Is my 89 yr old Mum hypothyroid?

[leroi01]

My elderly mum is having some symptoms which she describes as an occasional racing heart, especially at night, dizzy spells, feeling cold in the feet and a daytime lack of energy. The GP is currently arranging a 48h ECG as the short one showed nothing. The GP also arranged for a blood test and I managed to get a hard copy of today from the surgery, some of the results:

Serum urea level8.3 mmol/L2.00-7.80mmol/L

Serum creatinine116umol/L59.00-102umol/L

Serum ferritin113 ug/L15.00-300.00ug/L

Serum TSH3.13mu/L0.3-5.00mu/L

Serum free T412.6pmol/L8.80-21.00pmol/L

Hemoglobin normal, full blood count values all normal.

Initial comments on the blood test & at the surgery was that there seems to a kidney problem. She is anyway going back to the GP once the ECG testing is completed.

One thing which caught my eye was the TSH & Free T4 values which strike me as potentially less than optimal in range. She has never been diagnosed as hypothyroid or taken any medication. Are these a normal thyroid reading for an elderly lady? Next step I am thinking is to get the free T3 tested (privately as usual). The rest of the blood test was normal and I make sure she takes D3 and B12 in her daily breakfast routine. Anybody got any ideas what else should be tested (either via GP/or private)? Are the (slight) under-performing kidneys a sub-set of an under-performing thyroid (or vice-versa)? If the FT3 is also found to be low in range, is it not too late for her to start thyroid medication at her age? Any comments greatly appreciated.

[Spareribs]

leroi - good for you with the breakfast routine - & getting blood test printouts...

(low vit D is rife if no sun exposure leading onto allsorts....)

a TSH of 3+ is not ideal for most, but what's normal for your mum?

dizzy indicates low B12/low blood pressure and palps/cold hypo and/or iron - but bloods say ok - yet we know it's not all about bloods.... just a thought - B complex may help... and eating regularly? (sorry to be obvious). It sounds like you have a helpful GP 'tho, that means a lot J

(Sorry I cannot comment on kidney problems, I have no experience,)

[leroi01 in reply to Spareribs]

thanks sparerib. i guess let the gp investigation run its course and/or go with her to her next gp visit. Her mother died of kidney complications at a ripe old age some 50yrs ago so its in the family. That area is blackbox to most. She eats well and varied. No idea what her normal thyroid function is, its never been measured before.

[Spareribs in reply to leroi01]

I put my mum on Vit D & B12 too, I think it helped a bit - always cheerful for a start (& less joint pain)- with a good appetite & ate well...

(but couldn't encourage her to eat liver & onions even 'tho I had to!).

another thought.... has she had electrolytes done? (and not on water pills I hope). J x

it may be difficult to ignore something we're prone to, we can try fight it 'tho...

[leroi01]

yes my thoughts too. I have stockpiles of levo, NDT and T3 lying around the house for my own use (no thyroid) but I daren't give any to her in case it causes anything catastrophic.

[leroi01]

Thanks Sandy. Exactly my thought. She had another episode today, pulse went put to 135 and she felt close to collapse. She had a 24hr ECG monitoring device on (which comes off today) so the results will there for all to see.

It seems the racing heart is essentially the adrenals sending out wave loads of adrenaline due the under function of the thyroid.

I really need to get her FT3 tested as well. With a TSH of 3.13, I imagine the GP is not going to give her any thyroid medication. That discussion is yet to come but it makes me feel quite fearful already as they will probably go for the courses of action that you describe. What to do.

[leroi01]

I have already asked Louise Warwill for a list of docs. The FT4 is technically ok but low in range so the FT3 is likely also the same result. From what I have read there is an interdependence between kidney and thyroid performance. But in any event a low-in-range FT3 is not great place for her to be (if confirmed). Self-treatment is definitely an option, but I will see what the nhs does. What do you propose to start treating your relatives with?