A friend has recently had some blood tests done and these are her results :- TSH 0.99 Range 0.25 - 5.0 * FT3 3.89 Range 3.50 - 8.3 * FT4 13.65 Range 7.70 - 18.8 * B12 392 Range 197 - 866. A LFT also done with a result of 35 HIGH - no range given.
She has been coping with a frozen shoulder type situation for a long time and has been on SSRI's - Zoloft - for over 18 years. This lady will soon be 60 - looks fit and slim - is active too.
Would appreciate some help and advice as I am finding these results more difficult to interpret....apart from the B12 - which is low. Of course she was told at the lab that everything is ' normal' ,,,,!
Thanks for reading ........
Written by
Marz
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Thank you for your response. Am assuming you do not consider low mood a clinical sign.
Presumably she has symptoms if she's going for all these tests? Would she consider the Active B12 test? Her B12 is certainly low enough to be investigating further. I would also see if she can get folate and vit D tested - I think I remember reading somewhere that there might be a connection between vit D deficiency and frozen shoulder.
Thanks Hampster - I do agree with you about further tests and have given her the information re the Active B12 too. VitD seems to affect so many aspects of our health....
Also, check out the latest test ranges on ThyroidUK. Maybe she could list all her symptoms and history and go back to the Dr, with new ranges and symptoms list. Just a thought. Hope things improve soon
Your friends t3 is also very low at the bottom of the range. She would possibly benefit from some t3. T4 might also do the job if she can convert. Apart from the frozen shoulder how is she feeling.
Hi Joanna - thanks for your reply. Please see comment below and you will see I do not know my friend well enough to know all her signs and symptoms - but it seems I now have lots for her to read - and the book mentioned by Helenabc seems a must to increase the knowledge ! M x
My favourite Thyroid book so far is "The Thyroid Paradox" by James K. Rone M.D.. He devotes a lot of space to diagnosis. He talks about "The Zulewski List" which is a list of hypothyroid symptoms found to be helpful in diagnosis in a paper by Zulewski in 1997. They don't include tiredness/exhaustion because it is too non-specific, but I guess that's a given. The percentages show how often each symptom was found in people known to be hypothyroid (by blood testing).
Here's the list ~
Delayed reflexes (77%)
Dry skin (76%)
Rough skin (60%)
Puffiness (60%)
Poor sweating (54%)
Weight gain (54%)
Tingling or burning (52%)
Skin cold to the touch (50%)
Constipation (48%)
Slow movements (36%)
Hoarseness (34%)
Hearing loss (22%)
A score was calculated for each subject in the study, awarding one point to each of the symptoms found. People with a score of six or higher (that is, they had six or more of the twelve listed problems) were dubbed 'clinically hypothyroid'. Note: these symptoms are not equally sensitive: delayed reflexes are the best of the bunch.
A couple of pages on, Dr. Rone provides a list of "other clues to hypothyroidism" ~
Loss of interest in sex, infertility, menstrual problems
Impotence
Hair loss, brittle nails
Mild blood pressure elevation
Pale or yellowed skin
Leakage of milk from the nipples
He discusses the interaction of stress and depression on the thyroid system -- too complicated to repeat here. He also talks about T3 testing and -- everything related to hypothyroidism.
Marz: it would be great if your friend could be helped to genuinely not need the antidepressant any more, rather than adding another drug. The depression could indeed be a sign of hypothyroidism -- (though you say she has been on the antidepressant for 18 years, and I suspect that a thyroid disease would get much worse in that time and clearly show itself) -- but then again her drug, or the depression could be altering hormones.
She could look into NLP which stands for Neuro-Linguistic-Programming and means re-training your mind to be the way you need it to be. This would likely involve breaking negative thoughts and moods throughout the day with little routines that include a lot of smiling.
Wow - Helenbac - what a great and helpful reply. I have not heard of the book you mention - sounds interesting and another one to add to my list. I don't think they class T4 or T3 as a drug do they - a replacement hormone maybe ? - only what I have learnt from this forum. I don't know this friend well - in as much as I do not know all her signs and symptoms - but I am aware that she does smile spontaneously, especially when we are talking about our lovely dogs !! Living in Crete gives us lots to smile about ! You have certainly given me something to work on and hopefully my friend too. Thank you very much indeed for your input.....
I am wondering if your friend has secondary/tertiary hypothyroidism. The low TSH may be causing her depression because of the resultant low T3.
I know you don't know this friend well enough to know her other symptom, but perhaps she does have symptoms of hypothyroidism.
The lowish B12 could be contributing to her low TSH (I can't for the life of me remember where I read this and haven't been able to find it since!) I also wonder if her adrenals are not functioning as well as they could be.
If her TSH is low, she will not be converting t4 to t3 that brilliantly either.
I will have a look into the effects of SSRIs (particularly Zoloft) on TSH levels as perhaps this is at least contributing. Some medications can have an effect on TSH and therefore thyroid hormone levels.
