I am fairly new to the testing mystery for Hypothyroidism, but have been living with symptoms for several years.
Recently these have gotten worse along with the usual dry hair skin and nails, weight gain and aching joints I have now developed poor concentration, co-ordination problems, excessive weight gain, UTI's, swelling in my arms and feet, thinning hair and bloating......the list goes on.
Given that I exercise everyday which includes min 3 times a week resistance training and have an healthy diet the Dr agreed to do full blood counts.
My results were:-
TSH - 1.5 (0.3-5.5)
F T4 -9.8 (10-19.8)
Not sure what Serum Free T level is for but that was 4.6 (3.5-6.7)
Although I am pleased he agreed to the full tests second time around I can't help thinking that if we had done this two years ago when I pointed out some minor issues I could have saved myself some unnecessary symptoms.
Can anyone please help explain the results in layman terms and help me understand why the Dr advises there is nothing wrong????
Cheers
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Brown321
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Because he knows so little about thyroid that he is only looking at the TSH, which is nicely in range. If he had the slightest inkling of intelligence, he would see that the FT4 gives cause for concern. It is below the range when it should be up near the top. Did you mean Serum Free T3 level - 4.6 (3.5-6.7)? If it is FT3, then it is way too low. So it's no wonder you have symptoms, you are hypo.
TSH is a pituitary hormone (Thyroid Stimulating Hormone) that stimulates the thyroid to produce more thyroid hormone - T4 and T3 - which it is obviously having trouble doing. What time of the day did you have these tests?
What a relief to speak (or correspond lol) to somebody who listens, friends and family try their best but they don't always understand the frustration
My tests were done 8.30am and were done on a fasting basis. Not sure what the serum free ones are as it just says serum free triiodothyronine level?????? As you can tell I am fairly new to all of this.
I have to go back an discuss the results with my Dr as he thinks the issue isn't medical!!! And s looking to refer me to a gym. Although I regularly go and work with trainers who are all confused.....surely this should be an indicator.
Any suggestions on how to suggest/convince a Dr that I am Hypo would be greatly appreciated. Was even contemplating asking for a trial of thyroxine in the hope that my symptoms improved and he would recognise there was an issue.
Yes, serum free triiodothyronine is FT3. T4 and T3 are the hormones made by your thyroid that you need to live. T4 (thyroxine) is the storage hormone which is converted into T3 (triiodothyronine), the active hormone, as and when needed. Therefore you have to have a decent level of T4 so that it can be converted into T3. You have virtually nothing.at 9.8, which is below the the range.
I'm afraid I can't advise you on how to talk to doctors, I'm terrible at that. I either clam up in a dumb ball of misery, or I go for the jugular. Neither approach is very helpful! Hope someone with good diplomatic skills will speak up. lol
Hugs, Grey
HI - I agree with Greygoose -
Doesn't look as if the pituitary message (TSH) is getting through to your Thyroid to make enough hormone (low T4/T3) - here's an interpretation of blood tests on the main TUK site which may help. J
I have found this site to be a godsend in getting to grips with some of the basics. Was waiting for the results to comeback so I could show the Dr but only just found out today that my serum level was a FT3.
So now I will feel a lot more confident when asking him to reconsider
When running through the results with my Dr he simply advised that FT4 wasn't a concern as it was only just out of the range. Had I realised that it also works alongside (or used to convert) the FT3 I would have questioned it more.
I will try to and do some background reading and try to see what range (FT3) best suits people suffering with Hypo, so that I am prepared before the next appointment.
There are other reasons why your TSH might be nicely low even though your thyroid hormone levels are too low. One is low cortisol levels. If you can persuade your GP, a random cortisol test at as close to 8am would be a good idea. It should be at the top of the range at this time, but if it is low in range don't expect your GP to do anything Luckily there are plenty of websites that go into the details of this "mythical" (according to doctors) Adrenal Fatigue and will help you find the best way to recover.
Another reason for low TSH is a vitamin B12 deficiency. The lower end of the NHS reference range is way too low! If you are within range but your B12 is below 400-500 then you need to take a significant dose of B12 (around 5000mcg of methylcobalamin), preferably a sublingual supplement for best absorption. Low B12 causes problems in the communication between the hypothalamus and the pituitary gland, which results in a lower than expected TSH and possibly other problems too. It can also cause neurological problems so it is a good idea to get it tested.
If your GP is convinced your thyroid is fine then he shouldn't have any trouble looking into other reasons, such as B12 deficiency. While you are at it, it would also be wise to get your iron, ferritin, folate and vitamin D tested too as all of these can cause some or all of you symptoms.
If it turns out you have any of the above problems, your TSH should hopefully rise as they are treated. This will either result in your thyroid producing enough hormones, or a TSH high enough that you can get a hypothyroid diagnosis. I hope something works out anyway.
Thank you for the advice I will most definitely take it all on board may have to do some background reading before I see the Dr though so as not to get confused lol.
If I am reading this correctly then a lack of b-12 (if it comes back low) could be affecting my TSH levels which affects the FT4 and FT3, which when rectified could mean I am not Hypo.
