Thyroid Disorders Community
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Avatar universal

Help understanding my thyroid results


I've been feeling awful for a while now with both hypo and hyper symptoms so I ordered a thyroid panel and the results with ranges are;

TSH 0.49 (0.27-4.2)
FT4 14.5 (12.0-22.0)
FT3 4.1 (3.1-6.8)
TT4 95 (59-154)

TgAb 16.3 NEG (0-115)
TPOAb 12.0 (0-34)

The doctor from the lab said that they're all normal but I feel terrible all the time. I'm a usually healthy female of 33 with a BMI of 18.5 and I've got no medical conditions.
Opinions anyone? Am I looking in the wrong place for an answer?

8 Responses
Avatar universal
I agree that those symptoms are more often related to being hyperthyroid; however, they are also sometimes related to being hypothyroid.  I have a site I use quite frequently that lists about 26 symptoms that are most typical of hypothyroidism.  I think you will probably find most of the symptoms you called hypo, listed there.  The ones you identified as hyper can be found in this extremely long list of symptoms that can be due to hypothyroidism.  


Also, you probably were influenced by the TSH level that is in the low end of the range.  My interpretation of all this info is that you most likely have central hypothyroidism which is a dysfunction in the hypothalamus/pituitary system that results in relatively low TSH along with relatively low Free T4 and Free T3 levels, with accompanying hypo symptoms.  

Now, getting that recognized and treated in the UK is the problem for you.  Since everything is in the so-called "normal" range, you will have to become very aggressive with a doctor and insist that you are hypothyroid and that you need a therapeutic trial of thyroid meds, as necessary to relieve symptoms.   One of our UK members in a similar situation who was finally able to get the testing and treatment she needed told us this.  

"What I have learned from my experience is that you have to go to the Dr's office and TELL THEM WHAT YOU WANT and to go backed up with knowledge.  You have to tell them that you have done your reading and looked into your condition and care about the long-term treatment of your health and thyroid.  If you fight for what you want, you will eventually find someone that is happy to go along with your wishes.  But we all have to take charge of our own health, right?"

A good thyroid doctor will treat a hypo patient clinically by testing and adjusting Free T3 and Free T4 as necessary to relieve symptoms, without being constrained by resultant TSH levels.  You can get some good insight into clinical treatment from this link written by a good thyroid doctor.


If all esse fails to get what you need your best bet is to try to go private.  Would that be a possibility for you?
Avatar universal
Before discussing further, please tell us about the hypo and hyper symptoms you have.  
Avatar universal
Thanks for replying, gimel. It's a long list but here goes;
Fatigue even though I'm getting ample sleep. Getting up in the morning is so hard and it takes me a long time to come round. Brain fog, slow thinking, breathlessness, hunger (an hour after having a full meal I'll be hungry and shaking inwardly and outwardly with it like I'm out of fuel and have no reserves. This happened sporadically at first but now it's happening after every meal.), muscle weakness in thighs and upper arms, pains and cramps in legs and arms, sore gritty achy eyes (optician says everything is fine), worsening PMS and longer time between periods, cold intolerant, chills, sweaty cold hands and feet, constipation, nausea, headaches, upper back ache, palpitations, lightheaded/blood rushing in ears when standing from sitting, buzzing legs, dry cracked lips, unable to gain weight even though eating all the time, carpel tunnel symptoms, nails are looking terrible, dry mouth, acne. I'm also suffering with anxiety and, more recently, I don't know if I may be suffering with a little depression now because I feel slow.

My doctor ran tests last month, U&E's, LFT, creatinine, CBC, TSH. TSH was pretty much the same as it is now and all other tests are okay (I got the results printed for me). This all began in Aug last year and my dr picked up slight anemia due to low iron but by Jan this year my levels were optimal again and I stopped the daily iron, only taking 14mg a day during my periods.
I've steadily been feeling worse and worse so I ordered the thyroid panel privately (NHS stop at TSH if it's in range) as I heard that TSH isn't always reliable.
I really don't understand what's going on since I lead a relatively healthy lifestyle.
Avatar universal
You mentioned the NHS.  Where are you located?  Location makes a large difference in how hypo patients are tested and treated.  

Also, which symptoms did you consider as being hyper?

Even though your TSH is low n the range and your Free T4 and Free T3 levels are within their ranges, that does not mean that is adequate for you.  The ranges are far too broad to be functional across their entire breadth for ever patient.  I have a lot more to relate to you, but would like to know answers to above questions first.  
Avatar universal
I'm in the UK and hyper symptoms are the constant hunger, tremor, no weight gain even though eating double, muscle weakness, palpitations, anxiety, sore gritty achy eyes.
Avatar universal
Wow! That is quite a list of symptoms and it even added more onto my own symptom list that I hadn't noticed.
Yes, I expected to be closer to hyper because of my low TSH and low weight. I never thought hypothyroid could be a problem for me.
If private would be the only way then I would definitely consider it. I'll go back to my GP with these test results and insist that central hypothyroidism be looked into. I'll do my research on central hypothyroidism before I go as well.
Thank you so much for taking the time to talk to me, gimel, you've been very helpful and informative. :)
Avatar universal
In case you do have to go private, what area of the UK are you located in?  The  reason I ask is that we have knowledge of some doctors that have been recommended by other UK members, but most are in the area of London.  
649848 tn?1534637300
gimel has given you some very good advice, but I'd like to add that you should also get checked for diabetes.  Some of your symptoms, such as the inability to gain weight, dry mouth especially with frequent urination, eye problems, constant hunger, cold sweaty hands, lightheadedness, etc could also be indicative of high blood glucose levels.
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