Graves/Hyperthyroidism Latest blood test results - comments please

[cc251254]

I was on Block & Replace for 2 years which didn't go well as I never felt very good taking Levo Thyroxine. I am now on Carbimazole Titration Treatment (since April). I was started on 10 mgs Carb daily which proved to be too high according to blood test results. I was titrated down to 5 mgs daily 3 weeks ago and this is my latest blood test result:-

TSH 0.16 (0.34 - 5.6) Below Range

FT4 15.9 (7.5 - 21.1)

I would be very interested in your comments i.e. is this a good result? Does it show that I am Hyper or Hypo? Are there any symptoms that this result would give?

Many thanks in anticipation. CC

[Clutter]

Cc251254,

TSH is low but no longer suppressed, and FT4 isn't much above mid-range, so I would say you results are euthyroid (normal, neither hyper nor hypo) on your current dose.

[cc251254 in reply to Clutter]

Hi Clutter, many thanks for your response although I am now more confused ! I had an appointment with my Endo on Wednesday, she said that the TSH IS suppressed.

She asked how I was feeling, I told her that since being started on Carbimazole Titration on 19th April (starting dose of 10 mgs) and dose reduced to 5 mgs on 17th May I had progressively worsening breathlessness upon exertion (climbing stairs, lifting etc etc). Her reply was "MY patients must stop blaming every symptom they have on the thyroid. Your breathlessness must be caused by something else".

I was so taken aback and my head then racing with thoughts that I must now have some other dreadful problem with my heart or lungs that when she asked if I'd got any questions, I just said "no". However, having sat down and gathered my thoughts I think that it IS my thyroid / levels that have caused the shortness of breath - I have been taking 40 mgs of Carbimazole for 3 years and coming down from that dose to one quarter of that dose, followed very quickly by one eighth of that dose is surely going to have some effect on everything ?

On 4th April I had a TSH of 37.97 and FT4 of 6.3 and on 23rd June a TSH of 0.16 (below low reference limit) and FT4 of 15.9.

I have since "googled" low / suppressed TSH and found several websites where it is written that a low suppressed TSH CAN cause shortness of breath including this one which I have copied and pasted:-

"Recent reports found that mild or subclinical hyperthyroidism, in which the thyroid hormones, T4 and T3 are normal, but the pituitary hormone, TSH, is suppressed, may cause symptoms including fatigue, nervousness, anxiety, shortness of breath, palpitations, trouble sleeping, increased appetite, loose stool or diarrhea, ..."

What do you think ?

Christine

[Clutter in reply to cc251254]

Cc251254,

TSH 0.16 is below range 0.35-5.6 but suppressed TSH is usually expressed as <0.1.

Some endos can't see beyond blood test and will not accept that symptoms can be thyroidal when blood tests are in range. Symptoms can also lag behind good biochemistry by a couple of months. Pity your endo didn't tell you that instead of being so dismissive or investigate why you may be breathless. Ask your GP to check ferritin, vitamin D, B12 and folate which are often low in thyroid patients and amongst other symptoms can cause breathlessness.

You were very over medicated in April and June results show the dose reduction is adequate.

I don't agree that TSH has anything to do with symptoms. I believe symptoms are caused by low and high FT4 and FT3 and often by thyroid antibodies.

I'm hypothyroid and was breathless when I was over replaced with Levothyroxine to suppress my TSH which resulted in very high FT4 and FT3. However, I was also breathless when I was taken off meds and had high TSH, low FT4 and low FT3. I'm not breathless with suppressed TSH <0.01 and normal FT4 and FT3 and feel fine.

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I am not a medical professional and this information is not intended to be a substitute for medical guidance from your own doctor. Please check with your personal physician before applying any of these suggestions.

[cc251254 in reply to Clutter]

Thanks again Clutter. I've just posted my results from a blood test for vitamins - please take a look.

Christine