Symptoms but blood test normal ranges

[hoalarg]

My partner has symptoms that could be attributed to thyroid issues but her blood tests appear ok. I notice that the ranges of 3 and 4 are lower end of range, but TSH is low. She has stomach issues, especially constipation, she gets a blocked ear sensation intermittently where she feels fogged, she has a low temperature and reynaulds, infertility. Her vitamin D came back as low although she supplements. Any idea what's going on? Thanks.

[shaws Administrator]

Her TSH is not low enough. Should be 1 or lower or suppressed for some people. Doctors unfortunately think a low TSH may cause a heart attack or osteoporosis but these are rumours. Her Free T4 and FT3 are too low and should be towards the upper part of the range.T3 is the active thyroid hormone which is required in all of our receptor cells and enables our metabolism to work normally (heart, brain, everything in fact). Should be towards the top of the range.

Levothyroxine is T4 only (inactive) it's job is to convert to T3 so we have to be on an optimum dose. Some people are poor converters of levothyroxine and can feel better if some T3 (liothyronine) is added. The British Thyroid Association have recently stopped GPs from prescribing which has caused immense worry for those who are well on T3 only or addition of T3.

Also check B12, Vit D, iron, ferritin and folate as deficiences can also cause problems.

Blood tests should be at the very earliest, fasting (you can drink water) and allow a 24 hour gap between last dose of levo and the test and take afterwards.

Levo should be taken on an empty stomach with one full glass of water and wait one hour approx before eating. Food interferes with the uptake.

Always get a print-out for her own records and she can post if there's any query.

[hoalarg in reply to shaws]

Thanks for the message. I wonder if ndt would be best to see if we can raise t3? . I dont think the doctor thinks there's any issue.

[shaws Administrator in reply to hoalarg]

Doctors have been told only to refer to the TSH and it has to reach 10 in the UK before being diagnosed. Some will prescribe if TSH goes over top of range. Before blood tests and levothyroxine were introduced doctors diagnosed upon clinical symptoms alone and prescribed NDT. In the USA you are prescribed if TSH is 3+.

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

[Clutter]

Hoalarg,

Your girlfriend's results are euthyroid (normal) but FT4 and FT3 are low in range. Thyroid antibodies are negative for autoimmune thyroid disease (Hashimoto's).

I recommend she retests in 6 months to check FT4 hasn't dropped below range.

How much vitD is she supplementing? If vitD isn't rising she needs to increase dose.

It may be worth your girlfriend trying a gluten-free trial to see whether constipation improves. If not, she can always resume eating gluten.

[hoalarg in reply to Clutter]

Hi clutter, thanks for the message. Do you think that the t3 level is low enough to try ndt to see if it makes a difference?

[Clutter in reply to hoalarg]

Hoalarg,

Possibly, but if your girlfriend starts self-medicating now she will not get a NHS diagnosis and it is possible that the diagnosis would be secondary hypothyroidism as her TSH is low-normal with low FT4 and FT3.

[hoalarg in reply to Clutter]

How could they diagnose her if they only believe in high TSH?

[Clutter in reply to hoalarg]

Hoalarg,

Primary hypothyroidism is diagnosed by high TSH. Secondary hypothyroidism is diagnosed by low-normal TSH with low FT4.

[Angel_of_the_North]

TSH much lower than you would expect for such low FT4 and FT3 results. Could be secondary hypo, which most GPs aren't trained about. Ask for an endo referral and mention pituitiary and hypothalamus. It might be worth getting the list of decent doctors and endos from [e-mail]

[shaws Administrator]

I am not medically qualified but remained undiagnosed for a long, long time. I was given different diagnoses with treatment - one under anaesthetic and it was a first aider who finally diagnosed me. I was discharged after an overnight stay in the A&E and discharged as 'probably viral with high cholesterol'. high cholesterol is a clinical symptom. I wasn't diagnosed until 7 days later with a TSH of 100. The following link is for info only.....

web.archive.org/web/2010112...

Dr Lowe was an adviser to Thyroiduk.org.uk he was also a scientist/logistician/expert on fibromyalgia. Several of our doctors were against the method they use nowadays and before Dr Skinner died of a stroke being hauled before the GMC for treating patients as he was taught he said it was a parlous situation for many people. All Endocrinologists turned down his invitation to a Conference to discuss this Parlous Situation.

[hoalarg]

Thanks for the replies. Looks like this needs further investigation. Secondary hypothyroidism looks like a good bet as the TSH is low.

[Bluecat101]

This is a common problem l hate to tell you, and l have been battling medics for 40 years and now having make a big fuss as on downhill slide and unable to cope. l am always on the bottom figure of T4 yet all GP will say is you are 'within' normal, many times. What is 'normal' varies with individuals.Different Laboratories also quote different ranges you will find. GPs will insist you are normal or just below. They always conduct one same Basic test; l am not there yet but Endo first asked for expanded Thyroid test which showed l had Low Cortisol - and as it was done thru GP she asked for it to be done again as obviously didnt believe it or Me! Hospital did stupid Synacthen test and the Endo just said: nothing wrong you must have Chronic Fatigue (always over tired and years of extreme female probs) - even after first test showed Low Cortisol. l was so shocked l cdnt speak. Cortisol is produced by Adrenals (which hurt terribly in Reflexology) . Pituitary prompts Hypothalamus which triggers Adrenals - this is what they havent looked at in my case, and its more unusual problem than many thyroid issues. You will have to persevere and keep on till you get result. l wish l had before

Last 20 years l went to a magical Healer who was just bril on female problems, but sadly died 4 yrs ago. He worked on my Pituitary weekly for a year, then l had top ups 4x year every time l was losing energy. l cant find another Healer able to do same, so am stuck with Medics.

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