Hashimotos + blood test results

Hello everyone

I have been diagnosed with Hashimotos since April 2013 and have all the symptoms of hypothyroidism:

overwhelming fatigue - huge need for sleep

sudden inexplicable weight gain - more than 2 stone in 5 months

acute intolerance to cold - always cold when others hot

sudden spike in cholesterol - 7.3 when usually 4.5

strange numbness and pain in toe area of foot - it comes and goes

very low mood - weight gain and lack of energy causing anxiety

Doctors say all thyroid function tests are normal, though antibodies proving Hashi's were very high. Here are my latest results (they did not redo antibodies test, oddly, but Hashi's was diagnosed twice since April 2013):

Serum free T4 level - 11.2 pmol/L (9 - 23)

Serum free triiodothyronine level (This is free T3 right?) - 4.1 pmol/L (2.5 - 5.7)

Serum TSH level - 2.47 mu/L (0.3 - 4.2)

You are all so very knowledgeable so I am hoping you can help me figure out what to do.

The free T3 reading puts me as normal but not optimal, not in the top quarter percentile.

Because of these readings, my GP is saying I do not need any treatment for Hashi's.

Frustrated as my symptoms are acute.

Many thanks for weighing in!

Susanx

30 Replies

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  • Well, if your GP has tested you for antibodies, then you need levothyroxine. This is an excerpt from an article by Dr Toft in Pulse Online and I hope it is relevant. If you need a copy email louise.warvill@thyroiduk.org and send a copy to your GP before your next appointment, highlighting question 2.

    The combination of a normal serum T4 and raised serum TSH is known as subclinical hypothyroidism. If measured, serum T3 will also be normal. Repeat the thyroid function tests in two or three months in case the abnormality represents a resolving thyroiditis.

    But if it persists then antibodies to thyroid peroxidase should be measured. If these are positive – indicative of underlying autoimmune thyroid disease – the patient should be considered to have the mildest form of hypothyroidism.

    In the absence of symptoms some would simply recommend annual thyroid function tests until serum TSH is over 10mU/l or symptoms such as tiredness and weight gain develop. But a more pragmatic approach is to recognise that the thyroid failure is likely to become worse and try to nip things in the bud rather than risk loss to follow-up.

    Treatment should be started with levothyroxine in a dose sufficient to restore serum TSH to the lower part of its reference range. Levothyroxine in a dose of 75-100µg daily will usually be enough.

  • Huge thanks for both of your replies Shaw. My Hashi's brain fog is even foggier with all the research I've been doing. The takeaway seems to be that all bets are off with Hashi's - all the usual thyroid function tests are rendered dysfunctional. I will bring Dr Toft's article to my GP and let you know what happens. xx

  • This is for information:-

    thyroidlifestyle.com/

  • Hi Shaws, Does Dr Toft's mention of a 'raised serum TSH level' include higher levels within the 'normal reference range and would Susan's level 2.47 be considered to be raised in this case?

  • I am not medically qualified but she has antibodies and has Hashi's diagnosed twice. I believe your TSH can ebb and flow, i.e. hypo/hyper. Her latest TSH was not the original test.

    This is an excerpt:-

    Diagnosis is made by detecting elevated levels of anti-thyroid peroxidase antibodies in the serum.

    Given the relatively non-specific symptoms of initial hypothyroidism, Hashimoto's thyroiditis is often misdiagnosed as depression, cyclothymia, PMS, chronic fatigue syndrome, fibromyalgia and, less frequently, as ED or an anxiety disorder

    en.wikipedia.org/wiki/Hashi...

  • Thanks, Shaws. I've been diagnosed with Hashis but my Endo and GP are still insisting I have fibromyalgia as well because, apparently, the symptoms I'm experiencing can't possibly be due to the Hashis because my TSH and T4 levels are 'normal'!!! It's so frustrating.

  • ...bet your FT3 levels are LOW - that is the ACTIVE hormone and needs to be towards the top of the range. Aches and pains should then disappear....

  • Hi Marz - ta for taking such an interest. But isn't the second blood result an FT3 level? Do you think it is low?

    Serum free T4 level - 11.2 pmol/L (9 - 23)

    Serum free triiodothyronine level (This is free T3 right?) - 4.1 pmol/L (2.5 - 5.7)

    Serum TSH level - 2.47 mu/L (0.3 - 4.2)

  • ...sorry - must have muddled it with another :-) Yes your FT3 looks good....which is confusing as your FT4 looks low ?....maybe my post lower down is more relevant !! Apologies for the confusion...

  • Ta Confused77.

    I was wondering 'bout this. Found this in a useful, if convoluted, article on another thyroid info site:

    "There is no way to know how much of a negative effect those thyroid antibodies are having, we just know that they are there. The presence of thyroid antibodies throws off every thyroid test, including the TSH.”

    Link to article:

    thyroid.about.com/gi/o.htm?...

    Susanx

  • Hi Susan - I was diagnosed with Hashimotos in 2005. All my TFT's were in range and just the anti-bodies were HIGH - and still are :-( I live in Crete and my GP said - Welcome to the Club ! She said the small dose was of T4 was to support the thyroid whilst under attack.

