Thyroid UK
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Newbie with hyperthyroidism

Hello, my GP has diagnosed me with hyperthyroidism but I don't have any hyperthyroid symptoms. No sweating, no weight loss, tremor, insomnia, protruding eyes. Mostly symptoms like puffy eyes, weight gain, feeling cold, decreased sweating, pins and needles, tinnitus, sluggish bowels, depression, memory loss. Should I be challenging this diagnosis?

Thank you

TSH 0.89 (0.2 - 4.2)

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Yes, you should. Your TSH isn't even below range! Tell him that if he really thinks you have hyperthyroidism, he should prove it by testing FT4 and FT3, TSI antibodies or TRAB. And, certainly don't start taking any medication for hyperthyroidism without him doing so.

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I agree with Greygoose, Dr should do full thyroid tests and you certainly need FT3 result before accepting any diagnosis of any kind of thyroid condition. FT3 would be well over range if hyperthyroid with TSI or TRAB antibodies.

Besides, tinnitus and pins and needles are possible symptoms of B12 deficiency so you need B12, folate, ferritin and vitamin D testing as well as thyroid antibodies to find out the cause of your symptoms.

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Hello I had thyroid tested a month before and my levels were

TSH 6.5 (0.2 - 4.2)

FT4 14.1 (12 - 22)

FT3 3.3 (3.1 - 6.8)

TPO antibodies 805.5 (<34)

Thanks

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So your Tsh of 6.5 (high) together with FT3 of 3.3, (low) shows hypothyroidism with TPO antibodies consistent with Hashimotos. if you do not have TSI or TRAB antibodies as well then your diagnosis should be Hashimotos alone.

With Hashimotos Tsh levels can be temporarily suppressed due to release of additional thyroid hormone when the autoimmune disease attacks the thyroid, killing off cells and releasing hormone. Then things settle down and you return to hypothyroid state and so on and thyroid volume is gradually reduced as disease progresses, necessitating increased thyroid hormone replacement medication.

It looks like your autoimmune disease, Hashimotos attacked your thyroid and you had a Hashi flare that reduced your TSH level temporarily. You need to retest in a few weeks or if you start getting hypothyroid symptoms and check levels. Start taking Levothyroxine 50mcg when TSH rises. (edited: if already on Levothyroxine as per below post then continue on medication already prescribed, or adjust by 25mcg according to test result).

You also need vitamin levels testing as advised because you will feel unwell, even with Levothyroxine until all are good in range. When you have results, post them here for good advice.

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Was this test also done by your GP ? Just wondering what prompted the test - or were you already being treated for hypOthyroidism ?

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Test done by GP and already being treated for hypothyroidism

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Possibly a misunderstanding of language giving mixed messages by your GP then. If you are already being treated for hypothyroidism then your doctor does not mean you are hyperthyroid. He/she likely means your TSH is low and so you have high thyroid hormone levels at present. What dose of Levothyroxine are you taking?

What action if any has GP proposed?

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I take 175mcg Levo and 2x 5mcg T3 at present

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So, have you increased thyroid meds since the test results that showed a TSH of 6,5?

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No

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OK, well most likely reason for reduction in TSH then is Hashi flare. GP is probs panicked by low TSH value because they don't understand thyroid hormone. If your taking T3, then if well medicated TSH will be low

If FT3 and FT4 are in range, best for FT3 to be in top third of range then no need to worry.

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I think it's worth us all getting into the habit of confirming diagnosis using the terms 'overactive' and 'underactive' - although this wouldn't be the first time a GP has appeared to react to a low TSH and diagnose Graves' even though it wasn't the most likely option !

...although of course, it's difficult to see whether a thyroid that is either suppressed by carbimazole or supplemented by levo/t3 is truly over/under-active or not - and this also seems to cause confusion.

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Well, it's not really even an overactive thyroid if it's a Hashi flare, it's autoimmune activity that emits high hormone levels temporarily. Dying cells releasing hormone I thought. Thyroid UK has good explanation on their website. Patient is still hypothyroid and thyroid is not really overactive, FT3 might be normal, so simple terms can be tricky. Certainly NOT Graves in this case anyway.

