Quick Comment on Initial Results Appreciated - Discharged as 'Normal' - Just discovered half the blood tests not even back from the lab yet.

[Foggyme]

Hi All. I've just popped over from the PAS forum to ask for a quickie opinion.

I've had B12 deficiency for some time (initially undertreated but now sorted with help from the PAS folks), have multiple gastric problems and multiple other symptoms (including neurological ones)...which could be thyroid related but obviously many cross-over issues with other things that are going on.

Also recently diagnosed with undifferentiated connective tissue disease (an autoimmune condition) and currently being tested for lupus etc. (that's made short work of 18months trawling through the 'ologies' at a snails pace 😀).

When I last saw the endocrinologist he said all with thyroid, adrenals, parathyroid and pituary was 'normal'. Couldn't print the results and said he would send them in a letter.

I received the letter today and it contained very little information about results...but here's what has been said about thyroid (so far):

FT4 13 (19 - 25 normal range [no units given])

TSH 1 miu/L (0.3 - 5)

So....is the FT4 too low? And not much idea about where the TSH should sit in the scale and in relation to FT4. FT3 was tested but the results were not included.

Thyroid antibodies were reported as normal.

However, when I rang the secretary today to ask for copies of the results to be posted to me, I was told that the thyroid antibody tests (and about six others that they did) had not come back from the labs yet (out-sourced, apparently). I've asked her to chase these for me and will make sure I get them, eventually.

So...discharged without half the test results being either received or interrogated (probably the result of never seeing the same doctor twice).

So...in the interim, until I get more results to post...are the FT4 and TSH as 'normal' as reported?

Sorry for being a thyroid dunce...PA and B12 are more my thing 😀.

Thanks all 👍

[SeasideSusie Remembering]

Oh good grief, they get worse! How can an under range FT4 be classed as normal. Your endo should change jobs because he doesn't seem to be able to read test results!

Yes Foggyme , your FT4 is too low, way too low. TSH, amazingly, is theoretically in a very good place!

[gabkad in reply to SeasideSusie]

I think she did a typo. Bottom of range for fT4 is probably 9.

Her results are normal, except it would be good to see the fT3. People who are ill can have low fT3 when other things are normal.

[Foggyme in reply to gabkad]

Hi gabkad. Ah ha...its what the secretary put in the letter. Awaiting copies of the actual lab results so I'll check when they arrive.

Will keep an eye on the FT3 when it arrives.

Many thanks

👍

[Foggyme in reply to SeasideSusie]

Wow, that was quick...thanks SeasideSuzie.

Did think it was a bit low 😖.

Here's a daft question...been discharged as 'normal'...what treatment should I expect for this and would it be appropriate to ask for another appointment with the endo (but I don't think I'll get it).

Is it too much to expect that my GP would know how to treat low FT4?

Is it something I can self treat (yikes - okay doing tha with B12 - not sure about thyroid meds).

What on earth do people have to do to get try net in this country (don't worry, rhetorical question 😖).

👍

[SeasideSusie Remembering in reply to Foggyme]

Foggyme Can you just confirm the range for FT4, as gabkad has pointed out there may be a typo and the bottom of range might be 9 rather than 19.

[Foggyme in reply to SeasideSusie]

Hi SeasideSuzie. No...no typo from me...letter states range as 19 - 25. Thought I can't guarantee that it's not a typo in the letter.

Awaiting actual copies so will check when they arrive - though I expect this to be really slow.

👍

[SeasideSusie Remembering in reply to Foggyme]

It is a very narrow range compared with what we normally see, mine is 12-22. Possibly a typo in the letter you've received so see what the copy says when it arrives.

If it is a typo, and the range is 9-25 (which seems too wide a range but not impossible) then as gabkad says it is considered normal but it is nearer the lower end.

It would be good to see FT3 result for a better picture, hopefully that has been done.

[Foggyme in reply to SeasideSusie]

Just looked on old paper work and FT3 was stated as 4.5...but no reference range given...so awaiting that...

What would be a good figure for FT3?

And is there anything I can do - without doctors - to raise the FT4 slightly, if needed?

This is such tease - note to self - must read more about thyroid...

👍

[SeasideSusie Remembering in reply to Foggyme]

It's not possible to say what a good result for FT3 is without the range.

For a treated hypo patient, many feel best with FT4 and FT3 in the upper part of their respective ranges and TSH 1 or below. But in someone who is not diagnosed hypothyroid (and maybe isn't) then no-one knows what their 'normal' is because it's never tested when we're well.

[Foggyme in reply to SeasideSusie]

Ah ha, that makes sense.

Guess I'll wait for the lab copies of the results to arrive and then post again....hopefully with reference ranges 😖.

Thanks for your help SeasideSuzie 👍

Here's to wellness...

[SeasideSusie Remembering in reply to Foggyme]

You're welcome. Best to make a new thread when you have all your results as more members will see it.

[Foggyme in reply to SeasideSusie]

Thanks. Will do 👍

[CSmithLadd in reply to SeasideSusie]

Good points, SeasideSusie!

Some changes have happened due to using euthyroid people to discover what actually could be deemed a TSH range in healthy individuals (and therefore where we hypothyroid people want to be). This is how it is slowly but surely getting to be better known that TSH is optimal when near 1.0, and otherwise lower than 2.

