All the symptoms of hyperthyroidism, however all doctors say my results are normal?

[meldzikowska]

Hi, ever since April I've started showing symptoms of hyperthyroidism, and that's when I first went to the hospital, as I had trouble breathing, my breath would be trembling and my hands and muscles would shake terribly and i had heart palpitations. At the hospital they gave me an ecg and a blood test, and apparently everything was normal (platelet count very high, neutrophil count elevated, lower serum ferritin level). I was told that it's completely normal for my age (18) to have heart palpitations, however this has been happening since April until now-December and it has only been getting worse. Recently, I have been to poland and there i received a TSH level result of 0.503, and in April it was 0.22 (normal range is from 0.4). Over the course of these months I've been to the hospital a few times already and the last visit showed arrythmia and the doctors want to do an echo to rule out myocarditis/pericarditis, as when I have chest pains the only way to get relief from it is to lean forward because it gets worse if I lie down or sit. Over the last two or three weeks I've lost 8kg instantly and the doctor is sure that I have hyperthyroidism, as I have all the symptoms (weight loss, irritability, shaking hands, muscle weakness, insomnia, heart palpitations and the feeling of chest pains, tiredness throughout the day and recently I've been told that my eyes have gotten enlarged, my eye sight has gotten slightly worse and more blurry at times). In April my TSH level was 0.22, in October 0.503 and my serum free T4 level was 12, free thyroxine level 14.8. I was told that this is all caused by stress, although there have been no changes whatsoever in my life and I am definitely sure that I am not in any stress. So I just wanted to ask what should I do next, as these symptoms seem to get worse and the doctors don't want to do anything to find out the cause for these symptoms. Also, I wanted to find out if those results are in fact "normal".

Thank you

[greygoose]

I would have thought that if you were hyper, your TSH would have been lower than that. Can't comment on the Frees, because you haven't given the ranges - and, by the way, T4 and thyroxine are the same thing.

Have they ever tested your antibodies? Because that will tell you if you have Graves, which affects the eyes. If they don't do that, then they're just guessing. Maybe you should have the antibodies tested for Hashimoto's, too - autoimmune thyroiditis - because this could be the beginning of Hashi's.

[meldzikowska in reply to greygoose]

Thank you for your reply. Regarding the frees - I wasn't given any normal range, just the results in a table, over the course of a few months... :/ And if I want to get a test for my antibodies, to find out ifrom I have graves or hashimoto's - could I do it at the GP or would I need to ask at the hospital??

[humanbean]

Can you get the reference ranges? We need them if we are to help interpret your results. Depending on the lab that that did the testing the reference ranges vary, they are not fixed. A Free T4 level of 12 might be okay if the range is 7 - 16, but is not good if the reference range is 12 - 22 (for example).

One thing to be aware of is that underactive and overactive thyroid have a surprising number of symptoms in common. Doctors will tell you that a fast heart rate suggests overactive thyroid rather an underactive thyroid, but there are plenty of us here who have had a fast heart rate while being untreated or under-treated for underactive thyroid.

Another thing to consider is that low iron or low ferritin (iron stores) can cause a fast heart rate and arrhythmia, and low iron is very common in people who are hypothyroid.

A low TSH is not a guarantee of overactivity either. If you have pituitary or hypothalamus damage you could be hypothyroid with a low TSH. This condition is known as central hypothyroidism, or secondary or tertiary hypothyroidism, depending on the source of the problem.

[meldzikowska in reply to humanbean]

Thank you very much for your reply. And regarding the reference ranges - I wasn't given any on the results page,unfortunately. So to find out what exactly is causing these symptoms, should I go to an endocrinologist, get a thyroid scan, or what other options are there?

[humanbean in reply to meldzikowska]

Can you get back in touch with the lab or the doctor that arranged your tests and ask for the reference ranges? Having a result by itself is really not helpful in most cases, the range is essential.

To find out whether you are hyperthyroid (overactive) or hypothyroid (underactive), the best place for you to start would be to get a full set of thyroid results. And you must get a Free T3 level included. Low vitamins and minerals can cause all sorts of unpleasant symptoms too, and are common in people with thyroid problems. You really need to get these tests done :

TSH

Free T4

Free T3

Total T4

Thyroid Peroxidase Antibodies (TPOAb)

Thyroglobulin Antibodies (TgAb)

Ferritin

Folate

Vitamin B12

C Reactive Protein

Vitamin D (25-OH)

The antibodies mentioned above tell you whether or not you are suffering from Hashimoto's Thyroiditis.

To figure out whether you are suffering from Graves' Disease, you would need to get different antibodies tested (Thyroid stimulating hormone receptor antibody - TRAb) :

labtestsonline.org.uk/under...

labtestsonline.org.uk/under...

verywell.com/thyroid-antibo...

Bear in mind that you could be really unlucky and have Hashimoto's Thyroiditis and Graves' Disease at the same time.

To get all the above tested on the NHS is a struggle. Free T3 is hardly ever tested. Thyroglobulin antibodies (TgAb) are hardly ever tested. Vitamins and minerals are hardly ever tested, particularly vitamin D. I'm not sure how often TRAb antibodies are tested, I'm not hyperthyroid.

If you want to be sure of getting all the tests done that you need, sadly the only option is to pay privately. You don't have to get permission from a doctor, you can buy tests online, do testing by post, and get results via email.

thyroiduk.org.uk/tuk/testin...

bluehorizonmedicals.co.uk/T...

bluehorizonmedicals.co.uk/W...

medichecks.com/find-a-test/...

Sorry, but I don't know the best place to get a TRAb test.

[humanbean in reply to humanbean]

I forgot to say :

Make sure all testing is done early in the morning, by 9am at the latest.

Don't eat after about 9pm - 10pm the night before and only drink water until after the blood has been taken.

[elizabethanera]

Hi, only just seen your posting as I was unwell for 3 weeks, with exactly the same symptom s as you, and doctors saying the same.ended up in hospital with chest infection and water infection.gp had not listened again!My granddaughter s took me to a&e where I was admitted immediately. GPS say scelerodermarosis, sarcoidosis, possibly!this has been going on for 16 months and I was told it was Stress etc.yeah rite!!! GPS being cagey now that 2 docs thinking that yes, I could be right? One even said "ldid say a second option might help and it looks as if a colleague found something,but bloods normal!!!L decide d have no choice but to go private, as a referral

That doc was going to do means a wait of 6/8 months.do you have a rash on chest/neck with granulation? Have you seen an optician. I have and confirmed dry eyes,with scarring on one and some hurry lose of vision.Also if you have mouth problem see your dentist. Ihaving a test for sjgorens soon . Have you had a serious illness or traumatic time atall? Keep your spirits up, l know it s hard. I would like to wish you a very good Christmas, and extend it to all. Kind regards x

[ZippyAppletush]

Hi meldzikowska , I can’t offer comment on test results but years ago (in early 20’s, now 57) I had an increase in thyroid meds (T4 but can't recall if generic or named) from a doctor overseas, after a fall. When I returned to UK I felt fantastic, had lost weight! When my usual hospital doctor saw me he said “OMG you’ve had an overdose!”. I said I felt great, he said he wasn't surprised! When I asked him how he could tell he said my eyes were bulging! I said I was wearing contacts but he said it was my actual eyes that were bulging...he likened to Marty Feldman. He began reducing my meds to where I no longer had bulging eyes but felt happy and was healthy. Yours is the first post I’ve seen by another patient that mentions bulging eyes.

I hope your situation is resolved soon.