I'm new here can anyone help me Please!

[Emmaz3]

Hi Im new here, Please help! - High TGAB, low T3.

Can anyone help me please.. I've been feeling increasingly unwell. I've had fibromyalgia for 7 years, I recently got my thyroid privately tested and it shows that I have the following results..

TPO AB 9.0 ref range (0.00 - 34.00)

TGAB at 160,000 ref range (0.00 - 115.00)

My TSH is 1.65 ref range (0.27-4.20)

Free thyroxine 14 ref range (12.00 - 22.00)

Total T4 92.9 ref range (59.00 - 154.00)

Free T3 4.4 ref range ( 3.10 - 6.80)

Reverse T3 20 ref range ( 10.00 - 24.00)

Reverse T3 ratio 14.32 ref range (15.01 - 75.00)

Active B12 189.4 ref range (25.10 - 165.00) but I have been supplementing as I was previously low.

Folate serum 8.05 ref range (2.91 - 50.00)

Vitamin D 125 ref range (50.00 - 200.00)

Ferritin 57.1 ref range (13.00 - 150.00)

CRP 1.2 ref range (0.00 - 5.00)

My endocrinologist says these results are normal and indicates nothing except that genetically I may be at higher risk of developing a thyroid issue in the future. He is not concerned about my T3 levels and says they are normal but when I Google it says they are not and the lab have flagged them up too.

I also have a thyroid nodule which we screened and apparently also normal, not due to have another scan for 18 months time.

I am on no medication or treatment whatsoever.

Today my eyes are puffed up and my left lid has dropped so looks half shut. I am so fatigued I am struggling to stay awake despite a very heavy nights sleep. I have major brain fog.

I am overweight, my face is puffy, my eyelids are swollen and to me I look unrecognisable.

I keep getting optical aura migraines upon waking, experiencing bouts of racing heart beats, headaches and high blood pressure which my doc says is just anxiety,

I just don't know where if anywhere can I get Help? Xx

[jimh111]

Your fT3 (4.4) is not low but when considered with fT4 (14.0) along with a normal TSH of 1.65 they suggest your 'axis' is underperforming. With low normal fT4 and below average fT3 one would expect the TSH to be higher, especially with elevated antibodies. Unfortunately doctors treat TSH, fT3 and fT4 as if they are independant and of course they are not. I would try very hard to persuade your endocrinologist to give you a trial of levothyroxine (more than 25 mcg) to see how you respond. I suspect you will need some liothyronine (L-T3) also but take one step at a time. Point out that this is ruining your life and a three month trial is a cheap and safe option, it's not acceptible to be dogmatic and leave you to suffer. If you get nowhere you will have to find a better doctor or treat yourself but I'd have one last try with this endocrinologist for now, you may as well be assertive as you have nothing to lose.

[Emmaz3 in reply to jimh111]

Thank you very much for your advice. I am currently awaiting an NHS referral to an endocrinologist but I will certainly try this when I get there. I cannot go on like this. Thank you x

[fibrolinda]

Just a quick check, none of your supplements have biotin in them do they?

[Emmaz3 in reply to fibrolinda]

No they didn't at time if testing or previous but I have just purchased one two days ago which does. Should I not take that?

[SeasideSusie Remembering]

Emmaz3 Lord help us from ignorant endos who don't seem to know much about thyroid disease.

Yes, your results are 'normal' to an extent.

TSH is 1.65 ref range (0.27-4.20) Free thyroxine 14 ref range (12.00 - 22.00) Total T4 92.9 ref range (59.00 - 154.00) Free T3 4.4 ref range ( 3.10 - 6.80)

These are in range, but FT4 is very low in range, as is FT3, not where you'd expect to see them in a healthy person.

Have a look at bestpractice.bmj.com/best-p... then click on Normal TSH - associated with a low FT4 and/or FT3 which says

Normal TSH - associated with a low FT4 and/or FT3

•These results may occur following secondary (central) hypothyroidism, which is associated with pituitary or hypothalamic dysfunction. TSH can be low, normal, or slightly elevated. Evaluation for deficiencies in other pituitary hormones should be obtained before imaging (i.e., pituitary MRI). Hormone tests should include: ACTH with cortisol, FSH, LH, estradiol (female), testosterone (male), prolactin, GH, and (insulin-like growth factor 1 (IGF1). For this condition, thyroid replacement therapy is monitored by checking the levels of FT4 and FT3. [28]

I don't know if your free Ts are low enough to mean this, but it is certainly worth pursuing. You may need to research it and provide some good evidence for your endo to follow this up, most doctors haven't heard of this.

**

TPO AB 9.0 ref range (0.00 - 34.00)

TGAB at 160,000 ref range (0.00 - 115.00)

Your high TG antibodies mean that you are positive for autoimmune thyroid disease aka Hashimoto's which is where antibodies attack the thyroid and gradually destroy it. Dr Toft, past president of the British Thyroid Association and leading endocrinologist, says that where antibodies are persent then treatment with Levothyroxine should be started to 'nip things in the bud'.

The antibody attacks cause fluctuations in symptoms and test results. You can help reduce the antibodies by adopting a strict gluten free diet which has helped many members here. Gluten contains gliadin (a protein) which is thought to trigger autoimmune attacks so eliminating gluten can help reduce these attacks. You don't need to be gluten sensitive or have Coeliac disease for a gluten free diet to help.

Supplementing with selenium l-selenomethionine 200mcg daily can also help reduce the antibodies, as can keeping TSH suppressed.

Gluten/thyroid connection: chriskresser.com/the-gluten...

stopthethyroidmadness.com/h...

stopthethyroidmadness.com/h...

hypothyroidmom.com/hashimot...

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

**

Folate serum 8.05 ref range (2.91 - 50.00)

Folate should be at least half way through it's range, so with that range it needs to be 26.5 plus. You can help raise folate by supplementing with a good B Complex (which you should be taking as your are taking B12 as it balances all the B vitamins). Look at Thorne Basic B, it contains 400mcg methylfolate which will help.

**

Vitamin D 125 ref range (50.00 - 200.00)

This is fine, the Vit D Council recommends a level of 100-150nmol/L.

**

Ferritin 57.1 ref range (13.00 - 150.00)

Ferritin needs to be a minimum of 70 for thyroid hormone to work (our own or replacement), recommended is half way through range and I've seen it said for females it should be 100-130.

You can help raise your level by eating liver regularly, maximum 200g per week due to it's high Vit A content, and including lots of iron rich foods in your diet apjcn.nhri.org.tw/server/in...

[Maxxxx]

HI when you go to the endo appointment you could bring a list of your symptoms and also take your temperature every morning from now until you go. Judging by your other symptoms you could have a low temperature as well. Hopefully your endo will treat your symptoms and not just the numbers.

[Emmaz3 in reply to Maxxxx]

Thanks Maxxx one can live in hope..