My latest test results, dont understand what is going on :(

My latest test results, dont understand what is going on :(

Now I am borderline for Hashimoto based on TPOab, my TT4 keeps dropping which means I am not producing enough to make T4 and T3, only TSH remains normal. Between these tests on January 2015 I had blood taken on local private clinic when my TSH was 2.3 same range, T4 17(range 10-21) and T3 5.9 (range 3-6.5)

My selenium is now optimal, been taking brazil nuts. Iodine remains on the low side, but that I cannot fix as I cannot tolerate high amount of iodine, but I do supplement some and try to eat food naturally high on iodine. Iodine is actually the same than last time after high supplementation. Mercury slightly elevated but in the middle of the range so doesnt indicate mercury would be the reason. But this time for some reason arsenic and bromine were high, which just cannot understand.

Plus I have been avoiding any goitogrenic food even the millet I do eat for months before this test, yet my TPOab is now rising, been using quite a lot of dairy.


Thyroglobulin is very high. In the normal thyroid gland an elevated blood thyroglobulin (> 10 ng/ml) is considered a good marker

for iodine deficiency over the past weeks or longer. When iodine has been sufficient for thyroid hormone synthesis thyroglobulin levels are usually in the range of 3-10 ng/ml. However, in the abnormal thyroid gland, elevated blood thyroglobulin levels can indicate Grave's disease (hyperthyroidism), Hashimoto's thyroiditis, goiter, or, rarely, thyroid cancer ( Elevated thyroglobulin, in concert with elevated TSH and depressed total T4, may also occur with prolonged and excessive iodine supplementation, which can suppress thyroid hormone synthesis (Wolff-Chaikoff effect). With excessive iodine supplementation, elevated TSH and depressed total T4 are less likely to occur with concommitant thyroid therapy. More extensive evaluation of the thyroid may be worth considering.

Total T4 is lower than observed range. Total T4 is a good marker of the thyroid glands ability to synthesize thyroid hormones. A

low total T4 could be caused by one or more of the following: T3 therapy (e.g. Cytomel), Hashimoto's thyroditis, low iodine, low iodine uptake (caused by goitrogens), poor iodination of thyroglobulin (caused by goitrogenic inhibition of thyroid peroxidase iodination of thyroglobulin, low catalytic activity of thyroid peroxidase from low iron), and/or overall inhibition of thyroid hormone synthesis caused by excessive iodine supplementation (Wolff-Chaikoff Effect). The low total T4 is associated with symptoms of thyroid deficiency. Consider thyroid hormone therapy or increasing dosage if already taking.

Free T4 and free T3 are low-normal range, consistent with symptoms of thyroid deficiency. TSH is within normal range and not

reflective of the lower T3 and T4, which can be caused by impaired feedback response to the pituitary. This often is caused by high stress and associated high cortisol or catecholamines (norepinephrine), which suppress the hypothalamic/pituitary production of TSH and decreases hepatic conversion of T4 to T3. Chronic high stress/cortisol also directs hepatic conversion of T4 to bio-inert reverse T3. Thyroid therapy with T4 alone, and in many cases combination T4/T3 therapy often are not effective when stress/cortisol is high due to excessive conversion of T4 to reverse T3, which impedes the cellular actions of bioactive T3.

Consider replacement with a thyroid medication that contains both T4 and T3, or T3 alone (slow release). In addition, saliva

testing for cortisol, minimally am and pm testing but preferentially 4x throughout the day, is STRONGLY recommended prior to commencing thyroid therapy since normal cortisol levels are essential for normal tissue response to T3. For an excellent review explaining the interplay of stress/cortisol on thyroid function please see the following:

Thyroid peroxidase (TPO) antibodies are borderline positive, suggesting a possible evolving issue with Hashimoto's autoimmune

thyroiditis. If symptoms of thyroid dysfunction become more problematic it would be worthwhile to recheck TPO levels. Antibodies to this enzyme may cause an increase in autoimmune dysfunction around the thyroid causing an increase in inflammatory cytokines, increased T cells, and NK cell function. The autoimmune reaction to the thyroid tissue results in destruction of the thyroid cells with consequent release of high levels of thyroid hormones (T4 and to a lesser extent T3), which results in a hyperthyroid state. Continued destruction of the thyroid gland results in fibrosis and eventual depletion of the thyroid hormone, thus causing a hypothyroid state. Clinical studies show that selenium supplementation is helpful in decreasing TPO antibody levels and thus helps prevent autoimmune destruction of the thyroid gland (Duntas et al. Eur J Endocrinology 148: 389-393, 2003)

My note : I have not had symptoms of high or low cortisol for long time. Possible tho that they have been rather slightly elevated during this spring as I have had stressful time and been getting flu all the time.

So the specialist reviewing my results recommends either combination therapy or T3 only, but what do I do know? Where to go, what does this mean?

PS the hyper super special endo I saw said IT IS DEFINITELY NOT thyroid issue nor Hashimoto, never ever.