    Am re-reading Dr Alexander Haskell's book - Hope for Hashimotos - in which he explains things well about the blood results. He also has a website. I am also an Izabella Wentz fan !

    Do you have any gut issues ? Haskell also suggests starting low with T4 and increasing slowly to suppress the TSH. So much to read and learn and it does take a while - no wuick fixes I am afraid !

  • The article looks like it might be really useful but link doesn't seem to be working - would you mind checking that it's correct? Like you I've been diagnosed with Hashimotos (antibodies, ultrasound scan and fine needle aspiration) and have loads of symptoms but because my TSH and T4 levels are 'normal' neither the Endo or the GP will prescribe anything. It'd be great to be able to present this article to them xxx

  • Here 'tis:

    thyroid.about.com/gi/o.htm?...

    If it still doesn't work, there is an embedded link to it here:

    thyroid.about.com/cs/testsf...

    xx

  • Brill, the second one worked, thanks v much. Good luck at the GP's tomorrow and let us know how you got on x

  • Hi Maxi, I can understand your frustration. You say you are diagnosed but are you being treated? Are you on some hormone? Your levels plus your symptoms surely mean you NEED treatment and have room for improvement in those ranges. Here is an article regarding antibodies. stopthethyroidmadness.com/h...

  • You are all fabulous!

    Printer in overdrive as I prep for GP visit tomorrow.

    Heloise, I've had no treatment since Hashi's diagnosis in April 2013. I was living in Switzerland at the time and GP's initial finding was then confirmed by an endo.

    TPO was 535.5 kUl/l (<5.6)

    TgAB was 46.7 kUl/l (<4.1)

    Endo took the "let's watch it" approach and told me to follow-up with my London GP as I was heading back home.

    Marz, trying to manage "gut" issues - bloating and IBS-style upsets - with no gluten and my usual uber-healthy eating regime. I have just gone through the menopause and was putting most of my symptoms down to it. But the more I learn about Hashis, especially through all of you, the more I feel some sort of treatment is needed.

    Thanks to all for all your kind input.

    Susan xx

  • how doe s everyone get their gp to accept printouts from here an d the internet.mine blatantly refuses to accept them

  • My first try at this will be tomorrow. Ta for the warning..

  • hop eit goes well .let us know how youget on

  • The highest amount of T3 receptors are in the brain and the second highest amount are in the gut lining/immune system - I have learnt ! So when T3 is low then it does make sense that the brain fog kicks in along with other brain issues - and that in itself is connected to the gut. So many gut disorders abound - IBS - Crohns - Colitis - Diverticulitis and so ...

    Why Isn't My Brain Working - by Datis Kharrazian is a good read - long but interesting. I'm a Hashi's/Crohns girl and am still learning at 67 !!

  • V interesting. Encore, thanks Marz xx

  • This is what Dr Lowe said about Fibromyalgia, if you haven't already seen these links:-

    web.archive.org/web/2010103...

    web.archive.org/web/2010081...

  • Thanks again!

  • hi susan

    would you mind if I asked is your weight gian general or specific to one area.the reason being i ahve gained about 2 stone and it is all abdominal btu they say it is not oc or a cyst and it is not IBS.

  • Happy to share Anbuma. Generalised gain. I was putting it down to menopausal oestrogen depletion despite capping vitamin-packed calorie intake at 1500 mot days and despite lots of strength training (CrossFit) and cardio sessions. Feel as if I am suddenly encased in a fat suit I don't deserve.

    While this doesn't apply to me, this article about oestrogen dominance and poor thyroid function may interest you:

    facebook.com/permalink.php?...

  • Hi I have hashimotos & I was told that your levels need to be below the normal range. I feel best when my t4 is around 1.5 but everyone is different. I had my right side of thyroid removed as it was enlarged. I still struggle with my weight & pms seems to have got worse but 18 months ago I was a lot worse with terrible mood swings & other symptoms . Good luck

  • Thanks Dee75. And you too!

  • I was diagnosed hypo in 2007 and then antibodies (hashi's) last year. Just had thyroid scan shows severe atrophy. I was also diagnosed wheat intolerant 15 years ago. Now reading Robb Wolf "The Paleo Solution" and looking to do the diet. Hashi's is an autoimmune disease which is exacerbated by Gluten!

    The local hospital Endo merely suggested a small increase in my levo dose, nothing else, but last 2 years I have been on a roller coaster, hypo then hyper so hoping the diet will sort me.

  • Hi Crimple

    I hope this works for you.

    I have spent the past two weeks reading every article I can find on Hashi's and all the excellent advice from all of you. Conclusions: quitting gluten seems key and may as well go wheat free too a la Paleo.

    All the research also seems to point to a thyroid boosting regime that includes T3. I think I have conversion problems and maybe this is a path you can explore too.

    My blood tests were late so I will see my GP tomorrow and push for Armour or similar. For many of us it seems, replacement T4 alone is not the way to go.

    All the best getting off your roller coaster. xx

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