Diagnosis of Graves 9 years ago, in remission. Now chronic symptoms of fatigue, muscle & joint pain. Need help understanding my test results

[curlijo]

I'm a British expat living in SE Asia. I'm having problems getting an endocrinologist. For the last year I have experienced constant fatigue, very bad muscle pain that is really bad in the morning, random joint pains, hair loss, menorrhagia. I am in constant pain and this week I couldn't walk properly as my ankle felt badly swollen.

I was concerned that I may have a problem with my thyroid due to having Graves so I requested a test today. The test says that it is in normal range but for me I think my total T3 count is very low and I am unsure if the normal range is within the normal range for British women.

Here are my results:

Total T3 = 62.9 ng (range 58 - 159)

Total T4 = 5.93 µg (range 4.87 - 11.72)

TSH = 1.870 uIU/ml (range 0.350 - 4.940)

Do these ranges look like the normal ranges on your tests? My T3 level is very low in comparison to my other results - anyone experienced this before? If anyone could shed some light I'd be very grateful.

[tessintrouble]

I think it may be a good idea to ask to be tested for reumathoid arthritis, I have been on thyroxine for more than 25 years and was diagnosed with RA in 2009. I too felt as though I had spained my ankle - and my hands swelled up and were very painful. I hope it isnt RA but early treatment is essential to prevent joint damage. Good luck.

[curlijo in reply to tessintrouble]

Hi Tess, I certainly wouldn't rule it out. Once I know that my thyroid hormones are Ok and I still have the symptoms I'll know it's a secondary complaint. I woke up this morning with carpal tunnel in my right hand, each morning it's a random symptom, some days better than others.

[Heloise]

Have you had any antibody testing? There are many different aspects of thyroid disease and this short video explains one. youtube.com/watch?v=cIKmuIf...(Not working as expected?)

[curlijo in reply to Heloise]

Hi Heloise, Yes I do have the TSI antibody which was part of the diagnosis for Graves. It does make sense to me now because at the time my recovery rate was phenomenal, within 6 months I went into remission. My endocrinologist thought this was unusual so instructed me to have a test every 6 months. I've been living out here for 4.5 years and have felt totally fine until last year where I started to get lots of aches and pains and fatigue. I can't get an Endocrinologist here because she isn't taking on new patients so I am having to get the tests myself - it's pretty easy I just need to pay for them.

[Heloise]

You haven't said that you are on hormone at the moment. If you are, this article may help determine what you are asking. stopthethyroidmadness.com/l...

Your FT3 and FT4 are both low, so you are not producing enough thyroid serum (T4) and what you are producing is not converting into enough T3 to support the cells. TSH is not the best indicator since it is difficult to know what your best level would be. For instance, if it should be 0.50, your symptoms could be very pronounced at 1.87.

[Fruitandnutcase in reply to Heloise]

That's what I found. I've got Graves too. I know everyone is different but if it is any help I found that when my TSH went up to 1.4 which was well within the 0.35-5.5 range I felt awful, whereas when it was at 0.68 I felt pretty good but my FT 4 was 16.90 (10 - 19.8) so TSH was at the lower end of the scale and my FT4 near the top.

[curlijo in reply to Heloise]

I'm not on any hormone at the moment but I know the feeling of being hypo. As I went into remission from Graves I was taking 5mg of carbizamole which then turned me hypo as my body started to heal. I feel like I am hypo now with the fatigue and that dead weak muscle feeling (like you've been to the gym the day before). I think testing my free T3 and T4 range is the next step.

[Ansteynomad]

I think you really need Free T4 and Free T3 rather than Total T4 and T3 if that is possible where you are living.

That will give a better picture of what is happening with your thyroid.

[curlijo in reply to Ansteynomad]

Thanks I certainly think this is my next step! I'll post up my results on this thread.

[curlijo]

Still waiting on my FT3 and FT4 results to come in but I also checked my ferratin levels just to rule out anaemia (which can have similar symptoms to hypothyroidism).

I am low:

Ferratin 11.9 L ng/ml reference range (13 - 150)

I know low iron can cause thyroid problems - is there any way I can boost up to an acceptable level by eating iron rich food or do I need to supplement at this low level. I think I'd need to bring up my iron stores before I do anything else or can a thyroid problem cause low iron?

[curlijo]

FT3 and FT4 results are this:

FT3 1.88 pg/ml range is (1.71-3.71)

CMIA method sensitivity <1.0 pg/ml

FT4 1.10 ng/ml range is (0.70 - 1.48)

CMIA method sensitivity 0.4 ng/ml

Do these seem low to people on this forum?