Interpretation of Thyroid Tests.

[Bankieanne]

I have been battling for the las 2 years with ill health and my GP insisted nothing wrong with thyroid and was referred to an Endo a year ago who agreed with GP.

My ovaries were removed 2 years ago but despite different types and doses of HRT I have had no relief of symptoms - constant waves of chills, internal tremor, palpitations, tingling all over body but especially legs and feet, extreme fatigue, loss of concentration and interest in everything and feel generally horrible and prone to crying.

Anyway Thyroid checked again by a new Consultant and results:

TSH 0.94 mu/L ( 0.35-5.0)

FT4 9 pmol/l ( 9-21)

Antibodies were negative

B12/folate, iron, vitD all well within range (have been on supplements for over a year)

He says though not indicative of a primary Hypothyroidism he feels something is going on as looking at all my previous results over the last 2 years my TSH has more than halved and my FT4 has dropped.

I've to go in on Monday to get bloods done for cortisol levels.

Anyway my question is do you think I would feel this bad with Thyroid levels such as these and if so what treatment could I expect?

Would love to feel like a human being again!

[humanbean]

With results like yours, I bet your T3 is in your boots, and you really need to have this tested. You almost certainly have Secondary Hypothyroidism i.e. your thyroid gland may actually be okay but your pituitary is not sending out enough TSH to make your thyroid do its job. Secondary hypo gets a mention on this page :

patient.co.uk/doctor/hypoth...

And I'm a bit nervous about having made this post, because I'm out of my depth on the subject and could be totally barking up the wrong tree.

[Bankieanne in reply to humanbean]

Thanks for your reply.

I tend to agree with you regarding the pituitary issue.

I'm no expert on this at all but I'm just going on my instincts and a bit of knowledge gained here about thyroid status.

I've been feeling so horrific for such a long time that I truly think some days I'm losing my marbles!

Meant to say in original post that I've been checking my basal temperature and its always between 35 and 35.5C.

Have checked with two different thermometers just in case one was duff.

I'm sitting with the heating turned up full blast and wrapped up like an Eskimo but still feel cold and shivery. Even was like this during the summer. I force myself out for a walk each day but am so cold that it's like a form of torture!

My skin is a horrible colour with a reddish mottled effect especially on my arms and legs.

I just feel so unwell and am trying desperately to find a way forward.

Thanks again for your reply it's much appreciated.

[Ansteynomad in reply to humanbean]

Secondary Hypothyroidism was my first thought as well. I wouldn't disagree with anything you've said human

[Hidden]

Hi Bankieanne,

We sound like peas in a pod!!

I'm in a similar situation to you. I had my ovaries removed a few years ago and take ERT which is administered as a pellet into my abdomen every 9months or so. It gives me complete relief from any menopausal symptoms. However when my thyroid levels are too low I experience all the symptoms that you have listed above. I would therefore hazard a guess that these are all due to lack of thyroxine than lack of oestrogen ( my opinion only) Lack of oestrogen can make you feel bad, hot sweats, insomnia, achy, awful stuff but lack of Thyroxine can make you DEATHLY !!! Your T4 is on the floor and your TSH is also very low which could be pituitary. My thyroid results were very similar and my endo thought I had a dodgy pituitary. It's treated exactly the same as for primary hypo with Thyroxine. My cortisol was also tested and and was very low until stimulated. This I have managed to address by waking them up using Paul Robinsons circadian T3 method. It works. I hope you receive a definitive diagnosis soon because the symptoms are just awful aren't they. Wishing you some relief soon.xxxx

[Bankieanne in reply to Hidden]

Hi Joesmum

Thanks for your input. I am being made to feel like a hypochondriac by the medics except the doctor I saw on Monday. At least he's trying to figure it out but it's taken me nearly 2 years of harassment!

I've been so unwell that I had to take early retirement last year which was a major blow.

I currently use Oestrogel (3 pumps) daily as oestrogen replacement.

In the past I used pills, patches and Sandrena gel with no alleviation of symptoms except joint pain better. Had a break from HRT for 5 months and my joint pain increased again and I had some night sweats.

Since starting Oestrogel 6 weeks ago my pain is slightly better and night sweats all but gone but all the other hypothyroid type symptoms still there. I go to bed in layers of clothing with an electric blanket on full blast.

Don't think that's normal if it's all menopause.

The doctor did mention he might treat with low dose thyroxine.

Were you started on low dose?

Sorry I don't know what Paul Robinsons circadian T3 is but I will have a look.

Thank you, at least I know I'm not alone and going mad! X

[Hidden in reply to Bankieanne]

Hi Bankieanne,

If it was just low oestrogen, you would be having hot flushes all day. Those of us without ovaries suffer far worse because surgical menopause is very aggressive. Even when women are post menopausal their ovaries produce a tiny amount of oestrogen. We don't have that backup. The layers of clothing at night are a bit odd if this were just about oestrogen...... LOW Oestrogen makes you HOT!!

FT4 must be converted into FT3 which is the usable hormone. You're FT4 is so low that it must be converting like crazy to keep you going. With a low TSH like yours, you would expect to have a FT4 close to the top of the range. Thats why your doctor is suspecting pituitary issue. I was started on a low dose of thyroxine with the intention of building it up. My FT4 was on the floor like yours and so was my FT3. I even had breathing problems. My GP thought I was fine!!! I found the name of a good endo in london and went to see him......guns blazing! Without him I would be in serious trouble. We tried thyroxine but it made me feel so ill and I got worse. He then allowed me to take NDT which is what I take now. ERFA THYROID. He doesn't seem to mind how its treated so long as you get better!! His first line treatment will always be thyroxine first. PM me if you want.

Xxx

[Bankieanne in reply to Hidden]

Will do , thanks Joesmum. X