WHAT IS NORMAL?

[sheila60]

I see people giving their readings out on their TSH, T4 & T3 but was is normal ? as i havent a clue about these figures and where do i find out what mine are. Thank you

[SeasideSusie Remembering]

Ha ha sheila60 , that's the 64 thousand dollar question!

As we're all individuals, normal is whatever and wherever in the range feels right for us personally. As we're not tested for thyroid function when we're well, before thyroid problems come along, none of us actually know where we fall within the ranges to feel well.

Reading your previous post, you appear to by hyperthyroid and you're taking Carbimazole. Unfortunately, now you have developed thyroid disease you're never going to know what your 'normal' was before.

To find out your current figures, ask your surgery for a print out of your thyroid function test results, you are legally entitled to them (Data Protection Act) but they may make a small charge for printing.

I don't have experience of hyperthyroidism, I am hypothyroid and I know that a treated hypothyroid patient generally (but no everyone) feels better when TSH is 1 or below or wherever is necessary for FT4 and FT3 to be in the upper part of their ranges.

[shaws Administrator]

When we refer to 'normal' - it refers to the ranges of blood tests. Usually you find the ranges in brackets after the results. For instance:

Serum TSH Level

5.12 mU/L (0.30-4.40) High

It says high because it is above the last figure in the bracket, i.e. 4.40. so the normal range is between 0.30 to 4.40 but that doesn't mean a thing to us. It's the doctors who think if the above person's result is 4.40 that they're in the 'normal' range so the person should feel 'normal health' health. Not so.

For us to feel a bit better we'd do so if it was at the low end of normal, i.e. 0.30 or anywhere around 1 or lower. Never accept from a doctor 'bloods are 'normal' or 'fine' or o.k. - not when we have clinical symptoms.

The mainly use the TSH as a diagnosis and it is from the pituitary gland. What makes us feel better is a Free T4 and Free T3 towards the top of the range (against TSH's bottom of the range). I hope I haven't confused you but it is a big learning curve I'm afraid.

If you've had a blood test for thyroid hormones it should have been at the very earliest appointment and fast although you can drink water. This allows the TSH to be at its highest as doctors adjust meds according to it and it drops throughout the day. You also allow 24 hours between the last dose of levo and the test and take it afterwards.

You then get a print-out of your results from the surgery a few days after your test when the lab has returned the results. Post them, with the ranges, and you will get a response from members.

[sheila60 in reply to shaws]

Think i have a lot to learn here its very confusing, but thank you all for answering me, I will ask my doctor for a print out of my results and put them on here, hopefully i will understand it more, but for the past 12 days i have felt terrible. so back to my sofa i go. Take care

[shaws Administrator in reply to sheila60]

Many of us know how you feel. I was surprised that I had more symptoms after starting treatment than before and my TSH was 100 to start.

[sheila60 in reply to shaws]

i just want to know how to calm down, i wake up in the morning gritting teeth and nervous as hell i feel my body gonna explode with nerves, for breakfast i have my 2 carbs and a proprananol, i havent been to work for 2 weeks and am the boss, i have my staff running it,The stories i have read here looks like am in for a long ride

[shaws Administrator in reply to sheila60]

I have just realised you are/were hyper thyroid not hypo. Hyper is fast i.e. too much hormone circulating in your blood and hypo too little. That's why Endo has given you propropanol.

what else are you taking -thyroid wise - and I think you should call endos secretary to get advice. Also put up a new post entitled Hyperthyroidism and those who have had this will respond, although there are more hypo than hyper on the forum.

[sheila60 in reply to shaws]

I have just been given carb about a month ago but been on propananol for over 20 yrs due to panic attacks,, This may seem a stupid question but is it better to be hypo than hyper. i would rather be calm and tired than feeling like a spring ready to go off.

[shaws Administrator in reply to sheila60]

I'm sorry you are feeling so bad and that doctors haven't yet been able to sort your thyroid problems.

If I had to throw a dice I'd say hypo is preferential to hyper. Only due to the fact that panic attacks must be truly awful and frightening when they first start and your body always alert to flee anywhere, somewhere.

