HELP NEEDED PLEASE

[DawnieA]

HELP....blood results totally up the swanny at the mo TSH 150 ((0.25-5) off the scale), T4 30 (9-22), (repeat bloods have shown the same results) I have hashimotos but antibodies negative (rare but can happen), woke up with the most puffiest eye bags I’ve ever seen. My consultant is aware of blood results and speaking to a professor for his opinion. I’m just aware that with results like mine, I could end up very ill.....

[jimh111]

Your consultant should also have checked your fT3. They should also check your selenium level as low selenium can cause these sort of results.

How are your symptoms? Are you OK on the whole? A most likely reason for your 'high' TSH is antibody interference with the TSH assay. It happens and when a different assay is used you get a correct result. They can't trust this TSH result until an assay interference problem has been ruled out.

What sort of 'consultant' is this? They don't seem very knowledgable.

[DawnieA in reply to jimh111]

Hi, thanks for reply. My T3 is low at 2.5. They mentioned assay interference which is why they repeated the bloods. I had bloods done at my local GPS too which were the same. Basically had 3 blood tests in a week. My TSH has been 149, day after was 94, then off the scale and higher than 150 the day after. My T4 Started off at 64 😳, then 9, now 29. The changes in 3 days is odd. My consultant is based at Christie’s in Manchester, who have a specialist endocrine unit. My antibodies are always negative but have been redone this week. In the 23 years of been UA my bloods have never been stable.

[jimh111 in reply to DawnieA]

Are you saying your fT4 was 64, 9, 29 within a few days? This can't happen, the assays would be wrong, although it is usually TSH assays that go wrong I think.

[DawnieA in reply to jimh111]

Yes, these are the results from 3 days last week 😳

[jimh111 in reply to DawnieA]

Definitely assay error, your fT4 can't vary this much over a few days. Diogenes is an expert in this field and may be able to advise.

[DawnieA in reply to jimh111]

Been thick now, but what or who is Diogenes?

[jimh111 in reply to DawnieA]

He is someone who is on this forum, he has great expertise in blood tests. I'm hoping by quoting his name he gets an automatic prompt.

[DawnieA in reply to jimh111]

Thank you x

[helvella Administrator Thyroid UK in reply to jimh111]

Mentioning a member name does NOT prompt.

You need to type the person's name prefixed by @ - as in @diogenes - AND select the name from the list displayed.

diogenes

[Angel_of_the_North in reply to DawnieA]

Are you taking a Vitmain supplement containing biotin? That could invalidate the results

[diogenes Remembering in reply to DawnieA]

I think this wild swinging of numbers means the assays are compromised. Patients on T4 can produce autoantibodies that will react with the essential ingredients of the assay for FT4 and will give false high results. These antiboodies can come and go over a short period so sometimes they are there and interfere and sometimes not. Given you are taking your T4 religiously, then the TSH test is also interfered with by antibodies to the test ingredients. Both tests should be done by a different method.

[DawnieA in reply to diogenes]

I had a thyroid loading test yesterday and samples of the blood taken are been sent to 3 different hospitals. Will be interesting 😳

[DawnieA in reply to jimh111]

As for how I’m feeling, my eyes are really puffy today, Im aching, and feel like I have no energy even tho I slept for 12 hours solid last night.

[SlowDragon Administrator]

Are you strictly gluten free?

What about vitamin D, folate, ferritin and B12.

What supplements do you take

Have you considered or tried T3 or NDT

[DawnieA in reply to SlowDragon]

Sure I replied to this earlier but can’t see my reply, tried both T3 and NDT with no difference

[greygoose]

Do you take any biotin?

[DawnieA in reply to greygoose]

Only take Vit D and folate as prescribed

[greygoose in reply to DawnieA]

OK

[helvella Administrator Thyroid UK]

DawnieA,

Could you clarify a couple of points to help us to help you? (If we can!)

Were all the lab tests conducted by the same laboratory?

When you say but antibodies negative - do you mean Thyroid Peroxidase antibodies, Thyroglobulin antibodies, both, or any others?

Have you ever been tested for antibodies to TSH itself?

[DawnieA in reply to helvella]

Ok, I had my routine bloods on 28/11/17 at my endos at Christies

TSH: 0.26 mU/L

Free T4: 63.4 pmol/L (10 - 22)

Free T3: 4.6 pmol/L (3.5 - 6.5)

20/12/17 - re tested at local hospital due to previous results for free T4 being very high, these were relatively normal considering previous result but GP wanted them done again

TSH - 3.33

Free T4 - 19.3

Free T3 - 3.1

8/1/2018 - done at local blood clinic, but tested at Local hospital

TSH - 149 (0.25 - 5)

T4 - 9 (9 - 22)

T3 not tested

Another retest was requested

9/1/2018 done at Chorley hospital

TSH - 94.80

T4 - 8.9

T3 not tested

My consultant thought there was assay interference at local lab so requested bloods done back at Christie’s (Last bloods done there were on 28/11/17)

11/1/18 - done at Christie’s

TSH - 150 + off the scale!! I was told their scale only goes up to 150 and my result was higher

T4 - 29.5 (9-22)

T3 - 2.3 (3.5 - 6.5)

When I asked about antibodies I was told both TPO and thyroglobulin both negative.

[helvella Administrator Thyroid UK in reply to DawnieA]

DawnieA,

Re-reading this, I think we need further clarification!

In any test, did a single draw of blood go to different labs? (Obviously, I mean separate tubes, but actually taken at the same time.) That is the classic way of trying to accurately identify interference. Although the results are still difficult to understand and explain, there is always the possibility that the actual hormone levels are changing substantially.

[DawnieA in reply to helvella]

Hi, yes, in yesterday’s test, the bloods are going to 3 separate labs 😀

[helvella Administrator Thyroid UK in reply to DawnieA]

DawnieA,

Good-ho - look forward to the results!

[DawnieA in reply to helvella]

Me too lol x

[DawnieA in reply to helvella]

I did also ask about thyroid hormone resistance syndrome

[linda96]

Has any pituitary testing been done?

[DawnieA in reply to linda96]

Not that I know of, what should I ask for?