TSH levels all over the place.

[johnnyxs]

I have just had a snapshot blood test done at the request of my Dr when he recently recorded my blood pressure at 170/90 . up from 140/80

The test results are marked 'normal' with the exception of the TSH result which as yet has received no comment from the Doctor?

Perhaps someone could just advise me on the significance of the result please.

T4 10.1 range 11-26 pmol/L

T3 4.7 range 3.8-6.6 pmol/L

TSH 0.21 range 0-2.5? m/UL ?

GSR 5.8 nmol

glucose 5.0

Urea 7.2

sodium 140

potassium 4.0

creatine 1.11

[shaws]

Hi johnnyxs

Even though your TSH is o.k. your T4 is below range and your T3 just above the low range which might be in the 'normal' range but most feel better when T3 is in the upper part.

There's no history in your profile of when you were diagnosed and your prescription plus dose.

Are you taking levo or NDT?

Others will comment on your other blood tests.

Sometimes if we are underdosed blood pressure can rise and I assume you're not feeling very well. I wonder if you've had B12, Vit D, iron, ferritin and folate tested recently?

[johnnyxs in reply to shaws]

thank you for your advice Shaw its much appreciated.

I last had a full blood panel in January this year.

I had all the vits and minerals you mention tested and I posted the results somewhere on the forum but I haven't been able to locate them yet.

I'm going to make a fresh appointment with the Doctor tomorrow and the advice that I have received on this forum will hopefully be decisive in getting a referral to an Endo.

Johnny

[Clutter]

Johnny, you've typed the TSH range incorrectly. TSH 0.21 is below range but is fine. FT4 is below range again and this isn't fine at all, as I previously told you in healthunlocked.com/thyroidu...

Your GP should refer you to endocrinology to investigate why your FT4 is not responding to 125mcg Levothyroxine. FT3 4.7 is surprisingly good considering how low your FT4 is.

[johnnyxs in reply to Clutter]

I couldn't find a reference to the correct TSH range so I put a question mark against my post to indicate that. All I had to hand was a 8x year graph of my results and the reference range is not clearly indicated.

Unfortunately my Doctor refuses to do anything about my symptoms or results because he says they are 'satisfactory' and 'within range' and 'stable' etc .

He simply will not entertain the premise that my symptoms might reduce and I might feel better if the results were nearer the middle or top of the reference range by prescribing a higher dose of Levo.

I am currently on 125mg and have been for the past 5x years or so.

I'll see if I can add some details to my profile.

Thank you for your advice. I think I might try again to persuade him to refer me to an Endo . Like so many other sufferers on here I cannot think of facing another 5x years as exhausted as I am with so many psychological and physiological issues blighting my life every day

[Clutter in reply to johnnyxs]

Johnny, get a second opinion, see every doctor in the practice if necessary until you get a referral, or change your GP. It is not right that FT4 is so low on 125mcg Levothyroxine.

[johnnyxs in reply to Clutter]

thank you clutter thats what I needed to hear. I shall phone for an appointment tomorrow with some confidence and determination. I'll make sure I prepare for his arguments

[humanbean in reply to johnnyxs]

You could consider becoming independent of your doctor and self-medicating? Then you could medicate yourself according to your symptoms, and you wouldn't have to beg anyone for help.

I treat my own thyroid and I pay for my own thyroid function tests. I've told my doctor I'm doing this, and told her I didn't want my thyroid tested by the NHS. She asked me why I was doing this and I (truthfully) told her that I thought the NHS guidelines on treating hypothyroidism are inadequate and sadistic. The subject has never arisen with her since.

As a point of information there are NO guidelines for the treatment of hypothyroidism in the NHS - there is a "statement" by the Royal College Of Physicians, another more recent one by the British Thyroid Association, and there is the NICE Clinical Knowledge Summaries. But no actual guidelines at all.

rcplondon.ac.uk/sites/defau...

onlinelibrary.wiley.com/doi...

cks.nice.org.uk/hypothyroidism

For the last link click on the topic titles on the left hand side to see more on the subject.