In theory then if the above is correct once back to a correct level my Hypo symptoms should disappear?
I agree with what Carolyn says, yes, check the B12 as if this is low once fixed many of your symptoms may improve/go away, if not like Carolyn says then maybe by that point your GP may believe you?
It's difficult to tell how quickly you will notice a difference. You may notice a difference quite quickly or it might take longer.
Many people find it best to take at night. Try to take it two hours after food or an hour before, whatever time of day you take it, and don't take near other supplements or medication or even caffeine.
Hopefully you will notice an improvement soon. MOst people get on very well with levothyroxine.
It is still a good idea to get the other checks like vitamin B12, vit D and iron/ferritin.
your fT4 was below normal at 08:30am, if you had the test done at 6pm it would have been EVEN LOWER. The circadian rhythm of your body means that TSH, fT3, fT4 are at their highest from just after midnight then fall downwards from there throughout the day!
you don't have much fT3 either, your body is struggling to keep up, fT3 is what goes into your cells for metabolism the body is supposed to convert fT4 into fT3, from your bloods you can see your body is converting in a 'desperate' attempt to keep fT3 in normal range.
Carolyn is SO right about vitamin B12 please get this checked asap
So when speaking to the Dr who believes that nothing is wrong I should ask for a B12 test as well? Excuse me for appearing unknowledgeable but does this mean I am Hypo or that something else is causing the lack of conversion?
Even given that I showed the Dr two years worth of weight details showing how I can lose weight for a couple of days and then it comes back straight away even when I up the exercise regime.....surely when I ask about my metabolism he should of clicked!!!!!
If my FT4 were at a decent level do you have an idea where in the range someone should be (10-19.8) and the same for FT3 (3.5-6.7)?
The comments today have been so informative and if fir not your input I may have been inclined to believe him.
Currently I live off slim fast (which I loathe because of the sugars) but find that if I only have 1 meal a day it helps with the bloating. All I want is to be able to eat 3 healthy meals a day and get rid of these uncomfortable symptoms
Brown, you should definately ask for the B12 test, and iron, ferritin, folate and vitamin D too.
Personally, I wouldn't say you had a convertion problem. Your FT3, although low, is higher in its range than the FT4 in its. Your problem is that your TSH does not reflect this (and you have an ignorant doctor, which is a huge problem); which could be due to low B12 or something. However, you are absolutely hypo at the moment because your thyroid hormones are low - that is what makes people hypo. Both FT4 and FT3 should be up near the top of the range - where exactly is difficult to say because we are all so different, some people even need their levels over the top of the range.
Whether or not your hypo is due to low B12 or not you will only find out if your blood test shows you low and then your symptoms improve with supplimentation.
However, your doctor does not appear to have tested for antibodies. It could be that you have high antibodies, which means that you have the autoimmune disease, Hashimoto's. This is the most common cause of hypo. If you do have Hashimoto's then, although supplimenting with B12, iron, etc may make you feel better, you will always be hypo and need thyroid hormone replacement. If I were you, I'd ask him to test for antibodies, too.
Also, if I were you, I would give up the Slim Fast. It is incredibly unhealthy! Have you looked at the list of ingredients?
Fructose/High Fructose Corn Syrup/ Artificial sweetners! All these things are very bad for the health and very bad for thyroids in particular.
Canola oil and hydrogenated soybean oil - the soybean oil is especially bad. They remove the natural fat from the milk and then add these horrors in their place!
Then there are the artificial flavours and all sorts of other nasty additives.
Believe me, you are doing your thyroid no favours by consuming Slim Fast in the place of real food. You are not getting enough calories or fat but too much bad 'sugars'!
Thanks for the tips will definitely be discussing some extra testing and requesting a referral to Endo (which the Dr offered 2 yrs ago).
Regarding the Slim Fast - I only take this as a last resort - am very aware of healthy eating and exercise etc. But if I eat 3 meals a deal have issues with digestion and bloating which then causes other issues.....hence why I am annoyed that the Dr is not listening to me.
Although I am aware I am Hypo I have a feeling that my unusual readings are causing the Dr confusion - with a little more background reading into my levels it appears it could also be as a result of secondary hypothyroidism - this is the pituitary gland not registering the message that the FT4 is low - according to the NHSlothian website and this can only be treated by an Endo.
At the moment I will be happy for an acknowledgement of my Hypo condition and then I will prepare myself for the long road ahead.
Either way I will be back on here with the results and Dr's comments on the low reading that he just dismissed!!!
Have you tried eating five meals a day instead of three? You eat the same amount but break it up into smaller mini-meals. This would be easier on your digestion.
By the way, I wasn't suggesting that you didn't know about healthy eating, but I thought maybe you didn't know about the contents of slim fast and how bad some of that stuff is for hypos.
I didn't take offence at all lol, its just coming from a family who suffer with digestive diseases and watching how they manage their diet etc. Eventually found that slim fast (fortisips not an option) was the only thing which helped with the constipation.
If I eat more than 1 meal a day then I become extremely constipated and nothing is digested and it makes it difficult for me to move around. Although I loathe drinking them its the only way I can still go about my everyday.
