Lab help for a new Thyroid girl!

Hi Everyone. I'm a complete newbie to this forum and Thyroid related issues.

I went to the doc experiencing extreme Left side pain and they ran a load of bloods as you'd expect. I've had weight related problems for about 8 years. Never terribly overweight but not able to lose no matter what I do, also suffered terribly with ridiculously heavy periods (sorry guys) so when the doc called me in saying I had Thyroid issues I thought 'that explains a lot'

But then he hit me with these labs:

Serum Free T4 32.9 pmol/L (9.0-23.0)

Serum TSH level <0.01 mu/L (0.20 - 4.50)

Serum Total T3 2.2 nmol/L (1.1 - 2.6)

And said I was hyPERthyroid not Hypo like I was expecting.

He then ran a Thyroid Peroxidase Antibody level test which came back as <10 kiu/L (0 - 35)

BUT all of my symptoms point to Hypothyroid. Weight gain, heavy periods, feeling freezing all the time, depression, joint aches.

While I was waiting to see the Endo, I actually felt better than I had for years and my pain went away.. now, literally all of a sudden, everything has gotten worse. I've gained 1/2 stone in 2 weeks, serious joint pain, feeling crazy tired and down.

My question is, has anybody had labs that point to Hyper but actually, eventually had a hypo diagnosis? And is there a possibility that because they didn't do a free T3 test, my body could be producing lots of T4 but not actually able to use it? I don't really understand how it works!

Sorry, that was a lot of info and questions but I'd be so grateful for any light anyone could shed. I'm waiting on another Endo appointment in about 6 weeks and a Thyroid scan but I feel so rotten and if I need different labs I'd like to get them done privately so I can be armed with a lot of questions the next time I see my Endo.

Thanks all of you for reading this. Wishing you all good health. Thyroid problems are horrible. xx

3 Replies

  • Welcome to the forum, TEGS.

    There's no doubt with suppressed TSH 0.01 and elevated FT4 32.9 that you are hyperthyroid and not hypothyroid. Antibodies are negative for Hashimoto's but a thyroid receptor antibodies test is necessary to rule out Graves Disease.

    Thyroid controls metabolism and temperature and while weight gain and feeling cold are typically hypothyroid symptoms it isn't at all unusual for hyperthyroid patients to gain considerable weight and feel cold. Joint pain and fatigue are common to both :(

    Thyroid patients often have low/deficient ferritin (stored iron), vitamin D, B12 and folate which can cause musculoskeletal pain, fatigue and low mood so ask your GP to order blood tests.

  • Your results are strange because your T4, which is produced by your thyroid, is high, but your T3, which is the active hormone, is within the normal range. I suppose what is happening is that your thyroid is being overenthusiastic but your body is only converting what it actually needs into active hormone. I hope your doctor has referred you to an endocrinologist.

    Thyroid issues are complicated because although there are sets of typical symptoms for hypo and hyper, there can be cases (and you seem to be one) where the wrong symptoms appear. I have seen occasional reports on this forum from people with hypOthyroidism who can't keep weight ON!

    Keep us posted and let us know what the doctor prescribes and whether it works. We are all learning here.

    One thing you can do to help yourself is to ask the doctor to check your Ferritin, Vit D and Vit B12 levels. People with thyroid issues are very often short of these nutrients and can improve their symptoms markedly by addressing any deficiencies. Levels of these nutrients need to be really healthy, not just at the bottom of the normal range.

  • Well, it certainly looks like you are unable to convert all that T4 you're making, and certainly the correct tests could have shed more light on things, but l disagree that you are actually hyper because the T3 isn't over range. It looks as if your thyroid is pumping out massive quantities of T4 in a desperate attempt to get enough T3.

    So, if you're going to get private labs, get the Ft3, plus the other antibody for Hashis, Tgab and the antibody test for Graves, plus the vitamins and minerals, as suggested above. That will give you a clearer insight into what is going on.

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