New blood test.. Am I hyper now? This time the Gp will give me a referral I hope..

[Lore]

Dear all,

Just got back to take my blood tests results.

For those who don't know what happened in the past, let's say I got very angry with my Gp as I felt that something wasn't working and I didn't feel ok with levo (100-125 mg everyday) and I wanted so badly to try armour, so I asked for a referral to see and endo and my Gp refused that as she said my results were IN THE RANGE.

I gained weight and I felt always tired taking 100mg everyday so I followed the prescription of the endo I had in Italy about taking 125 (my TSH then was about 1.80).

Well this happened in February; my results now are:

TSH 0.09(0.3-4.2 mu/L)

FT4 15.4(9-23 pmol/L)

Serum free triiodothyronine level (is this ft3!?) 2.2 pmol/L (2.5-5.7)

I have to say I have been able of losing weight with a little less efforts than usually BUT I don't have a regular period (now it's been 45 days since the last one and the month before the same), and sometimes I feel palpitations.

I bet this time the stupid Gp won't be able of refusing to write me a referral!

I think levo is not working for me as maybe I'm not able to covert the t4 in t3, what you guys think?

Please help me to get a clearer view about these tests!

Thanks in advance

Lorenza

[PinkNinja]

Your TSH is very low considering how low your T3 and T4 are.

I don't know if you have a conversion problem but your T4 and T3 don't look to be high enough, which is a little odd considering your low TSH.

There are other reasons for a low TSH. It could be a pituitary problem or abnormal cortisol levels or low vitamin B12. It would be worth getting these investigated if you can.

Given that you also have palpitations it would be wise to get your serum iron and ferritin (stored iron) tested as this could be causing your symptoms. Iron and B12 are also believed to be important for your body to be able to use thyroid hormone properly.

Your blood test results are a classic example of why doctors should not be testing TSH alone but should also be looking at T3 and T4 levels.

I hope that helps a little.

Carolyn x

[Lore in reply to PinkNinja]

Thanks for your reply!

Yes this is strange... My ferritin is 14 ug/L (10-120), but I'm taking iron every day as I'm anaemic...

My b12 was a one range a couple of months ago,which was odd as well!

Honesty this is really weird:))

I have to see my Gp on Monday, hopefully she'll prescribe me some more tests I hope... Also my platelets are always low and I have a visit booked with an haematologist as maybe I could have another autoimmune disease to the blood:((

Well...I'm confused now!

I'm sure I've tested the adrenal in Italy and they were fine, not sure about the pituitary, how you test them, with a blood test as well?

[Lore in reply to Lore]

I meant my b12 was ABOVE range sorry...

[PinkNinja in reply to Lore]

Yes, there are blood tests for pituitary function.

Your case does seem quite complicated so I'm pleased you are seeing a haematologist about your abnormal results. Your anaemia may well be responsible for your palpitations.

Your ferritin is very low! Vitamins C and B2 are also important to take with iron to help with absorption and storage.

I hope you get some answers soon!

[Lore in reply to PinkNinja]

You think it's love even with iron supplements?

That might be why I always feel tired and with bad shadows under the eyes

[helvella Administrator in reply to Lore]

Maybe have a read of this old blog:

thyroiduk.healthunlocked.co...

Rod

[PinkNinja in reply to Lore]

Yes. A ferritin of 14 is way too low. Most women feel best with it above 70 but higher for men.

[helvella Administrator]

Yes , "Serum free triiodothyronine level" is FT3.

Looks to me like you continue to be under-dosed with FT4 at under halfway up the reference range and FT3 below the bottom of that range.

Maybe you do need something else, but possibly best to get the levels up before assuming that to be the case.

That your TSH is low is, in my opinion, more indicative that your pituitary is not producing an appropriate amount of TSH than a good reflection of the free thyroid hormone levels. I'd suspect you could be suffering from hypopituitary.

Rod

[Lore in reply to helvella]

Thank you so much for your reply.. I'll see what my Gp will say in Monday...

[JennyC2 in reply to helvella]

Hi Rod

Can you elaborate please? My TSH is 0.07, T4 is 153(59 -154) and T3 is 5.0 (3.1 - 6.8). Advice on this site seems to suggest that I may benefit from T3/NDT and I plan to seek a referral on my next visit to dr. What I don't understand is if the pituitary is not producing the thyroid hormone where is the T3 and T4 coming from?

