latest bloods results and back to square one

[belwom]

My latest blood results from Chelsea & Westminster are : Free T4 12.7; TSH 2.05; Free T3 4.6 'at the upper end of the normal range'. Iron/transferrin saturation normal, cortisol normal at 377 nmol/l, vit. D excellent at 85.8 nmol/l; haemoglobin 124 g/l. B12 and Folate normal and no ovarian, thyroid, adrenal and parietal cell antibodies. As such I will not be seen anymore at the endocrinology clinic of this hospital as they have not found an endocrine cause for my symptoms and there is currently no indication of autoimmune thyroid disease. I was diagnosed with this after a private blood test in December 2011 showed elevated thyroid antibodies at 400 times the maximum amount. I have now no eyebrows left- in spite of having had full and thick ones- after losing them for the past 4 years and I have constant under-eye puffiness, two of the visible symptoms of hypothyroidism. While at the last consultation the endo. said I did have features of subclinical hypothyroidism, I am now back at square one because of the blood results. I can tick almost all of the symptoms of adrenal stress and hypothyroidism and can hardly get anything done, whereas I would love to be able to. The results I have posted are a copy of what has been sent to my GP and for some, no specific values are mentioned. I fear that once again these results might confirm me as a hypochondriac or neurotic with my GP surgery and that I will have to keep plodding on myself. Can anyone shed some more light on some of the results such as the T3 please, I am not sure if this value qualifies as the higher end in all sources.

[tegz]

It would helpful to add ranges- but it still looks like your readings are not great.

Mine were similar last year [NHS] but a later private test showed TSH over limit by nearly 20% and ,due to my symptoms, I pushed for Levo- though it wasn't the best choice- just the only one in NHS via GP.

I also did a Cortisol check with a self imposed lower limit [9am] of 400 and I came in over that.

You haven't managed to reach that - so I would say, on the surface, you may need adrenal support in the first instance and perhaps consider a private test of TSH to confirm your latest results.

The antibody test [high ]result earlier seems odd.

Do they not consider you may have an intermittent case of autoimmune reaction which may fool the results on timings- and still leave you short overall?

Many a comment on personal [and even some technical reports] about bloods not always showing tissue levels of thyroid hormones correctly -and they haven't measured that.

The other thing that stands out is that you say your T3 is in the upper area- but my T3 labs range [private] go from 4- 6.8 and they don't vary so much from each other. Mine was higher than yours, at 4.8 !!

So- you may lower down the scale than you would like to be.

Time for a review...Good luck and don't give up.

Sub clinical doesn't mean without symptoms [for us] and neither do lab figures tell the complete story.

[belwom]

Thanks for this Tegz. I do not know where these ranges as proposed by specialists come from but I have noticed on more than one occasion that there is no consensus. It is unbelievable that a Free T3 of 4.6 is said to be at the upper end of the range, whereas your private blood test T3 range is from 4 to 6.8. According to the latter range I am at the bottom end in my book. I am very sceptical and have only just got the results back today.

[tegz in reply to belwom]

My understanding is that the ranges vary due to procedual variations between labs and also the fact that different make or spec. machines could be used for the tests 'lab to lab'.

I've had my doubts about this for a while, but there doesn't seem to any way to find out how the labs are cross checked - if at all.

The very fact that variations occur between NHS and private work makes me worry again- about the formers accuracy.

There could still be sample errors ,however- but not to the degree shown by your results, at first sight.

[NB: Still no ranges ]

[belwom in reply to tegz]

You would think it would be unscientific to allow such a divergent range of machines, procedures, ranges etc. wouldn't you, especially if such great store is set by the blood results only. The letter with my results (same to my GP) does not even contain ranges and specific values for some of the tests performed. Thanks for your help.

[editfmrt]

The ranges vary from lab to lab so it is always good to have the ones that belong to your results to get a better picture. Did the results you got today have ranges on there?

