New Blood Work and New Endo

[MrsBeasley]

Hi. I have posted before about my pituitary adenoma that wasn't responding to treatment and asked for a second opinion on that and my thyroid. The new endo tested everything including adrenal but I don't have those results yet as they went through the hospital. The endo thinks I have a different type of adenoma than I was told and he also said my TSH might be too low since I am not on any thyroid replacement since a partial thyroidectomy in 2004 and finally he tested my t3 as the previous endo hadn't. My bloods are available and I don't see him again until November 7 for these and the other results. Any opinion on thyroid function? My ferritin has gone up from 11 in May after supplementing with ferrous fumerate but it's moving slowly. Still feel like rubbish though!

Ferritin 15 (15-247)

TSH 0.86 (0.32-5.04)

T3 Free 4.65 (3.0-5.9)

T4 Free 11.7 (10.6-19.7)

TSH Receptor Ab <0.9 (<1.8)

IGF1 159 (57-196)

24 hour Creatinine 17 (5-16)

[Ruthi]

Well, with your ferritin that low you are guaranteed to feel rubbish! But its a slow process, this iron thing.

Your free T3 and free T4 are both sub optimal, but in an ideal world you would wait till your ferritin was better before testing again and considering supplementing.

TSH is really unimportant in the thyroid scheme of things, but is surprisingly low considering your T4/T3 results. Others would have a much higher TSH in that situation. I wonder if it is low due to the pituitary problems, but don't know enough about the pituitary to pass an opinion . Was that what the endo was suggesting?

I really think they should be testing B12 and vitamin D too.

[MrsBeasley in reply to Ruthi]

Thanks for your reply! My B12 was 247 (153-655). He didn't test vitamin D. The endo is looking at everything and seeing what's up.

[Angel_of_the_North]

Yeah, looks like a pituitary problem - low everything aka secondary or central hypothyroidism. That appallingly low ferritin won't help either. I'd get B12 and foalte cheked too and supplement with ferrous fumarate - get from pharmacy as it is half the price of a prescription

[MrsBeasley in reply to Angel_of_the_North]

Thank you for replying. B12 was 247 (153-655) but he didn't test folate. I've been on ferrous fumerate for months. It moved up my ferritin from 11 previously to 15 now

[Angel_of_the_North in reply to MrsBeasley]

B12 needs to be over 500, or you can have permanent neurological damage. ferritin needs to be at least 70, so there's a way to go yet.

[Roadrunnergreg]

Looking at that it looks like the pituitary and adrenals are the problem. A problem with the HPA axis (HPA hypothalamus pituitary adrenal) you can get these problems of thyroid levels plummeting and need an increase in thyroid meds, but the adrenals are most likely the underlying cause for them crashing as the thyroid can't handle the extra work. So that needs sorting out.

As for you ferretin that ought to be about mid range, also your zinc may be low so needs testing, B12 should be 50-75 points below the top of the range. Hope that helps...