Newbie and lost

[mpmp]

I've been feeling unwell for quite a while now and suspect I have symptoms of Hypothyroidism. Doctor claims I'm not. Blood test revealed TSH 3.47 and Free Thyroxine (T4) at 14.

Is the doctor right or can I push this any further

[Hidden]

Hello mpmp,

Welcome to our forum and sorry to hear that you are not feeling well.

Unfortunately most doctors won't prescribe until your TSH reaches 10.0 or above 5.0 with symptoms.

Have you been tested for thyroid antibodies TPOAb and TGAb as this could indicate Hashimotos, common in people with hypothyroidism?

Doctors are sometimes more inclined to treat Hashi patients with a TSH level lower than the guidelines.

Alternatively you could ask for a second opinion or email [e-mail] for a list of sympathetic doctors/endos that members have reported positive experience with. Depending on where you are located, this may involve travel.

Good luck,

Flower

[Gismo333]

Hi I would definitely push this further. Your TSH is only a guide and even if your TSH is suppressed further it does not mean you are not hypo. A good doctor will look at the TSH, FT4, FT3, test muscle reflexes, listen to your heart and above all listen to your symptoms. The TSH on it's own is worthless. Print the information below and give it to your doctor. It was sent to me by Dr Hertoghe whose clinic I attend yearly:

After working the whole week in Switzerland on a report of the

International Hormone Society on the TSH, T3 and T4 reference ranges,

I have sorted out all the studies that suggest that untreated patients

(in primary hypothyroidism, due to a weak thyroid gland) with a TSH

above 1.5 or 2.0 (reference 0.2-4.2) have cardiovascular

abnormalities, more obesity, depression, mortality, etc. enough data

to suggest a change of normal references to healthy references

(0.3-1.5 or 2.0). In case of secondary or tertiary hypothyroidism (due

to a weak secretion of TSH or TRH by respectively the pituitary gland

and hypothalamus), the TSH test itself is worthless. Likewise for T3

and T4, enough studies show that within the actual reference ranges

for T3 and T4, especially the lower half or lower third is correlated

with disease and higher mortality, enough to give serious arguments to

narrow considerably the reference range so that the tests help somewhat.

Of course the clinical condition of the patient (complaints and

physical signs) should predominate in the choice of the treatment as

they are the expression of what is really going on inside the cells.

There is data to support this view too.

Kindest regards

Dr Thierry Hertoghe

Hope this helps

[Patsy74]

You are on the border line of normal and possibly the only way to establish whether you should be treated is to get a second opinion either by asking for a referral to see an endocrinologist (which you are entitled to ask for) or to ask for a referral to a private hospital or clinic.

Like so many of us we have to seek out the doctor who is willing to help you establish why we are feeling unwell

[Sylvia22]

If you cannot get any help from your G.P. ask to be referred to a consultant. I you still get no joy you may need to change your doctor.

[Heloise]

Hi mpmp, the NHS has a terrible reputation for treating thyroid conditions because they do not recognize symptoms and usually treat on only the TSH result which we know is not a reliable source of thyroid function. Your free T4 (is it low in the range as it appears?) shows how little hormone your thyroid is producing but a free T3 test would tell how much of that T4 is CONVERTING to the ACTIVE hormone FT3. Sometimes your T4 only becomes reverse T3 which is inactive. That happens for various reasons but often the adrenal glands control that. This leaves you symptomatic with slow metabolism which can cause a myriad of other problems. Some people here have gone on to obtain their own thyroid hormone rather than deteriorate while waiting to find a GP who will treat them. It's a terrible situation. If you can get another test to prove that your thyroid is deteriorating, try to get the blood drawn as early in the morning as possible. This is the time of day when highest. Do not let go, it's too important.

health.howstuffworks.com/hu...

[Eddie83]

Doctor is wrong. The AACE TSH range is 0.3-3.0. Functional medicine practitioners want to see TSH in the range 1-2. I didn't feel great until I got my TSH down to 0.47 by using T3+T4. You didn't state what the normal range is for FT4 in the units you're using, but the more important test is FT3. If this doc won't ack the importance of T3 level by testing you, then you need to find another doc or do private testing. Docs who are stuck on the whole TSH+T4 style of diagnosis and treatment, are ignorant about the fact that impaired T4->T3 conversion, in the presence of normal FT4, will leave the patient in a perpetual state of physical and mental dysfunction.