My assumption is that you weren't given a blood test for your thyroid hormones for a long time ago and instead were told your problem was panic attacks only and given propropanol instead of being sent to an Endocrinologist for a thorough checkup. At least they couldn't make a mess (I assume) of your results being out of whack, i.e. hyper and given appropriate treatment.

I was undiagnosed hypo for a long, long time and, finally, a first aider suggested it. I was never given a blood test until I suggested it myself. Not one doctor, nor the A&E plus an overnight stay in hospital and been given other diagnoses for things I didn't have.

I think now you are a member that you will be able to put things in perspective and begin to improve your health. You can also put up a new post asking for a good Enocrinologist (give your area) who deals with hyper patients.

This is a link which might be helpful:-

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

Treatment:

nhs.uk/Conditions/Thyroid-o...

[sheila60 in reply to shaws]

Thank you Shaws . i just wish i understood half of all the figures and numbers on this site, i am due to see an enocrinologist in 6 weeks and might ask for the RAI as i am so scared of being on edge like this all the time all i am doing is pacing the floor and trying not to panic. Its nice to know there is someone here who understands as i think my family are a bit sick of me being like this which i understand..

[shaws Administrator in reply to sheila60]

I note you have an appointment in six weeks which most likely feels like six months.

We don't need to know 'numbers' after all what is the job of the Endos/doctors?

Fewer members have hyper than hypo but you should gt more responses and advice.

I know and so do most on this forum, know more than the professionals put together in the treatment of people who remain unwell.

Be cautious before you embark on RAI. Many have had as many problems after that than before. So be cautious.

[sheila60 in reply to shaws]

Thank you, yes it does feel longer than 6 weeks , last time i saw the enco he mentioned surgery as i have a large goiter also but i said i didnt want surgery so he said go for the RAI . i am just totally lost on what to do .

[shaws Administrator in reply to sheila60]

Put up a new post headed goiter and/or RAI and you should get responses. As I said fewer have hyper than hypo. Your head must be spinning

If you decide on RAI, I'd suggest asking what replacement you'd get if levo didn't suit you. At the very least some T3 should be added

[sheila60 in reply to shaws]

This is what i cant get my head round.....levo...t3 etc i know its some sort of medication but it beats me what it is, sorry if i sound stupid but i will learn eventually :/

[Ruthi]

Just a little explanation. 'Normal' is a statistical term - coming from the term 'norm' meaning average.

In medicine the statisticians take an arbitrary decision about how far from the average people can deviate before being deemed abnormal. Typically, and certainly in thyroid tests, it is deemed that 95% of all healthy patients, ie those not reporting symptoms have no thyroid problem.

This is problematic in all sorts of ways because we now know that individuals have different set points, so what is normal (in the conventional meaning of the term) for one person is not normal for someone else.

Then there is the fact that some people are much more tolerant of deviations from their norm than other. That is not to say some are wimps, more that some start to experience symptoms ( while their results are still within range) sooner than others . That will also depend on what other things are going on in their health and life.

And just to make the ranges even less reliable, we know that labs generally don't go out and find healthy people to take the test, they simply test blood that they already have for other reasons - so it is highly likely that these people who aren't reporting symptoms of thyroid disease are not actually healthy overall, and no-one has studied how other diseases affect the thyroid.

What we do know (but doctors do not) is that healthy people, who feel well, generally have a TSH around 1. That is no-where near the middle of the range that is usually given. And they generally have their free T3 towards the top of the range - again not near the middle of the range.

So when your doctor tells you your results are now normal, but you still feel unwell, demand your results!

I agree with what others have said, your panic attacks were probably hyperthyroidism. But its not guaranteed - I managed to have panic attacks while hypo, and anxiety is a common symptom of hypo- as well as hyperthyroidism. And yes, I think if there is such a thing as preferable, then its probably better to be mildly under than over. Being hyper can kill you much faster than being hypo. But both states are miserable and do damage long term, and it is not unreasonable to expect to feel well.