Blood test results

[Michaeladell]

I was diagnosed as hyperthyroid nearly 4 weeks ago. Been back to the GP today following a second lot of blood tests. I am taking 15mg carbimazole and just reduced propranolol from 120mg to 90mg each day. My T4 was 26.9 two weeks ago and is 21.7 now. My TSH has remained unchanged at less than 0.05. I see an endocrinologist on 27th if this month. Being totally new to this how do those results sound? And what do I need from the endocrinologist? Thanks. Michaela

[humanbean]

You really need the reference ranges to know how good or bad test results are.

My first instinct is to say that you are probably getting "hyper" results from a Hashimoto's attack on your thyroid, because your Free T4 doesn't look that high to me, and your TSH isn't that low to be "true" hyperthyroidism.

If I'm right then you might revert to normal or even become hypo on carbimazole quite quickly - until it happens again.

[humanbean in reply to humanbean]

What you need from your endocrinologist is your Free T3 tested (which may well be refused) and your thyroid antibodies measured. There are different kinds of antibodies. See this link :

labtestsonline.org.uk/under...

You need to know if you have Graves' Disease, and/or Hashimoto's Thyroiditis.

[Michaeladell in reply to humanbean]

Thank you. I’m seeing the endocrinologist privately so I guess I may have more of a chance x

[humanbean in reply to Michaeladell]

It really matters a lot which condition you have.

Self-help measures and "official" treatment are different depending on whether the hyper condition is caused by Graves or by Hashi's or some other problem with the thyroid e.g. hormone-producing nodules or whatever.

There have been people who had Hashi's which would have eventually made them hypo, but they were treated for Graves and had their thyroid destroyed or removed unnecessarily. Another issue with getting it wrong is not knowing whether or not you are at risk of Thyroid Eye Disease.

[Michaeladell in reply to humanbean]

Also I put my TSH in wrong. It’s less than 0.05

[humanbean in reply to Michaeladell]

I hope I haven't been tactless in saying you might not have "true" hyperthyroidism. I'm not trying to minimise the seriousness of your condition or suggest it isn't serious.

What I'm trying to get at with my posts is that hyperthyroidism can have multiple causes.

It could be transient due to Hashimoto's and eventually lead to permanent hypothyroidism. Fluctuating symptoms make life a misery for some but self-help may reduce these symptoms.

It could come and go with episodes of normality or hypothyroidism for unknown reasons.

It could be impossible to control due to hormone secreting nodules in the thyroid.

You could have Graves' Disease, which is incurable.

You might be at risk of Thyroid Eye Disease which is most commonly associated with Graves' Disease (I think).

Unfortunately, doctors know that hyperthyroidism is serious, but some of then seem to have a tendency to lump all causes together and treat them all the same - carbimazole to begin with, and fairly quickly they tell the patient they ought to kill off their thyroid by having radioactive thyroid treatment (a drink). They will tell the patient that they might then become hypothyroid, but not to worry, because all you need to take for that is a little white pill every day for the rest of your life and never have to think about your thyroid again. This might be true for some patients, but seriously - there are lots of people on this forum who have gone through RAI and have regretted it ever after.

I'm also not trying to scare you! If you get the appropriate treatment for the condition you have then great.

[humanbean in reply to humanbean]

There's a saying - when you are in hole, stop digging. I should heed these wise words.

[Michaeladell in reply to humanbean]

Haha it’s fine 😊

[Michaeladell in reply to humanbean]

I don’t think you’re tactless at all. It’s information I am after. Just wanted to correct the TSH levels I’d put on 😊 So that I’m armed with what I need to know when I see the consultant. I get two appointments through my insurance so I want to make the most of them x

[humanbean in reply to Michaeladell]

Okay. The short version :

1) You need to know why you are hyperthyroid.

2) You need to know which thyroid antibodies you have, if any.

3) You need to know your Free T3. Your doctors will tell you that TSH is the most important thing. But patients have found out that the thing which most reflects how they feel is their Free T3 level.

[Michaeladell in reply to humanbean]

Thank you x

[Valarian in reply to Michaeladell]

Humanbean's initial point was good - what you need most from your endo is for them not to pigeonhole you before they've seen all the results !

In addition to FT3 and antibody tests, it's important to discuss your projected long-term treatment plan with the endo, then if anyone later questions this, or tries to change it, you will be in a good position to ask why they are doing this. If you haven't had all the tests done by your first appointment, this may have to wait until the second.

Definitely ask for a copy of test results, including ranges - and note that a private hospital may use a different lab from your GP practice, so the ranges may be different. Not an issue, just something to bear in mind, the ranges and results go together.

Endos in private practice may work for the NHS too. If this is in one of your local hospitals, you may eventually be able to get an NHS referral to the same endo (assuming you are happy with them).

[Michaeladell]

I live near blackpool. Got my referral through the NHS with a choice of 6 hospitals. There were no appointments at all at Blackpool, Fleetwood, Preston, Southport or Ormskirk. I had a choice of one appointment in Chorley on the 29th December. Luckily I’m in Benenden so got a quicker appointment privately. The Endo I’m seeing I think runs clinics in Manchester so maybe it will be him in Chorley. No doubt I’ll find out. Thanks for your help x

[Shirley1968 in reply to Michaeladell]

Hi there can any one tell me what there first appointment was like with the thyroid dred was like