Help with result please

[Hattie19]

Hello everyone,

Wondered if I could ask for feedback from my very expensive blood test results, done out of desperation as I continue to remain overweight, despite moderate to poor appetite and low intake due to still undiagnosed stomach problems for which I have gone for every test. GP are saying chronic gastritis but I have insisted I go back to a gastroenterologist to be re scoped. I have piled on 2 1/2 stone in the past year and in total 3 3/4. Some of this I am sure is due to antidepressants. My depression is not really better. My fatigue is better but difficult to be sure as my depression seems to make it difficult to tell. Aches and pains better, but have developed carpal tunnel because of weight gain. can’t loose weight despite eating sod all! This alone is depressing me terribly as was originally 10 1/4 and fit and exercised regularly. Going to see endocrinologist Thursday evening so feedback before then would be much appreciated. My T4 has only come up3 points despite being on 100 mg of levothyroxine my T3 doesn’t seem that high??? My reverse T3 seems high. Looks like I’m negative for hashimoto. My vis & mins are not spectacular but they don’t seem that bad either.

I remain fat, no appetite, depressed and close to giving up, thanks in advance for any help.

Sue

Here are my results.

TSH 0.338 (0.270 -4.200)

FT3 - 4.3 (3.1 -6.8)

FT4 - 15.48 (12.0-22)

Total T3 - 1.8 (1.3 -3.1)

Total T4 - 107 (59 -154)

Reverse T3 - 21 (10-24)

TSH Receptor Antibodies - <0.4 (0.0- 0.4)

Thyroid Peroxidase Antibodies - Negative <60

Thyroglobuline 66 Iu/ml normal <280

Folate >40 (3.9 -26.8) they say this excess isn’t harmful but it has prompted me to get go to review this supplement.

B12 -655 (197 -771)

Vit D - 80 - (75 - 200 is optimally replete)

Ferritin - 78 (13 -150)

Magnesium 0.86 (0.70 -1.00)

Zinc - 14.57 (11 -24)

Selenium -1.01 (0.89 - 1.65)

[Clutter]

Hattie19,

TSH is low and FT4 is less than halfway through range so FT3 is low in range too. You could ask endo to increase dose to raise FT4 and FT3 but it will suppress TSH which many are reluctant to have happen.

rT3 21 is fine as it's within range.

Thyroid antibodies are negative for autoimmune thyroiditis Graves and Hashimoto's.

High folate is common in vegetarians and vegans due to the high amount of leafy green veg eaten. If you are supplementing folic acid, methyfolate or B Complex vitamins that will be why it high and you should stop supplementing.

VitD 75 is replete but you may need to supplement 2,000iu daily until April to maintain level. Take vitD 4 hours away from Levothyroxine.

The other vits and minerals are good.

[Hattie19 in reply to Clutter]

Thanks for the reply clutter, I’m grateful. What I don’t understand is why I’m piling on weight so quickly with a low appetite. I’m 14 stone and only 5ft 4. I’ve never been this heavy, it’s deeply distressing. So does the reverse t 3 level indicat that there is not a problem with conversion and why after 11 months on levo and such a suppressed TSH is my t4 and t3 still on the low side. I really hope the ends I’m going to see tomorrow has some answers. I can except that my depression is the primary illness, it’s hard because when I was diagnosed I hoped that thyroid treatment might help stabilise my moods. What I can’t live with is being so obese when I’m not doing anything to cause it. I’ve tried to up my exercise. I can’t really drop my calories as they are already so low because of my strange appetite. Thanks anyway clutter

[Clutter in reply to Hattie19]

Hattie19,

I'm sorry I can't help you with why you've gained weight or why you can't lose it when you're not eating much.

rT3 doesn't have anything to do with conversion. Your FT4 is low in range so FT3 4.3 probably indicates good conversion although you may need higher FT3 to speed up metabolism. Ask your endo whether s/he will add 10mcg T3 to your current Levothyroxine dose.

[Hattie19 in reply to Clutter]

Thanks clutter, I’d try anything, i wonder if endo would allow it with my TSH being so suppressed. Guess I’ll find out tomorrow.

[Kell-E]

Your FT3 is low in range and your RT3 is higher in range. What that says is that your body is converting a larger percentage of T4 into RT3 than is normal. At the very least RT3 is metabolically inactive. There are other theories that it actually slows metabolism. So if you aren't getting anywhere on T4 only, adding T3 has helped many people.

