Help reading required tests to obtain diagnosis - French endocrinologist

Hi

I posted on here a few days ago to say that I have a whole list of hypothyroid problems, low TSH and fT3 and fT4 and a family history of hypothyroidism. However as my results are officially JUST in the normal ranges, the endo has said it's not a thyroid problem. He dismissed secondary hypothyroidism as other hormone levels are 'normal' ... he then wrote to my doctor that I have CFS.

I was very upset about this diagnosis, as I'd like the chronic fatigue to be viewed as one symptom of all of my problems, rather than a definitive diagnosis. I want to investigate other causes first.

Anyway, my family asked me to send my blood tests to our french endocrinologist there. A family member showed him my results. He said he believes I DO have thyroid hormone related problem and wants me to obtain more tests.

He has scribbled down which blood tests he'd like me to get but we can't read it. I wondered if anyone could help read it?

Thanks in advance

[Nanaedake]

The top one looks like TPO, thyroid peroxidase Antibodies. And TRH? Then TSH but I don't understand the meaning of +30 and +60.

Have you had TPO and TgAb tested?

[Hidden in reply to Nanaedake]

Hi! Yes both were fine - thats thyroid perioxidase and anti thyroid globulin right? They were both negative

[Nanaedake in reply to Hidden]

OK. TRH or thyrotropin releasing hormone is a pituitary hormone. Do you think he wants you to get that tested?

[Hidden in reply to Nanaedake]

I wonder if that would help know if it's secondary / central hypothyroidism?

[Nanaedake in reply to Hidden]

I don't know enough about central hypothyroidism. Maybe someone else on here would know?

Maybe post another question specifically about it?

[Clutter in reply to Hidden]

Lulu2017,

If your results showed low-normal TSH with low or low-normal FT4 and FT3 that could indicate central hypothyroidism and TRH is a test to check pituitary/TSH function. I've not heard of anyone having TRH checked outside of endocrinology.

Negative TPO doesn't rule out Hashimoto's. Some people have neg TPO but are positive for thyroglobulin antibodies.

[Hidden]

One might be TSH - thyroid stimulating hormone test? Think he may be thinking is pituitary problem? X

[Hidden]

Thanks for this advice. My TSH was 1.6ish I think and then low fT4 (12.4) and low fT4 (3.4)

If my antibodies are ok and therefore not hashimotos, can it still be secondary hypothyroidism?

Yes, when i asked the endo said I was so rare and basically implied it wasn't worth testing for!

[humanbean]

If you read the description of how the TRH Stimulation test is performed it makes sense of the referall to TRH, TSH, +30, and +60. See this link :

en.wikipedia.org/wiki/TRH_s...

Sadly, I have no idea where you would get that done in the UK.

[humanbean in reply to humanbean]

Also look at Page 18 of this document - the Endocrinology Bible of the Imperial Centre for Endocrinology :

imperialendo.co.uk/Bible201...

[Hidden]

Hi! No no head injury or anything. I've had lots of my symptoms for years. Have had some tough infections including an awful kidney infection - since then my body never quite felt as healthy.

Yes hypothyroidism is on both sides of the family.

So so hard when you're at that low end of 'normal' and 0.something different and you'd be treated!

[Hidden]

Thanks a lot. I guess I'm just anxious about reacting to something if it hasn't officially been prescribed? But have your all been ok?

Would you mind messaging me about where you get it from?

Thank you xxx