leigh: I live in United States but would... - Thyroid UK

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leigh

Lrv44221 profile image
9 Replies

I live in United States but would appreciate any advice

I went to nurse practitioner and I had a tsh test only

It was .26 which she said it too low and my thyroid is making too many hormones and wanted to put me on a drug

I said I am cold a lot although i live in Florida

Gained weight thinning hair dry skin and mouth and eyes

I have symptoms of hypothyroidism not hyperthyroidism

she said it didn’t matter and to take the prescription or leave her office

Which I did

Any advice

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Lrv44221
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9 Replies
SlowDragon profile image
SlowDragonAdministrator

Never rely on just TSH

What did they prescribe?

Get FULL thyroid and vitamin testing done as next step

Then see an endocrinologist if necessary

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

Low vitamin levels are extremely common when hypothyroid, especially with autoimmune thyroid disease

About 90% of primary hypothyroidism is autoimmune thyroid disease, usually diagnosed by high TPO and/or high TG 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.

Significant minority of Hashimoto’s patients only have high TG antibodies (thyroglobulin)

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 that all thyroid blood tests early morning, ideally just before 9am, only drink water between waking and test

This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip)

Lrv44221 profile image
Lrv44221 in reply toSlowDragon

Ty for you help. I’m going to research and find an md who can prescribe the correct vitamin and thyroid tests

Your help and advice is greatly appreciated

The medication she wanted to prescribe was to stop producing all hormones because right away she said I have an overactive thyroid and wouldn’t listen to my concerns

I do believe some medical advice is backed by the big pharma and it’s their way of making more money, which is disappointing for me.

With your advice and specific recommendations I will find an md that would be willing to give me the blood test I need

Ty again and after I find an md and get the proper thyroid and vitamin test I would be happy to continue to be part of this site

I think this may take some time but I’m so grateful for all the support and time

I will continue with my journey thanks to your help. I hope to get this done as soon as I can

Jazzw profile image
Jazzw

Wow. It’s kind of scary how adamant the nurse practitioner was that there’s a problem that needs medicating. I’m glad you left her office. There is actually a scenario where you could have hypothyroidism with a low-ish TSH, which is secondary or central hypothyroidism. That’s when the pituitary doesn’t signal to the thyroid that it needs to make sufficient thyroid hormone.

Which is why thyroid conditions should never be diagnosed on the basis of just one test result.

To even have a hope of diagnosing what’s going on, you need a TSH and FT4 result and ideally a FT3 result as well. If it still looked like possible hyperthyroidism further tests would need to be done to make sure.

Is there somewhere you can go for a second opinion? And a full set of thyroid blood tests?

Lrv44221 profile image
Lrv44221 in reply toJazzw

Ty for your help

As of now since i feel fine im just continuing my vitamin therapy walking and eating well

greygoose profile image
greygoose

Hi Lrv44221, welcome to the forum. :)

I take it you haven't had any sort of thyroid diagnosis previously? Was this your first thyroid test?

What time of day was the blood draw for that test? Because TSH varies throughout the day and is highest before 9 am and at its lowest around midday.

That nurse is wrong on all counts. You haven't given a range for that result, but it's not suppressed so is not hyperthyroidism. And taking anti-thyroid drugs with a TSH that level would be a serious mistake and probably make you pretty ill. I'm amazed that a health professional would act that way! Glad you walked out on her. :)

Lrv44221 profile image
Lrv44221 in reply togreygoose

Ty so much for your time and attention to this. I’m so glad you’re able to help. After I find an md I will have a physical and complete thyroid work up. When I’m able to get my thyroid checked by a md and have results i will let you know my results. I hope to continue with this amazing site

Again ty so much

greygoose profile image
greygoose in reply toLrv44221

You're welcome. :)

Poniesrfun profile image
Poniesrfun

Hi Florida -

You can order tests yourself through LabCorp or Quest. You can also go online to Paloma — palomahealth.com and consult with a thyroid specialist and do home testing. Depending on your insurance, you may have to pay out of pocket (and possibly be reimbursed) and they will work with you if you do need thyroid medication.

I find, at least in my area, that NP’s are usually pretty knowledgeable about thyroid issues and test appropriately. I’m sorry you encountered one who seems pretty clueless. Many endocrinologists seem to know less than the folks on this forum and just practice cookbook medicine.

Make sure you get all the tests Slow Dragon suggested — any primary care doc or NP should be willing to order them for you, else do it yourself.

Patti in AZ

Lrv44221 profile image
Lrv44221 in reply toPoniesrfun

Ty Patti your response was so nice and informative. I plan to go to a dr that will order the tests and then when I get results I plan on sharing with some of the wonderful people on here and at last feel like some one cares to help me instead of making money of a drug.

I also love horses

As a child we had one and as an adult I don’t but still love them

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