Thyroid problems

[Tel3s]

I am new to the site and would be grateful if any one could help me.

I had half of my thyroid removed in 1988 and I have never been put on any thyroid medication.

My thyroid results are at present,

TSH .0.07. (0.30-3.94)

Free T3 4.9. (3.70-6.70)

Free T4 15.7 (12.30-20.20)

I have seen an endocrinologist this morning, who said my thyroid is working ok, not over worked, even thou my TSH is below range.

I have a been diagnoised with multinodlar goitre, with a degree of retrosternal extension, they said will need to be operated on within the next two years.

My thyroid results indicate over active, but I have symptoms of under active including : brain fog, lethargic, pain in joints and limbs, weight gain, no motivation and poor consontration.

I have very low vit D levels 29 (70-140)

Does anyone have any ideas why my vitamin D should be so low and why a goitre grows back, as had one removed in 1998

Do I also need to be considering any other supplements or medication

Thank you in advance

[Clutter]

Welcome to the forum, Tel3s.

Low TSH doesn't mean you are overactive unless FT4 and FT3 are elevated above range and yours are comfortably within range. Your pituitary gland is detecting sufficient T3 in your blood and that is why your TSH is low. TSH rises when T3 is low to stimulate the thyroid gland to produce more T4 for conversion to T3.

Your symptoms sound hypothyroid so it may be that the remaining lobe isn't producing as much T4 and T3 as you have previously been used to, a sign that the remaining lobe may be failing, although your bloods look don;t indicate a problem.

It isn't uncommon for multinodular goitres to develop on the remaining thyroid lobe after hemilobectomy to remove the previous lobe.

Low vitamin D can cause musculoskeletal pain, fatigue and low mood similar to hypothyroid symptoms. Supplement vitD3 10,000iu daily for 4-6 weeks and then reduce to 5,000iu daily. Retest after 6 months supplementing. VitD is optimal 75-200 and most of us are comfortable with it around 100 but usually need to supplement 2-3,000iu Oct-Apr to maintain levels.

Ask your GP to test ferritin, B12 and folate as they are often low in thyroid patients and low levels can also cause pain and fatigue.

[jimh111]

Don't let it rest, sort out your endocrinologist. If someone has primary hypothyroidism (failing thyroid gland) they can be more likely to develop secondary hypothyroidism (failing pituitary gland). They should check this given your low TSH and low fT3, fT4.

However, I think it is far more likely you have a 'down-regulated hypothalamic pituitary thyroid axis', a lower 'set-point'. If you have high hormone levels for some time the 'set-point', the level at which your thyroid hormones are regulated can be lowered, you produce less TSH leadiing to lower fT3 and fT4 and hypothyroidism. You could have been HYPERthyroid for sometime without realising it before your thyroid problems were discovered.

Also at night when you are asleep your TSH is higher and you produce a little more hormone. It may be that you are unable to do this as your output is marginal.

I suspect your endocrinologist specialises in diabetes, many do, and does not understand thyroidology very well. They should try you on levothroxine, if that doesn't work they should add in a little liothyronine (L-T3). With complex histories like yours they should pay more attention to your symptoms and the fT3, fT4 figures than the TSH which may not be responding as normal.

Your certainly have poor concentration, this is verified by your writing ' poor consontration' ;-).

Request another apppointment soon, be friendly but assertive. If the endocrinologist is reluctant or not helpful go over their head and ask for a referral to someone else. They should have a better understanding of thyroid disorders. They get paid enough.

[real_mission]

Oddly, I found I operated fine on half a thyroid , just before my full removal. Once it was gone, boy! I knew all about it.