Thank you CarolynB - that is very helpful. I think I have read somewhere that SSRI's can affect the Thyroid in general....but not sure in what way !....
I couldn't find a definitive answer except that it can affect thyroid levels. One thing I did see, but didn't get chance to read (fell asleep!), was that SSRIs often increase T3 levels (i.e. conversion of T4 to T3) which, in my opinion, is possibly why SSRIs work for some people.
If this is indeed the case, I wonder what would happen to your friend's levels if she were to stop her anti-depressants. Perhaps she is actually clinically hypothyroid but this is being masked by the anti-depressants.
Whatever the cause, I hope she gets treatment soon. I wouldn't be surprised if she no longer needed anti-depressants if she were to be prescribed T3.
After Rod posted a paper about the connection between TSH and conversion of T4 to T3, I would imagine T3 would be better for her as her TSH is rather lower than you would expect for her thyroid hormone levels.
Of course, I am not a doctor. I'm beginning to wish I had gone into medicine instead of physics after all!
Thank you so much. Yes I think the comment about the T3 instead of AD's would be a good move - so glad you mentioned it. It's never too late to change direction from physics to medicine ! Thank you for your good wishes.
I was on Sertraline, and it caused the onset of hypothyroidism, when I came off the drug it went back to normal, but after 12 months without medication, I was quite ill so my consultant at the hospital put me on Duloxetine as I suffer from fibro and ME , this made me feel a lot better, but I am back on levo at a very low dose of 25mg. So I am sure medication has a lot to do with messing your thyroid up.
Hi joyceconfused....thank you for posting. What are your thyroid blood test results ? 25mcg is a very small starter dose and could possibly be why you still have the symptoms of ME/Fibro. Often hypothyroidism takes years to be apparent - it literally creeps up on you - and yes we can keep blaming it on this and that. Maybe you have problems with tolerating the T4....or it's not converting into the ACTIVE hormone T3. If all is well then it may help to increase your dose slowly until symptoms disappear.
And -am trying to remember where -I think it was Dr Loews book on Fibromalgia but T3 is a much more effective thyroid medication for Fibromalgia then the T4 - I will try and find the info -I lent the book to someone and never got it back....lol.x
I remember being in your friends position several years before i was finally diagnosed with hypothyroidism. I think B12 is certainly worth checking further and then boosting up. I know for a fact that doing that made a big difference to my uptake of my thyroid meds. She maybe veering towards the early stages of hypothyroidism -this is why it does not show up very well with the thyroid tests -early signs can be a lowering of the levels of T4 & T3 but if they remain within range -especially the T4 a GP will not look further.. the trouble is no-one has a blood test to see what 'their' level is to feel well when they are well.... so people can feel ill even when their bloods are in 'range'
Secondly vit D3 imitates many of the symptoms of hypothyroidism -and there is some belief that low Vit D does affect thyroid hormone uptake.
before i was diagnosed with hypothyroidism I was told to take selenium ,vit C and good multi vit to include zinc, copper and magnesium -for me it did nothing.
many doc will adopt a wait and see attitude and may offer a repeat test in 6 months or a years time. the trouble is your friend could be waiting for a long time if it is hypothyroidism for her thyroid to decline further.
The other things your friend could do is to go and see a private reputable practitioner -thyroid Uk do have a list. She will more than likely have to pay but if it helps to resolve her current health problems than it would be worth it in the long run. Sadly at the moment she is unlikely to get treatment on the NHS as she will not be seen as meeting their 'gold standard'
be careful -thyroid hormones are very potent and personally i would not dabble without a qualified experienced practitioners advice.
Amongst your other books has she read How to treat your thyroid by Dr Peatfield - a great book that takes you from symptoms, assessment to treatment. Great little resource book.
Thank you for your post....we live in Crete so have no problem with obtaining T3 ! My friend is medically trained and I'm on T3 so between us we should sort it out safely ! I have - The Thyroid and How to Keep it Healthy - by Dr BDP. It is an excellent read and you are right my friend may find it useful. Have to be careful not to go into information overload
I'd like to clarify this TSH thing. A high TSH means hypothyroidism. A low TSH means hyperthyroidism. Also, research found that very few people who are not thyroid patients have a TSH above 2. Or people who are not thyroid patients and have a TSH above 2 are usually not too well. Dr Rone of the above-mentioned book therefore regards TSH's above 2 as abnormal in most cases. That means that there is probably nothing wrong with a TSH of 0.99, BUT TSH is personal -- we each have our individual sweet spot on the scale. Unless your friend was known to feel healthy with a different TSH some time in the past, there is no reason at all to regard 0.99 as unhealthy.
Some 2.5% of healthy people have a TSH above the reference range, and some 2.5% below the reference range -- why? because in calculating any reference range, the top and bottom 2.5% of people's scores are dropped.
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