I was recently diagnosed with hypothyroidism (autoimmune, Hashimoto). A while ago I wrote a blog about how I was diagnosed in Spain and subsequently denied a diagnose in the UK and ended up having to go private to get help…
I’m still new to all this world and still trying to learn as much as I can, so I don’t feel very qualified to impart words of wisdom, however I thought I’d share the following with this forum in case it helps or inspires others who like me are still trying to get to grips with this. This may very well be "old news" for the veterans, so apologies for those who may feel I'm just stating the obvious.
The private Dr. I went to after being denied a diagnose by my GP took a good look at the blood tests I had had done in Spain and confirmed that my diagnose is “obvious” given the elevated antibodies and my symptoms. He then proceeded to order two tests: a blood test for full thyroid panel and a 24 hour urine test for the same (this is a test where you collect your whole urine for 24 hours, which poses some logistical challenges!). I had both done on the same day and this was before starting medication.
Here’s what the results looked like:
TSH3.73 (range 0.3 – 4.5)
FT33.06 (range 2.1-4.2)
FT41.20 (range 0.7-1.8)
+elevated anti-thyroglobulin antibodies
(So, apart from the antibodies, all nicely “in range”… my tests in Spain months ago had had a much higher TSH and much lower FT4)
24 hr. Urine test
T3 445 pmol/24hr. (range 800-2500)
T42130 pmol/24hr (range 550-3160)
(So T3 is desperately low –half of what it should be- and T4 is more or less OK)
The Dr. explained the blood test gives a general idea of how much hormone is circulating in the blood at a particular point in time, but not necessarily how much is reaching the cells. The urine test gives a better idea of the level of thyroid hormone that reaches the tissues that need it.
He explained my urine test clearly points to a conversion problem, which explains why I have clear symptoms, in spite of the fact that my blood test “looks good” and that according to it I’d be classified, if anything, as “subclinical” (ie. symptom-free) by an "institutionalised" GP or Endo who would look no further... The urine is telling a very different story, my cells are only getting 50% of the T3 they should be getting, so I am significantly deficient in it, not just a wee bit... Standard T4 medication would not work for me at all, so he is giving me Euthyral which is a synthetic T4/T3 combination on a 4 to 1 ratio.
With my same blood test results, someone without a conversion problem would probably be feeling just about alright with no symptoms or hardly any… however due to the conversion problem I've started to struggle already.
The whole “conversion” issue is so complex. As far as I can work out the body needs an adequate level of iron, selenium and zinc for the process (all of which I am deficient in and I am now supplementing) as well as a healthy balanced intestinal flora, a detoxed liver in immaculately perfect condition and a mind in peaceful equilibrium free of stress, worries or concerns…
Whatever the case, the reason I wanted to post this is that for so many people who are being denied a diagnose and told by doctors that their symptoms have nothing to do with the thyroid because the blood test results look good… it seems to me that there is a test that can be done, the 24 hr. urine test, that should enlighten the doctors and make them understand that something is not right and that it is not all in the patients “head”!! Same goes for so many who don’t do well on T4 only medication and are denied T3. This test could be used to establish whether there is any point in giving T4 to someone who cannot convert it into T3…
All the best to everyone!