Prior to the progression of symptoms I had porridge and banana for breakfast, fruit salad or ham salad for lunch and then chicken or salmon with veg in the evenings. Along with 3 brazil nuts a day for selenium.
That is awful! Poor you. I didn't realise it was for the constipation. Have you thought about whey protein powder? I sometimes resort to that for various reasons.
I don't know what it would do for the constipation but it would give you a decent amount of protein without all the nasties that are in slim fast. Quite tastey too!
I don't use Slim Fast now but did use it when I was desperate and looking on the web for real support. It helped me stay alive and bought me some time so I could adjust my dietry needs while eliminating all the foods which made me so ill.
I'm pleased you are getting some good advice. People always seem to worry about T3 and T4 although they are very important there are other considerations to think about which GP's don't even consider to be important. I was so upset when my GP and the hospital refused to recognise my condition. Being told I was fine when it was obvious the many signs and symptoms could not be ignored.
My body was so swollen I went up from 10st to a massive 13st which took me up two dress sizes. I looked like the Mitchelin tyre man (from old advert on TV), could not get shoes on and had to go around in slippers and Velcro fastening sandals to allow extra room for more swelling, continuous vomiting and diarrhoea through the nights. Could not eat most foods, I eliminated so many foods that I had to start using "slimfast" ( not as a diet but to get the best of all the nutrients into my body), Tea, coffee and juice tasted strange, could only drink water or milk, skin and hair to dry, cold hands and feet, Very white and puffy faced complexion which later became a puffy olive complexion, At bed time I could not put my head on the pillow because my whole head would go like pins and needles (blood supply not reaching the head), forced to sleep with a thermal hat on and only part of my cheek could touch the edge of the pillow which stopped me getting pins and needles in the head. I would often wake up and my whole face would be like a block of ice and the rest of my body was cold too. Yes I was dying.
Still denied medical help and being on the brink of death I prayed to God for an answer. I was so desperate knowing that, that night was the night my heart had nothing left to give and I would not be here when dawn broke. My cockatiel was even screeching with fear that night as he knew If I died so might he.
The Lord answered my prayers in two ways. HE sent me the gift of sleep and I knew nothing more until the next morning. HE also placed thoughts in my head to search for an American specialist who pointed me in the right direction and gave good advice. I have never looked back. My health improved slowly over a long period. It took so long because my whole body had nothing left to give. I knew it would take a long time because every cell in my body needed to be replaced. My health improved dramatically. Being on the brink of death at the time I was brought back into good health. I praise the Lord for pointing me in the right direction and finding me a way forward. My participation here is true and correct.
I don't use Slim Fast now but did use it when I was desperate and looking on the web for real support. It helped me stay alive and bought me some time so I could adjust my dietry needs while eliminating all the foods which made me so ill.
The GPs are amazing arent they? First they rely on the TSH tests - which are pretty meaningless by themselves.
Then they ignore that tests that are more meaningful - the T3 and FT3 tests.
It's like they ignore that the house is on fire, and look only to see if the pan of water is boiling over - oh no it isnt, so therefore everything else is OK.
Been banging my head against a brick wall for the past two years (looking back now realise this was just the condition getting worse) as pointed out to the DR concerns that I was going to the gym twice a day and still putting on weight?????
To which the reply was it's your portion sizes!!!!!
When that the weight gain increased to 9st in total he finally agrees something is wrong (proud that I even managed to lose 2st with no meds).
Don't hold out much hope for tomoz's appointment, am sure they will have another prognosis anything but the real issue.
Well Dr agreed to the additional tests but still putting the case across that my FT4's are fine and I have no thyroid issues.
Apparently they are only just out of range and even given that I have doubled my weight nothing is screaming out at the Dr.....The positive is that he has agreed to my request for a referral to an Endo.
Was thinking of looking up Dr Skinner has anyone had any experience with him?
I have just called Dr Skinner for an appointment and his secretary is sending out an info pack to me. He is not back until June so do get in touch.
I feel fairly demented as I have put on 3 srone in 3 years and have developed high cholesterol and low Vitamin D both of which are connected to hypothyroidism. I discovered this information on this site. Don't know if my GP has even made the connection. When ever I get my thyroid checked at my GP all that comes back from the lab is the TSH. Once I asked for my T3 & T4 to be done and I watched my GP write it on the form but despite this the lab only sends back the TSH !!!!!!!!!!!
I truly understand and feel where are you coming from, as if the illness isn't a pain in its self. Then we have to contend with fighting the GP's like we are in a war. Apparently I am a rarity as my Cholesterol levels aren't high (hardly surprising as I only live off fruit, salad and protein) and workout everyday!!!!!
Dr Skinner seems to have done some amazing work on behalf of ppl with thyroid issues and I spoke to somebody from their offices today. If my GP agreed to treat me on NHS by his recommendations then I would be in like a shot, so for now I will ave to go with Endo.
But please let me know how you get on it'll be nice to hear how you get on. Do you know what your TSH levels have been previously?
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