Sorry if I am being slow but sometimes it seems the more I find out the less I understand.

Thanks

Jenny

[helvella Administrator in reply to JennyC2]

Please believe me when I say that I totally identify with:

Sorry if I am being slow but sometimes it seems the more I find out the less I understand.

The thyroid produces thyroid hormone because it is stimulated by the TSH from the pituitary. However, it can also produce thyroid hormones (T4 and T3) if it is stimulated by TSH-receptor antibodies which are of the stimulating type. Or some part of it can go autonomous and push out thyroid hormones on its own entirely ignoring TSH levels. Or a struma ovarii can produce thyroid hormone from ovaries. Or, of course, you might be taking T4 and/or T3. (I am probably missing out some other possibilities.)

Nothing in the world of thyroid is ever as simple as it first appears.

If I have not answered adequately - let me know and I shall try to add what I can.

Rod

[JennyC2 in reply to helvella]

I think I understand. Thyroid hormones can come from other places and, yes I am taking T4. Is this one of the reasons why we aren't too keen on relying on TSH and if that is true does it matter if your pituitary isn't working to produce TSH as long as you are getting the thyroid hormones from somewhere else???

I do remember a time when I could assimilate this type of information more easily, so thanks for for your patience.

Jenny

[helvella Administrator in reply to JennyC2]

There is an ongoing debate about whether TSH has any other function or effect than stimulating the thyroid. It is still not beyond doubt either way.

However, in general terms, the TSH value itself does not matter - it is how much T4 and T3 you actually have in your system that matters. But medics seem to insist that TSH alone is such a wonderful indicator.

So whether or not your pituitary does or does not produce TSH doesn't seem to be important. There might be something subtle which means it has some relevance but not, so far as I know, proved.

Rod

[JennyC2 in reply to helvella]

Thanks very much, I'm now less concerned about my low TSH and can try to get my GP to focus on the others.

Jenny

[spring13 in reply to helvella]

As she previously had a normal TSH its not going to be a pituitary problem.

[helvella Administrator in reply to spring13]

Would really like to follow what you are saying. Would you please expand a bit?

Rod

[spring13]

When she was on a lower dose her pituitary was producing TSH, as you would expect the TSH will drop as the dose goes up. A low TSH now is not always a sign of hypopituitarism but shows the pituitary "senses" there is sufficient thyroid hormone in the body. It would be a very unusual coincidence for the pituitary to have suddenly stopped working at the same time as the thyroxine dose goes up.

[Lore]

I'm confused as well!! I really hope to see an endo very soon...

After increasing the dose I started to have bad acne on the chin and my period is not regular (now it's been 50 days and nothing happened). I think it is really a mess! Do you know if acne could be a side effect of the levothyroxine?

[Catseyes235]

You are not within range but below and therefore a bit hyper which could explain weight loss and palpitations. Get your doc to read again or show to chemist as they can be helpful.

[helvella Administrator in reply to Catseyes235]

Catseyes235,

I sincerely hope that the original poster has got somewhere in the five years since posting.

[Catseyes235 in reply to helvella]

Strange . .I don't generally check the date as this one popped up sounding new. Ha ha maybe everyone needs a follow up after 5 years!? I do sometimes want to find out how things are resolved especially when some confusing advice given!

[helvella Administrator in reply to Catseyes235]

Catseyes235,

The related posts thing seemed to be blind to age of post. Sometimes that is a good thing; often not.

[Catseyes235 in reply to helvella]

Could you possibly change the font colour on the date which only shows as a pale grey on white - not obvious or a great contrast for old, tired eyes - and many of us use small screens? The other site I visit is macular degeneration so get odd wiggly lines and small writing not good. The RNIB site is useful for advice on best font colours. Many thanks and keep up the great work!

[helvella Administrator in reply to Catseyes235]

Catseyes235,

No - we as administrators are really simple moderators and have no access to settings. There are very things we can change at all - and absolutely nothing that affects more than one forum.

[Catseyes235 in reply to helvella]

No worries . . Bit of a a shame but maybe you can pass it over to the powers that be?!