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agreed, I was thinking of more of mishearing 'hypo' for 'hyper', and vice versa. Easily done when you are a bit numb from the diagnosis, but not the case here as the GP did say 'Graves'. At least they haven't started Krissie87 on carbi.

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Sounds more like Hashimoto's.

For full evaluation you ideally need TSH, FT4, FT3, TT4, TPO and TG antibodies, plus vitamin D, folate, ferritin and B12 tested

Insist on TSI or TRab testing for Graves.

High TPO and/or high TG antibodies are more common in Hashimoto's (autoimmune hypothyroidism) though can be present in Graves (Autoimmune hyperthyroidism)

It's not unheard of for GP to get muddled up

See if you can get full thyroid and vitamin testing from GP. Unlikely to get FT3

Private tests are available

thyroiduk.org.uk/tuk/testin...

Vitamindtest.org.uk - £28 postal kit

Medichecks Thyroid plus ultra vitamin or Blue Horizon Thyroid plus eleven are the most popular choice. DIY finger prick test or option to pay extra for private blood draw. Both companies often have money off offers.

All thyroid tests should be done as early as possible in morning and fasting and don't take Levo in the 24 hours prior to test, delay and take straight after. This gives highest TSH, lowest FT4 and most consistent results

Link about antibodies

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

Link about thyroid blood tests

thyroiduk.org/tuk/testing/t...

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

thyroiduk.org/tuk/about_the...

If you have Hashimoto's then low vitamin levels are common and may need supplementing

Come back with new post once you get test results

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Hello I had thyroid tested a month before and my levels were

TSH 6.5 (0.2 - 4.2)

FT4 14.1 (12 - 22)

FT3 3.3 (3.1 - 6.8)

TPO antibodies 805.5 (<34)

Thanks

Reply

This is Hashimoto's or autoimmune hypothyroidism.

I would suggest you see a different GP. This is not hyperthyroid.

You need to be started on replacement thyroid hormone called Levothyroxine. Standard starter dose is 50mcgs. Bloods should be retested 6-8 weeks after each dose increase. Dose increases in 25mcg steps until TSH is around one and FT4 towards top of range and FT3 at least half way in range

You will be entitled to free prescriptions.

About 90% of all hypothyroidism in Uk is due to Hashimoto's

Essential to test vitamin D, folate, ferritin and B12.

Extremely likely to be low

Always get actual results and ranges. Post results when you have them, members can advise

Hashimoto's affects the gut and leads to low stomach acid and then low vitamin levels

Low vitamin levels stop Thyroid hormone working

Poor gut function can lead leaky gut (literally holes in gut wall) this can cause food intolerances. Most common by far is gluten

According to Izabella Wentz the Thyroid Pharmacist approx 5% with Hashimoto's are coeliac, but over 80% find gluten free diet helps significantly. Either due to direct gluten intolerance (no test available) or due to leaky gut and gluten causing molecular mimicry (see Amy Myers link)

But don't be surprised that GP or endo never mention gut, gluten or low vitamins. Hashimoto's is very poorly understood

Changing to a strictly gluten free diet may help reduce symptoms, help gut heal and slowly lower TPO antibodies

thyroidpharmacist.com/artic...

thyroidpharmacist.com/artic...

amymyersmd.com/2017/02/3-im...

chriskresser.com/the-gluten...

scdlifestyle.com/2014/08/th...

drknews.com/changing-your-d...

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See discussion higher up, she's taking levo.

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It would be helpful if you put a brief outline in profile or within first post

Otherwise most answers are waste of time

So you are still on 175mcg plus 2x 5mcg T3. Presumably the T3 means you were prescribed by an endocrinologist? Are you still managing to get this on NHS?

GP should not be interfering in your thyroid management. Endocrinologist is the thyroid specialist

Highly likely to have low vitamin levels with Hashimoto's.

T3 can not work well if vitamin levels are too low

Usual advice is to correct these before starting T3 , but endo's rarely consider the gut and low vitamins, even though they are key to getting levels stable

Post your vitamin results when you get them

Are you on strictly gluten free diet? If not you seriously need to try it for 3-6 months, if it helps stick on it

If your FT3 remains low you need increase in T3

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