Blood test results - advice please.

[snugglemonkey]

Hello everyone,

Based upon my clinical symptoms I suspect that I have undiagnosed hypothyroidism. I asked my GP for blood tests and was dismayed to be advised this week that the results below are 'normal', and that no further action is necessary:

My results are as follows:

Anti-Thyroglobulin Abs. - 1 U/ml - (0.00 - 150.00U/ml)

Anti-TPO Antibodies - 6U/ml - (0.00 - 150.00U/ml)

Serum TSH Level - 1.1 mlU/L - (0.30 - 5.50mlU/L)

Serum free T4 level - 12.3 pmol/L - (9.00 - 25.00 pmol/L)

Serum ferritin - 86 ug/L - (20.00 - 300.00ug/L)

My Vitamin B12/Folate/Vitamin D are all above the 'normal' range due to supplementation.

I would very much appreciate your opinions/feedback/advice.

[shaws]

thyroiduk.org.uk/tuk/testin...

Excerpt - FT4 = FREE T4

Thyroid hormones not bound to proteins. FT4 lowers when the thyroid is struggling.

Your FT4 is quite low.

The approx. reference range for this test is 10 to 24

thyroiduk.org.uk/tuk/testin...

If you wish to see someone privately, email [e-mail] for a list of practitioners.

[Harding01]

May I ask what are your symptoms ?

[snugglemonkey]

Thank you Shaws and Harding01 for your replies.

Louise has kindly sent me a list of practitoners.

My main symptoms are fatigue, muscle weakness, brain fog, anaemia, low basal temperature, poor concentration, irritability and low tolerance for any kind of stress.

[Maddie]

A low/normal TSH along with a low T4 plus symptoms can indicate secondary (central hypothyroidism).

This is caused by a problem with the pituitary gland and it cannot produce enough TSH to raise the T4 level. Getting this diagnosis can be difficult and is often overlooked so you will need to make sure that it is not dismissed.

The pituitary can become damaged by a head injury and/or excessive blood loss during/after pregnancy - Maddie

[snugglemonkey in reply to Maddie]

Hello Maddie,

Thank you so much for your reply. I have an appointment with my GP tomorrow so will put the possibility of secondary hypothyroidism to him then.

Very much appreciated.

Carl

[Maddie in reply to snugglemonkey]

Hi Carl - if you manage to get anywhere with your GP then he should refer you to an Endocrinologist who should then arrange testing. Hypopituitary is a complex area so reading up on the condition will be helpful. It is treatable, unfortunately, many cases are missed or just treated as primary hypothyroidism. Taking thyroid meds without pituitary testing will not help and will just mask the condition as the T4 level will increase. Many end up in the chronic fatigue dustbin.

Hope you will keep the forum updated with your progress, I have two friends who, at the moment, are having to point out to their GP that their thyroid function tests are not normal and require further testing, it is proving difficult - Maddie

[snugglemonkey in reply to Maddie]

Hello Maddie,

I have been referred to an Endocrinologist because my serum testosterone and free androgen index are both at the very bottom of the lab range.

My GP is generally thorough but was not 'buying' the secondary hypothyroidism hypothesis. In his experience hypopituitarism is "rare". Rare or not I will try to ensure that this is not overlooked by my Endo as I could be one of said "rare" cases.

Maddie, I can't thank you enough for sharing your knowledge with me on this forum.

Carl

[Maddie in reply to snugglemonkey]

Hi Carl - pleased to hear that you have a referral.

Do go well prepared, a friend of mine saw an endo who insisted that he did not have any pituitary problem and would not carry out the tests. My friend went privately only to find that he did, he'd had a fractured skull and other head injuries so all the pointers were there to suspect something was wrong. He had become very ill due to the delay.

Have a look around the Pituitary Foundation website.

pituitary.org.uk/informatio...

This link for Dr Myhill may be useful;

tinyurl.com/kcx4wss

Maddie

[snugglemonkey in reply to Maddie]

Hello Maddie,

Thank you so much for those links.

I experienced repeated head trauma as a child at the hands of an abusive parent, so I shall be sure to bring this to the Endocrinologist's attention.

Thank you again,

Carl

[Maddie in reply to snugglemonkey]

Hi Carl - So sorry to hear of your childhood experiences. My friend who I mentioned that had the fractured skull, also turned out to have shruken adrenal glands that he told me had been caused by the effect of long term stress caused by his neglectfull abusive parents.

Sounds like you will also need adrenal testing for cortisl production, usually the short synacthen test, see this link;

patient.co.uk/health/synact...

There are other tests eg the Glucagon stimulation test and the Cortisol day curve test. The short synacthen test misses some cases of adrenal insufficiency so it is not always reliable.

Here's something else for you to get clued up about, Dr Chandy's Protocol for Hypoadrenalism;

tinyurl.com/qjdfehk

You can see his you tube video presentation at the Pernicious Anaemia Conference 2013, he starts talking at 21 minutes and continues in part 5.

youtube.com/watch?v=mdGfMG4...(Not working as expected?)

Sorry to overload you with info but I have found that some endocrinologists do not always suggest or carry out the proper testing so best to have some knowledge - Maddie

[snugglemonkey in reply to Maddie]

Maddie,

I cannot thank you enough. I have quite a bit of reading to do.

All the best,

Carl