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17 Replies

  • Justiina,

    Why not start with T4+T3? If it doesn't suit you can switch to T3 only.

  • Thats it, I need a doctor to prescribe me the meds. Cannot go self medicating as I cannot get tested, meaning first of all I cannot afford it and second of all I could only use ZRT at the moment and it takes a month total to order and return the test.

    But I am still not convinced any doctor would believe me :(

  • Justiina,

    They might if you show them the test results and report.

  • You are right, as always :D I am just having very skeptic moment. It is still very hard for me to believe that for example low T3 can have such an impact for one's life.

  • Justiina,

    Low T3 made me feel desperately unwell. I'm fine with it halfway through range.

  • Justina, goitrogens have nothing to do with antibodies.

  • I know, my mistake. Tried to explain that tried to avoid anything compromising thyroid function and flare up triggers. So confused and tired I don't type what I think.

    Trying understand why everything is going downhill. Like if my iodine is so low and why my TSH is not high then, why my thyroid gland looks good as I have then been deficient long enough to it to show. Why taking iodine has no effect. Why my tt4 is dropping so dramatically. Why my tpoab is now rising and thyroglobulin still above the ranges.

    And the top notch endo said it's not thyroid issue and never will be, it is just IBS. That time I was rapidly losing weight and feeling very bad and if he had tested me maybe my antibodies were higher, dunno. So lots of whys.

    Not expecting you to answer these questions :D but I mean I am trying to get things to make sense as I feel nutrition wise I am doing everything right etc.

  • If I were you, I would forget the TT4 - don't know why they even still do it! It contains no useful information. I know it's below range, but your FT4 isn't - it's very low, but not below range - and that's the important number.

    That 'top' endo (pft!) was only looking at the TSH, wasn't he. That's a nice number. But meaningless. He needs to look at your FT3 and see how low that is. No wonder you feel ill! I think he's totally, absolutely, undeniably wrong. And I think he should be looking at your pituitary, because that TSH is much too low for an FT3 like that.

  • TT4 is done because of iodine. It is considered as a good marker. That's why I am puzzled as I am supplementing! When I wasn't my TT4 was in the range.

    Yeah now I am planning on asking about the pituitary function too. I suffered from proper concussion at age of 12 and fell ill few years later. Been always wondering if it could affect but they don't even look at my papers to see I really had a head trauma. Annoying!

  • Well, I've never heard that before! How does that work? TT4 is a good marker for iodine? Except it isn't, because you are taking iodine, and the TT4 is getting lower and lower...

  • Hahahhah exactly, thats why I dont understand what the F is going on. I know I am on relatively low dose of iodine, but still. I am starting to suspect the whole iodine thing. Tho that was sort of have to do thing with this test, so it isnt something I wanted to measure.

    I have been told and I have been myself get scared of everything that can go wrong with low iodine as I have had to avoid it relatively long time and my diet has not contained a lot because of my sensitivities that I was 100 % sure it shows up. But nowhere in my body it shows up. I was so sure I have cysts in my uterus and ovaries and when I had that vaginal ultrasound scan for other reasons it showed very healthy uterus and ovaries. Only thing that was wrong was edema around my bowel which I read could be down to hashimoto as it can cause swelling around any tissue or body part.

    So all I can think of it is something going on with pituitary or I am just stressed enough plus smoking affecting TSH preventing it not to rise. I am operating on pure will power so that must cause stress. Or I am some weirdo having one of those over 50 different type of genetic issues that have not all studied enough yet causing this all. Was one finnish endo saying it is around 50 different genes affecting thyroid function and so far only DI02 tested. So

    That idiotic topnotch endo also said that all these fluctuations are normal and with my T3 I am perfectly functional and healthy individual, this latest test he of course has not seen, tho 3.2 isnt much better than 2.5. When I asked him about thyroglobulin he said it is normal protein and as it had gone down nothing is wrong. But as this latest test shows it is rising again! But if thyroglobulin is leaking and antibodies is destroying it doesnt it mean that is why T4 and T3 are low as there is no material where to produce the hormones?

    Only thing I am happy about this moment is that my selenium level is optimal, was very low in the beginning and now that has been fixed just by eating brazil nuts. As we know the quantity of selenium varies between different nuts, the type I am taking seems to contain adequate amount of selenium to fulfill the need of it.

    But now hair is graying rapid, at age of 37 and I developed melasma/hyperpigmentation on my forehead which I read could be down to pregnancy, which I dont think I am , tho who knows what dr mengele that gynecologist is.. :D Or menopause, which I am not proved by that same gynecologist or pituitary and/or hypo and/or hashimoto can cause that.

    I am starting to question everything and wonder how many and how debiliating my symptoms have to be before it is taken seriously, how ill I have to get. Because of course after supplementing vitamins and eating correct I have gotten rid of many symptoms, so it is many things going on at the same thing, not every symptom was caused by one thing. And it is my damn perky attitude wrong too.

    after complaining about this shit to the gynecologist, she asked me at some point that how is my mental state, do I feel depressed. I said that I cannot understand, I have not lost my sanity and my mental well being is good when I should be very down and depressed after going through this for this many years without any help and my future is very hopeless. But no, my mind keeps staying positive. And she said yes you seem very level and perky, positive and calm. I said I have no choice, but never ever for some reason I fall into a state of that type of depression I would be non functional because of it.

