Thyroid Test Results What Next?

[russdee]

Below are my test results obtained from Medi Checks. My symptoms are weight gain around the middle, fat on back of neck ,tired, often feel sick, muscle aches, high cholesterol, dry brittle nails /dry skin, libido loss, anxiety. I am 61 not on any meds I have never taken HRT. I am currently not taking any meds as I stopped statins and sertraline to see how I would be without them .I had early menopause at 45 my female GP thinks a lot of my symptoms are due to post menopause thought my thyroid was a bit low offered me HRT but warned of Breast Cancer risk. I asked her about a Cortisol Test but was told I would only see what I wanted to see? Thinking of trying to self medicate ?

I would really appreciate any thoughts from others

TSH 1.45 mIU/L

FT4 11.21 pmol/L

TT4 53.4 nmol/L

FT3 3.99 pmol/L

REVERSE T3 13 ng/dL RT3 ratio 19.98

TGAB 11.86 IU/ml TPOAB 8.43 IU/ml

[Clutter]

Russdee,

Can you post the lab ref ranges (the figures in brackets after results)?

[russdee]

YES THE LAB RANGES ARE

TSH 0.270 - 4.200

FT4 12.000 - 22.000

TT4 59.000 -154.000

FT3 3.100 - 6.800

RT3 10.000 -24.000

RT3 RATIO 15.010 - 75.000

TgAB 0.000 -115.000

TpoAb 0.000 - 34.000

Kind Regards Dee

[Clutter in reply to russdee]

Russdee,

TSH 1.45 rules out primary hypothyroidism but FT4 11.21 is below range (12 - 22) so your GP should consider secondary (or central) hypothyroidism. Secondary hypothyroidism is caused by pituitary dysfunction or isolated TSH deficiency. The thyroid gland is usually healthy but incapable of producing T4 and T3 hormone without sufficient TSH to stimulate the thyroid gland.

Secondary hypothyroidism should be referred to endocrinology for investigation and management, not least because other pituitary hormones should be investigated for deficiency.

TgAb and TPO antibodies are negative for autoimmune thyroiditis (Hashimoto's) which rules out damage to the thyroid gland and lends credence to the suspicion of secondary/central hypothyroidism.

[russdee in reply to Clutter]

Thank you Clutter for your reply . Your comments have been most helpful .I will see if she will refer me but am worried that she may say no and then I will panic. Kind regards Dee

[Clutter in reply to russdee]

Russdee,

Refer your GP to NICE recommendations cks.nice.org.uk/hypothyroid...

If you are in England you are entitled to choose which specialist you are referred to. Email [e-mail] for a list of member recommended endos.

[russdee in reply to Clutter]

Dear Clutter

Thank you again I will email Louise however the problem I have is that my NHS Thyroid test comes in at TSH 1.6 NHS lab test range is {0.4 -5mIU/L} and my FT4 is 11pmol/L range is{ 9 -19 pmol/L} making me in the NHS NORMAL boundaries

My tests since 2008 show that I have very consistent Thyroid results the lowest read of FT4 being 10pmol/L and a highest read of TSH being 1.6

It clearly looks like these results are all that my body can come up with! I have only just found these results online through Patient Access. I have already shown my Medichecks result to another GP at same Practice along with the comments that Medichecks Doctor thought that my Pituitary gland may not be working efficiently.I was told by GP not to read too much into the comments and that they{medichecks} were covering their backs.

I do feel that the Nhs do not want to spend the money on testing or referring. I have read that the NHS are not obliged to take on board private testing results. This is why I am worried that they do not have to refer me. I would appreciate your views on this situation.

[Clutter in reply to russdee]

Russdee,

Your GP does not have to accept private blood tests. As your FT4 is within range via your GP results you may have a battle to persuade your GP that secondary hypothyroidism should be investigated and your GP may not be prepared to take action until your FT4 is below range. I can only suggest you see every GP at your practice until you find one who listens.

[Angel_of_the_North]

Sounds like high cortisol (but not necessarily Cushings) possibly stopping proper production of thyroid hormones as your FT3 and Ft4 are much lower than you'd expect with that TSH. Alternatively secondary hypo = pituitary problem

[russdee in reply to Angel_of_the_North]

Thank you Angel of the North for replying to me .My problem is that the results I had were done privately through Medichecks.My NHS tests that I had over the past 8 years have always been either

10 or 11pmol/L the low limit for NHS starts at 9 my TSH has been consistent at 1.45 or 1.6. I think I may have to pay for a cortisol test and see what that says and then ask her if she will refer me or go privately. It really should not be such a battle so draining financially and mentally! Thank you again .

[Angel_of_the_North in reply to russdee]

NHS won't treat cortisol problems unless it is Addisons or Cushings. I fyou are one point away from those, you are normal (as I discovered). I'd try and fight for a referral to an endo on Louise's list on the grounds that it might be secondary/central hypo.

[russdee in reply to Angel_of_the_North]

Thank you kindly for the info I will email Louise for her list.