Hi there! Having recently been diagnosed with autoimmune thyroiditis, I have started doing my own reading and research about this whole new world of "the thyroid". There is so much to take in... I lived in blissful ignorance of anything thyroid related until my diagnose, which was in January this year. The thing I am struggling to get my head around is the abismal standard of healthcare offered to us... But anyway, here is the thing:
Since well before my diagnose, my younger sister has been having health problems, with symptoms including tremendous fatigue, depression, cognitive difficulties, memory loss, pins and needles in hands, numbness in legs, certain muscuclar pains... Unable to cope with full time employment, she has had to go part time, so her situation is quite worrying. During months she has been seen by a neurologist, an orthopedic surgeon and has had numerous blood tests requested by the GP and the end result of it all has been a "chronic fatigue" diagnose. They can't find anything wrong with her so they have given her that lable and are offering little in the way of treatment.
Now, having read everything I have read about the thyroid since January, I started wondering. I said to myself "hang on a minute, those symptoms"... They are different from mine (I am nowhere near as poorly as she is and for me it's more about weight difficulties and hairloss).
I asked my sister, "has your thyroid been checked?" "Yes, but the Dr says it's normal".
Bearing in mind my personal experience of my GP saying "everything is normal" when it clearly wasn't normal in my case (I've written a blog about it) I presumed her GP has probably only done a silly, pointless TSH test without looking further... So I decided to invest in a blood test for my sister, a full thyroid profile. I have had the results today and they are:
TSH 1.24 (range 0.27 - 4.2)
FT4 13.6 (range 12.0 - 22.0)
TT4 82 (range 59-154)
TT3 *2.9 (range 3.1 - 6.8)
Thyroglobulin Antibody 13.4 / range 0-115 negative
TPO Antibodies 9.1 / range 0-34
I would very much value your views on this.
Clearly Free T3 is too low? Couldn't this account for how she is feeling?? At least partly? If this is the case, how can it possibly have been missed for months?
Could the numbers point towards a "conversion problem" (unable to convert T4 to T3 for some reason), meaning, the FT4 seem somehow within range and the TSH has not gone up, but the T3 is very low? As said earlier, I am very new to this battle and still trying to learn.
Any ideas or suggestions would be sincerely appreciated.
Many thanks!
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Chiquitita
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Hi First weight and lots of symptoms often down to low Ft3, check yours is near the top of range, if on treatment and not below range if not on treatment. T4 on any treatment should be in top third, not too high. If you feel right ,then the results should also be.
Your sister,I am sure you know of the family connection.This is interesting. As without any tratment , only the Free T3 would be recognised as low.I have had Hashinotos for about 50 years, untreated for 20. When I started treatment Free T3 was always tested , even though there was no specific treatment for T3, armour which contains both.My further complication is that my TSH has always been immeasurable. You can see how that would effect your sister`s treatment, these days!. Before treatment my symptoms were very severe and in fact to some extent have damaged my health, how can one really tell in the end? I am lucky once I discovered my problem, no Web, TUK or on line tests then, or receiving results!I have a brilliant Endo now, who understands these problems, In fact now without treatment both FT3 and T4 would be extremely low. I did see an understanding private doc but he was just thyroid and did not test or find all my other autoimmune diseases.I was finally referred to my choice of Endo, after lots of unpleasantness.
So all I can say is find a brilliant Endo, but very carefully research, then as k the GP, not their choice but yours.
I hope that gives you some ideas. Most people do have to fight for the correct care.
If I can help further, click on "Reply to this" under my post.
Hi Chiquitita, according to the results you've given above, you didn't have an FT3 done. You had a TT3 (total) which doesn't give any useful information except that it is low. This being the case, the FT3 (free) could possibly be lower. And, yes, this would account for her feeling bad!
You ask how could this have been missed. Well, it probably wasn't done. They probably only did the TSH, and as this is nicely in range, they didn't consider it necessary to do the other tests. That's how it is these days, I'm afraid.
Yes, the FT4 is in range, but it is very, very low. So low she doesn't have very much to convert. Too low for a conversion problem to stand out.
So, the problem here is the TSH, which is the only test doctors really look at. That could indicate a ptiuitary problem and I would say that that should be your next step, getting the pituitary checked out.
Hope you get to the bottom of things soon, Grey
PS for future tests, don't bother with the totals, they are just a waste of money. You need the frees.
I do think the tests have measured Free T4 and Free T3, they say so... It was my own typo in my text (apologies!! were I meant FT3 y typed erroneously TT3)
Looking at the exact wording of the printout in front of me it says:
Thyroglobulin Antibody 13.4 / range 0-115 negative
TPO Antibodies 9.1 / range 0-34
My next question is, how does one get the pituitary get checked out? What is the name of the test that would shed light on this?
As I said, I'm just new to all this stuff. I'm guessing that what you are pointing out is a condition in which, for whichever reason, the communication that needs to happen between the thyroid and the pituitary to make the pituitary secrete more TSH for hormones to go up is not happening properly? Am I getting this right? If you know of any good links were I can read about that aspect of things I'd be truly grateful.
Once again, thanks so much for taking the trouble to respond.
OK, so if the tests are FT then that is fine and yes, the FT3 is way, way too low.
I'm afraid I dont have any experience with pituitary so I would suggest you ask in a seperate question and then those with that experience can tell you what you need to know. Yes, it could be the link between the pituitary and the thyroid that is broken or maybe there is a problem with the pituitary itself. You won't know until it's been investigated. I'm sorry, I don't have any links.
Hugs, Grey
Hi, you need to discount pernicious anaemia in your sister (b12 deficiency). Autoimmune diseases run in families but you can all present with different ones, graves, hashis, coeliac etc.
Heloise, thank you SO MUCH for your link, I have found it very interestin and useful. The information is very clearly laid out and easy to follow. Thank you for sharing.
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Different lab results on Same dose. Conflicting free assays. 
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