    Told her that its one thing I dont understand why it is seen as depression even though regardless of my physical state I do what I have to do, I do not skip meals, I cook, I take my vitamins, I brush my hair and my teeth, I do laundry, I clean up, I try to exercise a bit even tho it throws me into mode where I am nothing but irritated (i guess that is low T3). I just keep doing everything. I do not neglect my cats, and nothing that would indicate my physical state would be caused by mental disability. I enjoy being with people, it does wear me out, but I know how it is, then I do stay in bed day or two and get up and continue as normal life as possible.

    All these years I have been told it is in my head and I believed it and I restrained myself from life. Last year when I joined here and learned it actually is physical illness I got that light bulb moment. Last weekend I let myself go out on a date, which I have not done for years. Someone from my past. For 17 years someone has had me on their mind. Me sitting there knowing I am not the same girl, I am much older and looking much older as this shit is wearing me out, ending up hearing I have become so very beautiful. Someone being so happy to see me, smiling with their whole body, almost jumping up and down, hugging me every five minutes. What a feeling. And all this I have missed being housebound and bedridden because it was just all in my head, but miraculously some of it fixed by as simple things as large dosages of certain missing vitamins. SIGH.

    I wonder when the bitterness hits me...

    I would love to apply to school to have something reasonable to do, I have organized all and I would get a spot at school where you can study from home , so it does require some, but with illness and paper from a doctor I would get tailored plan just for me. But no doctor is signing that paper for me as they see me so very healthy. So I am stuck. I am someone who wants to educate themselves to get bachelor's degree and have more opportunities, but no. Having plans for my future means I cannot be ill. Ill people dont have plans, they are miserable and suicidal.

    They have this wonderful program in University where no one is left out regardless of your illness or handicap, designed for people like me , but I just cannot apply. I am not ill enough, but not healthy enough either to be approved normally, this I have confirmed from healthcare from the university, they recommend to apply with signed paper from a doctor. What a wonderful place Funland, I mean Finland is, full of joy and opportunities.

    I hate myself not being able to write short, but I guess I just had to get this out of my chest, sorry :D

  • Please don't apologies, writing is great therapy. And, I'm so happy for you about your date. I do hope you like him as much as he likes you. That would be so wonderful. :)

    Thyroglobuline is a normal problem. It's the thyroglobuline antibodies that are the problem! I don't think he knew what he was talking about! You're absolutely right, that is why the T4 and T3 are lowering. This man must be a diabetes specialist, no?

    You know, if it's at all possible, I think you should forget all these ignorant idiots that are keeping you sick, and self-treat. Why waste any more of your life? If I'd known about thyroid sooner, and had had all these people saying it was in my head, I would have self-treated immediately I found out how. No hesitation. I don't know how easy it is for you over there, but do consider it, and find a way. x

  • I know they don't know what they're doing! lol I've known that for a long, long time. Long before I was diagnosed as hypo.

    I keep calm because I know what I'm doing, and I don't rely on doctors anymore. And, it's not just the NHS where you live. It's the NHS all over the UK. And it's health service all over the world! Here, in France, the main aim of all doctors is to get you on as many drugs as possible! You should see the poor OAPs, shuffling into the pharmacy, after shuffling out of the surgery. And shuffling out of the pharmacy with shopping bags full of stuff. Most old people are on so many drugs, they don't know if they're coming or going! So, I've opted out!

  • Yes, it is scary. I had a six month baby, and two small children when I did it - and no help from my ex!

    I'm in the Oise. Possibly the worst part of France, but that's where the work is. Been here for about 41 years.

    I haven't had a blood test for ages! I go by symptoms. I got up to this dose with my doctor at the time - despite my doctor, I should say, and felt good with it, so stayed on it. I've experimented with going a little higher, or a little lower, but the weight just starts piling on. So, I think this is the dose for me. For now, anyway.

  • I don't know the Limousin area, never been there. But anything must be better than the Oise! I, too, would love to own a chateau. There are so many of them for sale, and comparatively cheap. But, it won't happen now. Never mind.

    I don't have any magic secret for getting better - and I'm still not 100 % by any means! Doubt if I ever will be, now, I'm 71. All I did was found which form of thyroid hormone replacement suited me - not what my doctor thought ought to suit me! - got my T3 to the level that suited me, and optimised my nutrients. Oh, and there was a little problem with adrenals along the way, But HydroCortisone fixed that. I also tried Growth Hormone, which was lovely, but I can no-longer afford that, so have to do without. And, that's all I can tell you. :)

  • Looks like your thyroid is gradually failing in spite of your best efforts with diet etc and you need meds - badly. Buying your own levo or T3 is very inexpensive.

  • Your low tsh indicates central hypothyroid loud and clear as does your lowering t4

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