for your needs.

FT4 is 18% through the ref range

FT3 is 26.76% ditto

We aim to have both Frees approaching 75% through ref range.

What symptoms do you have?

thyroiduk.org/signs-and-sym...

Tick yours on this extensive list!

You sound undermedicated and should be treated with levothyroxine....starter dose 50mcg

Test should be repeated 6/8 weeks after start of treatment...

Depending on results this will need to be repeated....you will likely need a further increase/s

Essential to optimise vit D, vit B12, folate and ferritin to support thyroid function

Both antibodies are low which eliminates thyroid autoimmune disease/ Hashimoto's

I suggest you need to have a further conversation with your GP!

We are often at the mercy of ill informed medics and penny pinching these days....and poor thyroid treatment!

We're all here to help....just ask.

Good luck

sash779 profile image
sash779 in reply toDippyDame

Hi thank you for this - not yet diagnosed, so not medicataed either. Will go through the symptom checker and take it back to GP.

DippyDame profile image
DippyDame in reply tosash779

Yes, I gathered you still had to be diagnosed...hope the GP is on the ball...refuse to be diagnosed on the basis of TSH only....if they refuse....request appointment with an endocrinologist...but it should be a straight forward diagnosis...starter dose 50mcg levothyroxine with test/ increase to follow

Guidance tells medics that symptoms, not just numbers, must be considered during diagnosis.

And this might help...

thyroidpatients.ca/2021/07/...

In haste...

Good luck

Spritze profile image
Spritze

Sash I am new here too and also undiagnosed. Your results are not dissimilar to mine. Although my T4 has dropped a bit lower than yours, my TSH and T3 are still in range.

My GP also had 3 attempts to test T3/4 rejected by the NHS lab even though I had already given them my own private low T4 results !

Google 'Secondary Hypothyroidism' and ask your GP if they have ruled it out. If they can't rule it out they have to make an URGENT referral to Endocrinology according to Nice Guidelines. I'm not suggesting this is what you have but it may get you an appointment with a specialist.

Hope you get sorted !

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