Thyroid Levels

[Galadriel1]

Hi, I need a little help with my thyroid results. I wanted testing, I just cannot lose weight and have long thought there is an issue. In Dec this was the results:

Serum free triiodothyronine level 4.40 pmol/L [2.63 - 5.7]

Serum free T4 level 13.00 pmol/L [9.01 - 19.05]

THYROID STIMULATING HORM.

Serum TSH level 3.75 mIU/L [0.35 - 4.94]

As you can see no antibodies test so Dr. did these on Mon. Here are results:

ANTI THYROID PEROXIDASE

Anti-Thyroid Microsomal Ab < 0.5 IU/mL

Anti-TPO RESULT Negative

[shaws]

You need more thyroid hormones. Your TSH is too high, should be 1 or below.

web.archive.org/web/2010103...

web.archive.org/web/2010103...

Research has shown that we do best with T4/T3 combination but now they have stopped prescribing T3 and they had a perfect excuse when the supplier multiplied the price astronomically.

[Galadriel1 in reply to shaws]

Thank you shaws , I was told that last year on the B12 forum that my TSH was too high and I should be on treatment, hence me pushing for tests but now this new Dr has done the antibodies test and it came back negative ..... where do I go from here? Do I self treat? I am at present on B12 injections, SI every other day, 5mg Folic Acid daily, B complex, Vit. D(deficient), Vit C (deficient). Begginning to rattle!

[shaws in reply to Galadriel1]

You have to make a decision alone as I cannot advise and many on our forum have been forced to self-medicate and don't look back.

In the UK it must be the only country in the world that insists our TSH must reach 10, (which is 5 points above the top of the range) whereas in other countries if TSH is 3+ they prescribe.

Before the blood tests were brought in we were diagnosed on our clinical symptoms alone and gven NDT. If we improved we were hypo and continued on it and it was adjusted according to symptoms.

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

[Galadriel1 in reply to shaws]

Thank you. I am awaiting an appointment with an Endocrinologist, Dr is keen for me to see him and seems genuinely interested. I will wait on my appointment and see what he says but if he suggests T4 I think I will say no, I can't afford to gain weight and will ask why I can't be prescribed the much more effective T3/T4 or NDT? Is that correct? I can try to gather evidence to give to G.P. who is old school and seems to understand B12 far better than his younger counterparts! He may be likely to listen and prescribe appropriately if he is allowed!

[shaws in reply to Galadriel1]

They definitely wont prescribe NDT I'm sure and if you are in the UK, they have now stopped prescribing T3.

Your GP may have at one time prescribed NDT but he may not go against the guidelines now. (untruths have been told so they could discontinue it).

thyroidscience.com/Criticis...

I doubt many doctors/endos know the cause of weight gain:

first it is a clinical symptom if undiagnosed

second - it can also be due when prescription of levo is too low.

[Galadriel1 in reply to shaws]

Well at the moment, the results are saying 'normal' as far as G.P. is concerned, don't know if Endo will have same view or not.... Upshot is at the moment, I am not being treated at all of course.

[shaws in reply to Galadriel1]

You are not being treated as you are 'normal'

It makes one's head spin when you read comments made by those supposed to be trained. They take no account of symptoms because they know none.

The biggest problem is that doctors have been told we've to remain undiagnosed until the TSH reaches 10.

[Hidden]

Galadriel1 the NHS only test one type of thyroid antibodies so it would help if you had thyroglobulin antibodies tested. Here's more info:

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

[Galadriel1 in reply to Hidden]

Hi Hidden , Dr just did the tests I put in post for antibodies, so I'm guessing I can't have the one you mention on the NHS. I'm not sure whether I should look at private testing of the antibodies you mention, I thought the test by Dr was for all the anti-bodies..... Even if I do the test privately G.P. might not accept the results... Or do I just find best way to treat and see if there are any changes... It's trying to separate all the cross-over symptoms of B12d Vit D deficiency and what may be thyroid lol..... Confused!

[Clutter in reply to Galadriel1]

Galadriel1,

NHS usually tests thyroid peroxidase antibodies but many people are positive for thyroglobulin antibodies which is rarely tested in primary care. NHS doesn't usually diagnose hypothyroidism or treat with Levothyroxine until TSH is over range or FT4 below range even when thyroid antibodies are high.

If you have referral to an endocrinologist it may be best to wait and see whether endo intends to treat you. If s/he does it will be with Levothyroxine as the BTA claim there is a lack of evidence supporting T3+T4 combination therapy and NDT is not licensed for UK use.

[Galadriel1 in reply to Clutter]

Thank you Clutter , having just about got my head around the B12 issue and vit D and got them under control, I am now trying to understand the Thyroid and whether I truly have an issue or not but this and other forums have all said my TSH is high and I need treatment. I used to believe in G.P's ........ but B12 has taught me to not trust a 'normal' result and seek answers from people who know from experience.

[Clutter in reply to Galadriel1]

Galadriel1,

TSH level 3.75 mIU/L [0.35 - 4.94] indicates your thyroid is struggling but most doctors will not commence treatment until TSH is >4.95.

You can, of course, self medicate to see whether symptoms improve as many others have. Three months trial should be long enough for you to tell whether thyroid replacement is helpful. Bear in mind though you will not be able to get a NHS diagnosis at a later date without stopping replacement for several weeks to see whether TSH is over range. You will also need to arrange private thyroid tests to guide your dosing.

[Hidden in reply to Galadriel1]

Galadriel1 it's probable that GPs don't realise that there's more than one type of antibody, remember they're taught to diagnose hypothyroidism by numbers. Personally I think it's helpful to have the full picture, my TPO was below range yet my TGAb (privately tested) was over 300.

I wouldn't worry about a GP accepting results, they know very little about thyroid disorders and are taught that Thyroxine works for everyone. The best thing you can do is to educate yourself, a good start would be reading Dr Durrant-Peatfield's book entitled 'your thyroid and how to keep it healthy'.

Definitely address nutritional deficiencies with good quality supplements, this will make a difference.

NHS treatment of thyroid disorders is woeful where unless your TSH is over 10 then you're not hypothyroid. Many of us have had to go it alone, you'll get good advice on here.