Could it be more than hashimotos?

[Emilychazza98]

So two people ( on different forums) have told me that they think I could have something more than just hashimotos going on.

My recent results are:

TSH: 4.9 (normal range 0.3-5.5)

Free T4:13.6 (normal range 8.1-22.5)

Free T3: 7.4 (normal range 4.1-7.9)

I also have antibodies involved and an enlarged pituitary gland (no tumours found there)

I have increased my dosage to 75 micrograms around 2 weeks ago, however I feel extremely fatigued all the time to the point where I don't want to move and I get cold very easily. cancer is now a big worry to me.

Does anyone else think I could have something else going on because of my results?

[shaws]

I think your TSH is too high for you to feel well. 75mcg is not too high a dose so suspect you were on a lower dose before the increase to 75 two weeks ago?

Did you leave around 24 hours between taking levothyroxine and your blood test, which should be a fasting one and have the earliest appointment?

You will not feel very well at all until you get to an optimum dose for you (we all differ).

You should have a blood test every six weeks approx with a 25mcg increment in levo until you feel much better.

[Emilychazza98 in reply to shaws]

The endocrinologist first put me on 50 micrograms and then changed me to 75 after the test. I didn't take any levothyroxine that morning and I didn't know it was a fasting one.

I have another blood test on the 18th of August to see any changes.

[shaws in reply to Emilychazza98]

It's only recently that a fasting test was recommended. Your Free T3 is good but as you've only been on the increased dose for two weeks, you might feel better by the time your next blood test is due with a lower TSH.

[shaws]

This is an explanation of Hashimoto's also known as Autoimmune Thyroid Disease.

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

[Emilychazza98]

I'm in the UK.. When I went to the endocrinologist after finding my pituitary gland was slightly larger he did some blood tests and found out that I have hashimotos. Then he said I have to have another MRI next year to keep an eye on my gland.

I'm worried because what else could be going on to give out strange results. :/

[Clutter in reply to Emilychazza98]

EmilyChazza, your enlarged pituitary gland may be causing some pituitary dysfunction so instead of TSH responding to high FT3 by dropping, it remains high. I'm a bit surprised he increased dose to 75mcg because although it will lower TSH and raise FT4 it's also likely to raise FT3.

The other likelihood is that you are in the early days of Hashimoto's. As the thyroid gland is attacked cells die off and dump hormone into the blood. FT4 &/or FT3 can be elevated above range for a while (Hashitoxicosis) but eventually the thyroid atrophies and stops producing hormone.

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

[Emilychazza98 in reply to Clutter]

This now makes a bit more sense as he did say it was subclinical hypothyroidism and that my thyroid will just die eventually.

I guess I will just have to see what the results are to my next blood test

[PinkNinja in reply to Emilychazza98]

Your T3 is most likely high because your TSH is high. Conversion of T4 to T3 is directly correlated to TSH levels. When you are hypothyroid one of the side effects of the raised TSH is the up-regulation of conversion of T4 to T3 to compensate for the overall lack of thyroid hormones.

One of the side-effects of hypothyroidism is the enlargement of the pituitary gland. This is likely due to the increased need for it to produce more TSH to try and get the thyroid to produce more thyroid hormone. Your doctor will be keeping an eye on it to make sure that this is the only reason it is enlarged, hence the repeat MRI next year. Have a look at the outline of this study. 85% of the patients in this study who had pituitary enlargement due to hypothyroidism saw a decrease in size following treatment with levothyroxine.

ncbi.nlm.nih.gov/pubmed/165...

What was your TSH when you were diagnosed? If it was very high it is not surprising your pituitary gland is enlarged and your T3 is relatively high.

Your doctor is keeping an eye on things by doing a further MRI. If there is anything to worry about, steps will be taken. Although it is likely there is nothing to worry about, do see your doctor as soon as possible if you get any worrying symptoms just in case.

Hopefully you will be one of the 85% and your pituitary gland will return to normal soon!

Carolyn x

[Emilychazza98]

I'm not quite sure what my tsh was when I was diagnosed. I had a blood test last year with the gp which showed my thyroid was borderline so he said it wasn't a problem. Then the endocrinologist did a full thyroid test and the levels had got higher with antibodies involved. I'm not sure what they were though.

What is the average that T3 should be?