The change came about after studies using only euthyroid subjects showed that healthy people's TSH is optimal around 1.0 and when higher than 2, subjects are more likely to develop hypothyroidism in twenty years.

It took a long time for researchers to finally realize that using information gleaned from hypothyroid patients to dictate treatment was in total error. Doing so resulted in the numbers used for "normal" TSH being far too high -- because, as you said, the blood tests of hypothyroid patients were used in those outdated studies.

In 2003, the American Association of Clinical Endocrinologists issued a press release in support of lowering the upper limit of the reference range to TSH level range of 0.3 to 3.0.

(From hypothyroidmom.com/is-your-thyroid-doctor-using-the-old-tsh-lab-standards/):

Until November 2002, doctors had relied on a normal TSH level ranging from 0.5 to 5.0 to diagnose and treat patients with a thyroid disorder who tested outside the boundaries of that range. Now AACE encourages doctors to consider treatment for patients who test outside the boundaries of a narrower margin based on a target TSH level of 0.3 to 3.0. AACE believes the new range will result in proper diagnosis for millions of Americans who suffer from a mild thyroid disorder, but have gone untreated until now."

[silverfox7]

Just to clarify, what are you taking for your thyroid. I'm assuming it is Levo and nothing with T3 in it? Can make a difference as to how results are interpreted. FT3 needs to be at least halfway up tgecrange, better in top third or even top quarter. To work it out quickly take bottom of range from top then easy to divide by two to get half way and add that to bottom of range or divide by 3 or 4 to get top third and top quarter. Best way to read all about your thyroid is to look atctgecThyroid UK site. Loads of info about best way to take it, what to avoid, different symptoms etc and ask if anything you don't follow. Make sure you chase up your results, you have every right to have a copy.

[Foggyme in reply to silverfox7]

Thanks silverfox7. I'm not taking any thyroid meds...advised everything normal at the last endocrinology appointment and discharged....but have since discovered that half the result arn't even in yet - apparently.

I've asked for what they have and also asked for them to chase the missing ones (thyroid antibodies and others).

While I'm waiting, I'll get reading...👍

[silverfox7 in reply to Foggyme]

Good plan!

[posthinking01]

Whats the PAS forum may I ask

[sunny-64 in reply to posthinking01]

Pernicious Anemia society, Posthinking 01:))

[Heloise]

Hi Foggy, so many circumstances can cause your thyroid to put out less hormone than you need and most have nothing to do with the gland itself. The man goes through 24 reasons you can have your problem. There are more of them on you tube but this first one shows how complicated it can be to figure out the cause.

youtube.com/watch?v=nZ_CP7l...(Not working as expected?)

[Foggyme in reply to Heloise]

Thanks Heloise. Will have a watch on the morning when I've got a brain 👍

[Marz]

Did you ever get the remaining test results ? - anti-bodies and the FT3. Also the correct range for the FT4 .... ??

[Foggyme in reply to Marz]

Hi Marz. Yes, end of this week Just gone...it's been a nightmare...only have the thyroid ones...everything else...grief I'm going to have to write aging and ask for the actual lab results...they didn't include any of the reference ranges.

Catch...

TSH 1miu/L (0.3 - 5)

FT4 13 (9 - 25)

FT3 4.5 (3.5 - 6.5)

Parathyroid Hormone 1.8 pmol/L (1.6 - 7.5)

Do you think these are too low in the range? Pituitary implications? Or not?

Thyroid antibodies bloods were ordered and taken but they never came back from the labs....nobody was prepared to chase them.

And the tests were not fasting. So...I'm going to order the whole lot again from Blue Horizon.

Know there lots of cross-over symptoms but my goodness...sometimes I'm soooo cold - temp often as low as 35!

Do you know Marz, the NHS is such hard work...😖.

And thank you for asking about the results...much appreciated.

😄 x

[Marz in reply to Foggyme]

I would wait for the BH ones. Thyroid Profile 11 is the most popular albeit you wont need

the B12 😊

Labs often refuse to test anti-bodies when the TSH is in range.

Strange the TSH is low along with the T4 & T3. Could suggest Central Hypo rather than Primary. Positive anti-bodies could explain more - or not 😴

[Foggyme]

Thanks Marz. Will look for Thyroid profile 11.

And perhaps that's why the anti-bodies didn't arrive back then.

So...FT3 and FT4 are low then (no idea where they should be in the range - thyroid dunce)? Could they be low enough to cause symptoms?

And not sure what central hypo is?

In fact, not sure of very much at the moment am I 🙃🙃

Thanks Marz 👍 X

[Marz in reply to Foggyme]

When I am at the computer I will send you info about ranges etc. Yes your results are low enough to cause symptoms but usually the TSH rises.

thyroiduk.org

Lots of info above including interpretation of test results.

Advisable to have T4 & T3 towards top of range. Am assuming Ferritin is mid range for good conversion of T4 into T3.

[Foggyme in reply to Marz]

Hi Marz. Thanks for the link.

Ferritin's not good...was 14, now up to 47...but struggling to get it up any further. GP thinks it's okay - as usual.

Hey ho... Blue Horizon here I come, then back to the HHS for more battles 😖.

Thanks again 👍

[Marz in reply to Foggyme]

healthunlocked.com/thyroidu...

Some more iron options for you - thanks to Helvella

[Foggyme in reply to Marz]

Thanks Marz. Thanks helvella .

🆒