Blue horizon results advice please

Just got these results back for my mum T4 +174 (range 59-154)

Tsh 1.54 (0.27-4.2)

Free thyroxine +28.3 (12.0-22)

Free +2.9 t3 (3.1-6.8)

Thyroglobulin 25.6

Per oxidase 9.5

My mum went to GPS this morn complaining of a distended tummy and lots of wind. Because of a stricture last year he sent her to a&e where she is now...these results have just come in and I am wondering if they could be the cause of so many symptoms she has...

Muscle weakness.

Brain fog / paranoia/anxiety and PTSD ( she went to a chiro and he gave her 5 fractures in her vertebrae - we didn't know she had weak bones! But she relives this over and over with no amount of reassurance to calm her.

She had rai (total ablation) in 2010 and has been on varying amounts of thyroxine - her tsh has been up and down but seems to have settled at the moment! At present she is on 150.

Constipation but could be due to pain killers for her back pain which has not be cured despite having epidural steroid injections - I wonder if this could be due to t3 -

Anyone she'd any light ? I will be mentioning to a&e docs when I go back now but wanted to go armed with as much info as poss!

Thank u in advance

[humanbean]

Your mother's very high free T4 and low free T3 indicate that she is not converting well from T4 to T3. She needs to cut her levothyroxine and take some T3, but I'm not confident on suggesting what dosages she should try.

There are several reasons for poor conversion.

1) Your mother may have genetic faults which cause poor conversion. There are tests available for this. If they come back positive then (I think) the treatment is taking T3 only - no levothyroxine.

2) Your mother needs good levels of iron, ferritin, vitamin B12, folate and vitamin D to encourage absorption of her thyroid meds and to enable conversion to take place. Her GP should agree to test all these. Ask for the results, including the reference ranges and post them here for comment.

3) A lot of conversion goes on in the gut. There are lots of things that can help and it may be necessary to try all of them - it can be hard work. Going gluten-free is one good idea. Dealing with candida is another vital step, if it turns out to be an issue. Making sure that your mother has good gut bacteria is essential (using good quality probiotics is a good idea), and low stomach acid needs to be addressed.

4) If your mother's adrenal function is poor - with high or low cortisol (or a mixture of high and low readings), then she will not feel well, and her thyroid function will be affected badly. The test for this is an adrenal stress profile saliva test - Genova Diagnostics UK do one that many people use. The NHS doesn't help with adrenal issues unless the person concerned has problems at either extreme - too little cortisol (Addisons) or too much cortisol (Cushings). Once the results are known post the results and ask for advice on here.

[humanbean in reply to humanbean]

I should also have mentioned... Low T3 can have dire effects on the brain. I'm badly affected when my T3 levels drop. I have read anecdotal reports that it is easier to get a prescription for T3 out of a psychiatrist than it is out of an endocrinologist.

[Clutter]

Jcoops, Low T3 means your mother is functionally hypothyroid as T3 is the active thyroid hormone and it may be the reason for your mother's constipation, paranoia and anxiety.

I agree with Humanbean that high FT4 and low FT3 suggests a conversion issue. Your mother may benefit from the addition of some T3 to a reduced dose of Levothyroxine and should have ferritin, vitamin D, B12 and folate tested. Good levels of vitD are needed to aid conversion of T4 to T3.

If A&E or your GP won't prescribe Liothyronine (T3) you should ask for an endocrinology referral.