[johnnyxs in reply to humanbean]

thank you for the links they are much appreciated. I'll have lots to read tonight !

I agree about self medicating and taking responsibility for ones own health however whilst I am an unpaid carer I cannot afford it yet.

[Clutter in reply to humanbean]

HB, I've no problem with people self medicating to wellness but I think Johnny needs investigation into why FT4 is deficient on 125mcg but TSH is low. The results are unusual and if it's anything to do with pituitary or hypothalmus other hormones may be low too and need addressing.

[humanbean in reply to Clutter]

Clutter, it was me (humanbean) suggesting self-medicating, not humphrey.

I think this is the second time you've got us confused.

[Clutter in reply to humanbean]

HB, I've edited my post. I'm so sorry, and yes, it is the second time I've done it

[humanbean in reply to Clutter]

No need to apologise! Mistakes happen.

[Clutter in reply to humanbean]

HB, beginning to feel like Groundhog Day though

[johnnyxs in reply to johnnyxs]

I have found my Jan 2015 blood panel results . Hopefully the link I include will show both of the jpegs.

[URL=s130.photobucket.com/user/p...]

[URL=s130.photobucket.com/user/p...]

[shaws in reply to johnnyxs]

Sometimes we do have to take things into our own hands to try to recover our health. After all I bet your GP would soon be looking for advice if he developed hypothyroidism particularly when his method of dosing/levo didn't improve his condition and with continuing ill-health. I would like to be a fly on the wall then.

[Muffy]

In the blood test results, the patient is being told the results are 'normal'. Normal is not the word as the patient feels ill. The lab should be saying within range and anyhow the T4 is low and the T3 not as high as it should be!

Hopefully if you get a referral to an endo, they will try to sort this out for you.

[johnnyxs in reply to Muffy]

I believe the Doctor is adding the text 'tell patient Normal' I don't know if the Labs are commenting on the results. If they are its not on the print out the surgery give me.

Hoping I get the referral....I don't even remember how long it is I have been feeling ill now . Feeling well again is like an unobtainable dream.

Thanks for the good wishes ,much appreciated Muffy

[Muffy]

125 mcg isn't a very high dose, so you would almost certainly need an increase to make you feel better. If your local range for TSH is 0.2 - 5, then you are within range. Talk to your doctor particularly about the T4 result.

Worth a read -

doctormyhill.co.uk/wiki/Thy...

[fundu123]

make sure to check for hypopitutarism. It might be a possibility. If these results are precise , something is surely wrong. Please pursue this with doctors .

[johnnyxs]

thank you for your timely reminder and advice. I'll make an appointment tomorrow and show him yours and others advice .

He surely cannot ignore the advice and experience of so many sufferers and if he does I'll request a second opinion or a referral to an Endo.

thank you fundu

[johnnyxs]

well there has been a bit of a development at long last thanks to all the help advice and support I have received from everyone on this forum.

I telephoned my Doctor last night and he has reluctantly agreed to refer me to an endocrinologist after 15 years of misery.!

I've just experienced a continuous migraine for the past 3.5 days and nights and finally I decided enoughs enough!. Although the migraine is probably completely unrelated to my Thyroidism I just felt so rough that I decided to stand up to my Dr and demand some action about my ongoing symptoms. (So I telephoned him lol)

He was his usual evasive self and pointed out that in his opinion my blood panel results had stayed pretty stable over the past 10 years or so .......so I pointed out that

my anxiety ,depression,chronic fatigue, weight gain, mood swings ,dry skin,hypoglycemic attacks and brain fog had also remained the same ...poor !

He said he thought that the Endo would agree with his interpretation that my results were unremarkable and I countered saying that doing nothing was simply no longer a logical option and nothing ventured nothing gained I wanted to get some of my life back before I reach 70

In desperation he suggested I up my Levo from 125 to 150mg and so we agreed that I would increase my Levo to 150 and he would book my Endo appointment . In the intervening 2x months or so my new Levo dose would stabilise and a full blood panel for the Endo appointment should show where things are at.

What sort of tests etc should I expect at the Endo appointment ?