Help with test results please

[CABDutch]

I've never posted anything on these forums before just read other people's posts but I need a little help as my doctor isn't helping at all. Sorry for the long post.

I have been having many symptoms of being hypothyroid even down to the swollen and scalloped tongue for a couple of years now but I suffer from Endometriosis so put the fatigue down to that. I did eventually go to my doctor who did some blood tests and my tsh came back borderline (they didn't seem to want to give me the actual figure). I was told to have another test after 3 months which came back perfectly normal (doctors words not mine), with a bit of pushing they did give me the figure of tsh 4.05. doctor decided that my physical symptoms were due to depression and upped my antidepressant dose each time I saw him.

I have done a bit of reading and asked if I could have complete thyroid tests done, doctor reluctantly tested again but only did tsh which was 7.26 (0.35 - 4.5) and free t4 at 12.1 (11 - 23). I then pushed for a thyroid antibody test, the results came back as TSH 6.67 (0.35 - 4.5), free t3 4.5 (3.5 - 6.5), free t4 11.9 (11 - 23) and Se thyroid per oxidase Ab conc 1300u/ml (0 - 60). The action they want to take is to re-test in a year but I'm not sure I can put up with all the symptoms for another year. Doctor still insisting it's depression and wants me to up my antidepressant dose again. Is my doctor correct in saying my levels are normal?

[Clutter]

Welcome to the forum, CABDutch.

I'm not sure what your GP thinks is normal about TSH 6.67 which is over range. FT4 is almost bottom of the range, ideally it would be >19.

Thyroid peroxidase antibodies are very high and means you have autoimmune thyroid disease (Hashimoto's) which is destroying your thyroid gland and causing your hypothyroidism. Treatment now will slow progression of the disease and prevent you becoming overtly hypothyroid ie TSH >10.

Read Dr. A. Toft's comments in this link thyroiduk.org.uk/tuk/about_... If it would be helpful to have a full copy of the Pulse article to show your GP email [e-mail]

Many people have found a gluten-free diet to be helpful in reducing Hashimoto's attacks on the thyroid and antibodies.

thyroiduk.org.uk/tuk/about_...

[CABDutch in reply to Clutter]

I have now changed my doctor and unfortunately they don't seem to be any better than my previous. My old doctor did reluctantly agree to give me a trial of Levo 25microgram after I phoned him to say I didn't feel well enough to wait a year for bloods retest. I've had blood tests with the new surgery and the receptionist phoned me to say just carry on with the 25microgram dose and retest in 6months. They seem to be fixated with their 'guidelines folder' as she didn't listen when I tried to list my symptoms and just kept pointing at the guideline figures. At least she did feel my neck as I've been having the sensation of a lump in my throat and shortness of breath especially when laying down. She said everything felt fine so I guess I'll just have to keep trying to sleep in an upright position as it makes me feel a bit panicky when I feel that I can't breath when I'm trying to go to sleep. I'm sure it's just the fact that everything seems worse at night but probably isn't!

Results from 25th June (taken about an hour later in the morning than my previous, TSH has gone down to 5.0, Free T3 is now 4.4, Free T4 is 11.4 and antibodies >1300. There was no mention of Hashimotos just sub clinical hypothyroidism. I do feel very alone with all this, unfortunately however hard I try I'm one of those people who says I'm fine when actually I feel rubbish.

[Clutter in reply to CABDutch]

CABDutch, you are undermedicated, your TSH is too high and your FT4 too low. The goal of Levothyroxine is to restore the patient to euthyroid status and for most people this means TSH 1.0 with FT4 towards the top 75% of range.

Take the Dr. Toft Pulse article I linked above to your GP and ask for dose to be increased.

Subclinical hypothyroidism means TSH is >5 and <10 with FT4 and FT3 in normal range. It is autoimmune thyroid disease (Hashimoto's) which is causing your hypothyroidism. Progression can be slowed with Levothyroxine but will eventually destroy the thyroid gland. As I mentioned above, gluten-free diet can be helpful in reducing Hashi flares and antibodies.

[imagisal]

I am by no means well versed in all the tests but have just come back from a rheumatologist for blood test results and TSH and FT4 were similar to yours and with similar reference range and from those two alone (antibody tests not back yet) it is considered hypothyroid. I am sure you will get more experienced help from a forum member but if I were you I would go to another doctor !

[CABDutch]

Thank you so much for your help. I really don't feel well at the moment and haven't for some time, it takes a lot for me to go to the Doctors and when I do and they don't help it's very frustrating. At least I have a bit more ammunition now, I just have to wait as the earliest appointment I can get with my GP is well into July!

[CABDutch]

I've just managed to speak to my GP regarding my results and he is still insisting that it probably isn't my thyroid as my results were "borderline" and the antibodies doesn't actually mean my thyroid is damaged. He has agreed to give me a small dosage of Thyroxine as a trial and go back for blood tests in 4 weeks. He is also sending me to a Rheumatologist, I'm not quite sure how that will help with my swollen tongue and many other symptoms but I wasn't sure how upping my antidepressant dosage several times was either (no it didn't help). Thanks for your help.

[CABDutch]

I have now changed my doctor and unfortunately they don't seem to be any better than my previous. My old doctor did reluctantly agree to give me a trial of Levo 25microgram after I phoned him to say I didn't feel well enough to wait a year for bloods retest. I've had blood tests with the new surgery and the receptionist phoned me to say just carry on with the 25microgram dose and retest in 6months. They seem to be fixated with their 'guidelines folder' as she didn't listen when I tried to list my symptoms and just kept pointing at the guideline figures. At least she did feel my neck as I've been having the sensation of a lump in my throat and shortness of breath especially when laying down. She said everything felt fine so I guess I'll just have to keep trying to sleep in an upright position as it makes me feel a bit panicky when I feel that I can't breath when I'm trying to go to sleep. I'm sure it's just the fact that everything seems worse at night but probably isn't!

Results from 25th June (taken about an hour later in the morning than my previous, TSH has gone down to 5.0, Free T3 is now 4.4, Free T4 is 11.4 and antibodies >1300. There was no mention of Hashimotos just sub clinical hypothyroidism. I do feel very alone with all this, unfortunately however hard I try I'm one of those people who says I'm fine when actually I feel rubbish.