That said, have you ever been treated following your private blood test in 2011 or was the endocronology department just monitoring you?

Have they checked for antibodies since your private tests? Tegz is correct by asking if they have considered the intermittent aspect of autoimmune reaction.

This is the whole problem with Hashimoto's - for goodness sake why they don't consider this just dumbfounds me. It is well known that the autoimmune reaction fluctuates and gradually attacks the thyroid until eventually it is completely destroyed and no longer produces the thyroid hormones. Victims can have periods of attack and remission and can even have periods of over activity during these phases. That is why the blood results can fluctuate too and may be why your current results are 'in range'. You may have had this last blood taken during a small window of remission. The problem is that the sufferers signs and symtoms take a while to catch up with what is actually happening in the blood stream - just the same as it can take several weeks for them to start improving with medication.

All in all, it's complex and cannot be proved or disproved on one set of test results.

I do fear though that you will not be heard and especially as they choose to completely ignore all the signs and symptoms. Is it possible for you to go and see one of the recommended private doctors who will look at your clinical symptoms instead of the blood results and possibly give you a trial on thyroid meds?

.

[belwom in reply to editfmrt]

Many thanks for your elaborate reply. My GP prescribed Levothyroxine 25 mcg for 6 mths after my private blood test showed elevated thyroid antibodies. The dose was not reviewed. The first hospital dismissed antibody tests and I was told to stop the Levothyroxine. The second hospital I was referred to on my request did carry out a whole battery of tests but without giving ranges or blood values for all of the tests. Here, the endo said an episode of elevated antibodies is possible and this may be normalised again. Getting increasingly sceptical...

[Hashi_since_age9-1988]

are you sure this is free T3 and not total T3? Are you on any thyroid meds? If not and your T3 is at the top of the range then it would suggest that your thyroid is producing too much T3. Your T4 is a bit on the low side and your TSH is right at the top of what I consider normal. Perhaps you should get the antibody test repeated by the same lab that got the positive result as its unusual that you had 1 positive and one negative. Its possible that the recent one could be wrong.

[belwom in reply to Hashi_since_age9-1988]

Many txs. The letter does say clearly 'free T3'. I also think the T4 is at the lower end. Self-treat or go private seems the only option left. Thank you for your help.

.

[tegz in reply to belwom]

Bel- are you actually on meds now?

The tests look garbled & in the way you've been advised.

Can you demand a print out from all sources and update us here.

Something looks odd in all this -but we have all been through these hoops known as NH'Service'!

MOTs are easier to get done..

[belwom in reply to tegz]

Thanks for that. Not actually on meds now. I also think the ranges and values should be there but have been sent a copy of the same letter as to the GP. I will PM Louise to remove this hospital from list.

[Heloise]

bel, I have a suspicion that they removed some of the information perhaps your doctor did not want you to see on your copy. Does it look like that to you? If so, tell them that your copy seems to be missing some numbers. Don't be afraid to push a little, that FT3 is very important to know and evaluate with the lab ranges involved. It's the whole reason possibly that you have symptoms. If they don't accommodate you, call the lab and find out what ranges they use. I know each lab can honestly be different.

stopthethyroidmadness.com/l...

[belwom in reply to Heloise]

Many txs for this. I received the letter as a 'cc' to me, implying that the GP received the same. I find it poor that ranges/values are not mentioned for all tests performed and will ask Louise to remove hospital from list. Self-treat/experiment/plod on? Wouldn't know which lab performed the tests, presumably hospital's internal lab.

[belwom]

Many thanks Reallyfedup123 for your reply. I have been taking liquid gentle iron (Floradix or Vitabiotics) for about 6 weeks now and Nutri Thyroid and Nutri Adrenal. I also take B12, vit D, calcium and magnesium. I am beginning to feel more energetic and think the supplements are making a difference. The hospital did test ferritin and I think it was below 70, I would have to check again. All the best.