[Hattie19 in reply to Kell-E]

Hi scottbnk, thanks for taking the time to reply to my post. Is it likelythe endo will consider T3 with a TSH that is very suppressed?

[Kell-E in reply to Hattie19]

It is not likely the endo will consider T3 at all if you are in the UK. It won't hurt to ask. But you may find that your only option is to source it yourself, as many on this forum do. Some source T3 and others NDT (desiccated thyroid with a 4:1 T4:T3 ratio)

Maybe your endo will have an open mind. Many do not. I have one in the US that has actually prescribed NDT. My GP thinks it is from the devil. Very strong an opposite opinions.

The low tsh is not harmful in of itself. (despite what you will be told) It is simply a pituitary hormone showing what the body is calling for from your thyroid. If you start taking T3 it will go down even lower. My endo does not even care about my tsh because I'm on NDT.

Let us know how your endo responds.

[Kell-E in reply to Hattie19]

Oh, and I was looking at the other posts. T4 converts to FT3 and RT3, usually at about a 60/40 ratio. Many things can shift the ratio to more RT3. So, you have less FT3 and more RT3. It is a controversial subject, but there are many who believe that RT3 slows metabolism by either occupying T3 receptors or via some unknown cellular mechanism.

Here is a good article...

holtorfmed.com/treating-thy...

[SlowDragon Administrator]

Your FT4 and TT4 are not very high and FT3 and TT3 are too low

You most likely either need more Levo or to add small dose of T3

Dr Toft, past president of the British Thyroid Association and leading endocrinologist, states in Pulse Magazine,

"The appropriate dose of levothyroxine is that which restores euthyroidism and serum TSH to the lower part of the reference range - 0.2-0.5mU/l.

In this case, free thyroxine is likely to be in the upper part of its reference range or even slightly elevated – 18-22pmol/l.

Most patients will feel well in that circumstance. But some need a higher dose of levothyroxine to suppress serum TSH and then the serum-free T4 concentration will be elevated at around 24-28pmol/l.

This 'exogenous subclinical hyperthyroidism' is not dangerous as long as serum T3 is unequivocally normal – that is, serum total around T3 1.7nmol/l (reference range 1.0-2.2nmol/l)."

You can obtain a copy of the articles from Thyroid UK email [e-mail]. print it and highlight question 6 to show your doctor.

Prof Toft - article just published now saying T3 is likely essential for many (or very high FT4)

rcpe.ac.uk/sites/default/fi...

[Hattie19]

Hi, I’ve just tried to email Dionne for copy of pulse article and it’s come back as an invalid email address. Can anyone help me over this issue. Thanks

[milupa]

Hi Hattie19 - here’s a tool to calculate your fT3 to rT3 ratio, with links that explain the result. You need to check the units used in each test.

stopthethyroidmadness.com/r...

Hope that helps!

[magsyh]

If you dont have hashis lets just put the breaks on here! Ive been in the similar boat for about 11 years. I have normal tsh but low t4 and t3. I have been doing battle with docs and endos and they dont have a clue. I was on 25mcg levo only made a slight difference. Got fat, no appetite cant loose weight, anxiety, depression blood sugar too low. If you dont mind me asking, how old are you? If you dont have hashimotos then your thyroid is malfunctioning for a reason. The big thing is your progesterone levels. Your thyroid wont function without descent amounts and you wont produce t4 and t3 without it also not enough thyroid hormone no production of progesterone. That is why women with low thyroid dont ovulate properly, have heavy periods and cant conceive or miscarry or pre eclampsia. Its all lack of progesterone and one causes the other. The other connection is blood sugar. High/low blood sugar, lack of appetite but gaining weight. Diabetes, its progesterone or lack of it! Are you menopausal, premenopausal or a young woman using hormonal birth control, had hysterectomy etc? It all messes with your progesterone levels and docs dismiss it coz they havent a clue xx

[Hattie19 in reply to magsyh]

Hi magsyh, I’m 56, got mire a coil and am on Premarin which is Oestrogen HRT because mirena coil has some progesterone in it. I’m not sure if I am postmenapause as with mirena in you don’t bleed. I want for the mirena coil as all through my adult life I had ver painful period cramps. GP are a little reluctant to take me off HRT because of the worry about my depression which for 3 years has been severe. There are some life events leading to this long bout of depression but I have struggled and am still struggling to recovery. My stress response seems to me to be totally abnormal. I have quite catastrophic over reactions to events that might have previously irritated me. I used to be quite normal before this all started. Quite strong, resilient.

