Medichecks results, could someone please take a look? Thanks

[Vicm78]

Hi

I posted a little while ago to say my FT4 was low but TSH normal. Endo and GP didn't seem to think that the low FT4 was a problem. I was advised on here to get tested through Medichecks. Medichecks say that although my FT4 is low it wouldn't cause any of my symptoms especially as my TSH is in normal range. Is this correct? Here are my results. I would welcome your thoughts:

TSH 2.31 Range 0.27-4.2 mIU/L

FT4 11.9 Range 12-22 pmol/l

T4 Total Thyroxine 71 Range 59-104 nmol/L

FT3 4.5 Range 3.1-6.8 pmol/L

Thyroglobulin Antibody <10 Range 0-115 IU/ml

Thyroid peroxidase Antibodies 11.7 Range 0-34 IU/ml

Not really sure what most of this means or where to go next with this and would welcome support please xx Thanks

[marsaday]

Thyroid levels are lower, but you are converting ok. It would be nice to see the Ft3 in the 5's however.

You don't have many antibodies, so you can rule out hashi's.

For me this is classic lower thyroid output which starts in all humans. It just depends on your age when it starts. Typically this happens when we get older, so in the 50/60's. If it happens when younger the docs will say you are fine, but really you have early onset of a failing thyroid.

I doubt anyone will treat you, so this is where we look at self treatment.

I suppose you have many symptoms, but the docs will just ignore this and it can go on for years.

I had pretty much the same bloods for TSH and FT4 aged 21. I was fit and healthy, but i was so ill. For 16 years i endured poor health until i self treated with T4. Things improved pretty much straight away. I just wish i had tried 25mcg T4 aged 21. I wouldn't have suffered as much as i did.

I would be looking to rial some T4 starting with 25mcg. Then get blood tested. IT might be that a small 50mcg dose is all you need to keep your levels topped up.

[Vicm78 in reply to marsaday]

Thank you for your reply. So the lower Free T4 could in fact still be making me feel rubbish?

How do you go about self medicating? Is it safe to do?

[marsaday in reply to Vicm78]

Yes low T4 is the same as having low petrol in your cars tank. You want to try seeing what a little T4 feels like over a few weeks. It will not damage your thyroid and you can stop no problem if you don't notice anything.

You would need to source some on the net. It is thyroxine you need and there are different brands, levothyroxine is one.

Ideally you would get the NHS to prescribe for you on a trial basis, but i think this is really hard to get, so most people have no option but to self treat. Maybe if you spoke to the GP about doing a trial from the internet, he/she may agree to do it for you.

I self trialled, got better and stopped and got ill again. So i started on T4 again and then i went to the endo and said look at what has happened and he agreed i needed thyroid meds. This was with a TSH of 3.7 and Ft4 12 (10-22). If i hadn't done the trial myself i would have no proof i needed the meds. I now get treatment on the NHS.

You will also need to look into your vitamins and mineral levels as these want to be in good order. There is lots of info on the ukthyroid website about the areas you need to top up.

[Vicm78 in reply to marsaday]

Thanks that is very clear and useful information. I have terrible fatigue, headaches, dizziness when I stand, Ménière's disease (tinnitus), awful emotional reactions to ovulation and menstruation and I'm currently signed off with anxiety and panic attacks.

If it makes me feel better to try medication then it would be fantastic! I'll discuss with my GP.

Thanks again.

[SlowDragon Ambassador in reply to Vicm78]

Before you consider self treatment

Get your vitamin D, folate, ferritin and B12 tested.

Medichecks do this if GP won't

Low vitamins are linked to low thyroid, but need supplementing first to see if Thyroid will pick up.

Low vitamin levels stop Thyroid hormones working

Low B12 causes tinnitus and balance issues

b12deficiency.info/signs-an...

Print this list of symptoms off, tick all that apply and take to GP

thyroiduk.org/tuk/about_the...

See Box 1

Some possible causes of persistent symptoms in euthyroid patients on L-T4

onlinelibrary.wiley.com/doi...

[marsaday]

Sounds like all the classic symptoms of low thyroid hormones. But the GP's never see this and give you antidepressants. This happened to me for 16 yrs. I was ill all the time. I had a little more energy but was basically ill 24/7. As soon as i took thyroid meds i got better and stopped the antiD tablet straight away. I was never depressed and always told the doctors this, but this is all they could offer. If only i had had these forums back in the early 90's to help me.

[Clutter]

Vicm78,

Your GP and endo are wrong. FT4 below range is a problem. It means you are hypothyroid. TSH would be high with primary hypothyroidism but secondary/central hypothyroidism insufficient production of bioactive TSH due to a pituitary or hypothalamic disorder means the TSH doesn't rise enough to stimulate the production of T4. Treatment is Levothyroxine to replace low T4 but secondary/central hypothyroidism is managed in endocrinology because investigation should be made to check sex and growth hormone deficiencies are not also deficient.

Thyroid antibodies are negative for autoimmune thyroiditis (Hashimoto's).

You should go back to your GP and ask for secondary/central hypothyroidism to be considered and for referral to a consultant endocrinologist, preferably not the ignoramus you've already seen.

Show your GP the NICE CKS recommendation which recommends urgent referral to endocrinology when secondary/central hypothyroidism is suspected.

cks.nice.org.uk/hypothyroid...