[magsyh in reply to Hattie19]

Oh dear well im hitting 60 still bleeding monthly. Very light thank goodness. I have low progesterone but the problem is docs wont give you progesterone without estrogen. Ive argued with them for years on this one. I stopped heavy periods at 57. The problem is the coil will prevent bleeding and will protect you from endrometrial cancer but its shutting down your thyroid. Giving you the estrogen is putting you at greater risk of breast cancer. Without natural progesterone your depression will be bad. No natural progesterone means the body produces cortisol to cope with stress. The more cortisol yoh produce the more weight you will put on and the more your adrenals will suffer. Progesterone is the calming hormone, lowers anxiety, depression and blood pressure and they have gone and switched off production by putting you on these hormones. I had terrible anxiety and depression. Im still 2 stone over weight but i have lost 10lb. Im no longer depressed and my anxiety has been turned down. My heartrate was at a gallop but that has calmed down too. I had bad pms and back, shoulder and neck pain. I now have all my important minerals and vits at optimum levels just waiting for a blood test after new year to re check my thyroid levels. I had very heavy bleeding, couldn't leave the house and it lasted a month. I also have fibroids which have shrunk to half size. My doc, endo and gynecologist wouldnt listen to me. I refused hrt because i only wanted progesterone. I told them i was already estrogen dominant. They refused to test my hormones so i had it done privately and yes it proved i was. The problem is they only know what they have been told by the drug companies. Give them combined hrt! I had to go it alone as no doc would help me because they had no idea how to treat estrogen dominance. Your estrogen could be low but if your progesterone to e2 ratio is not right they are treating you wrongly. At menopause it should be at least 10:1. As long as you are on chemical hormones you will never over come your depression and once your 5 years on hrt is up they will take away the hrt and replace it with antidepressants. Dont let them do that to you. If you need any help message me xx

[Hattie19 in reply to magsyh]

I’m so sorry to hear about the struggles you had with you health, it sound awful, I think I have always had a tendency toward depression. My first bout was in my early 40s. The difference is I was able to recover and return to normal me. My resiliance would return and my normal personality, albeit with a new awareness of my vulnerability. May I ask you wether you are uk based or us? Also i was lead to believe when I had the medina coil has it has progesterone, albeit synthetic, or have I got that wrong. Thanks for replying, I very grateful. I’m feeling bad about not having responded to all the kind people who have responded but the weight gain has left me with fairly viscous Carpal Tunnel and I’m struggling with all sorts of manual thinks at the moment. I hope to have a steroid injection in the new year

[magsyh in reply to Hattie19]

Im in scotland. The coil is progestin not progesterone. Progestin shuts down your thyroid as does the primarin. So as long as you are on hrt your health problems will not improve. Im using natural progesterone cream and utrogestan to stop the build up of womb lining until my estrogen level drops enough to stop bleeding. By sounds of things you may have had a progesterone problem for a long time. Mine started after my second daughter was born at 33. The problem here is the doctors ignorance. I would suggest you read some of the many articles about progesterone therapy and estrogen dominace. Be aware that some articles refer to progestin as progesterone and visa versa like everything on the internet there are truths and half truths so it can be difficult knowing who to believe but natural is the only safe option xx

[Hidden]

If you have put on a lot of weight especially around your tummy, having insomnia, a round red face,muscle weakness then it could be Cushing's which will affect your thyroid levels as your pituitary may be having problems with producing ACTH. It might be worth raising it with the Endo. he will tell you it's rare, it's not as rare as they believe!!!

[Hattie19 in reply to Hidden]

Hi PaulineS, yes the weight has gone on around my tummy. I have a very fat face because I am so enormous now, but I don’t think it’s round, I have numerous chins 😬 I wouldn’t say my face is red. My muscles are not in great shape as my depression has made me very inert over a long period but I have notice that they are specifically weak. Thanks so much for coming back to me