Thyroid UK
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Do I need meds for hypothyroidism

Since my 4 th child was born two years ago I have all the symptoms of the above. I keep putting on weight regardless of cutting back and a x5 a week exercise plan. I teach PE. I’m fatigued, weak, constipated and zero sex drive. None of these were before the birth.

I’ve been to my young doctor who threw antidepressants at me. I didn’t take them. She said my bloods for rufous were low to normal

My last reading in Oct 17 was TSH 1.096, t4 11.46 and t3 1.59

Last week it was TSH 0.93 t4 9.4 and t3 4.9

Can anybody advise. Even though I exhibited all the symptoms and I am really suffering she refuses to help. I’m struggling to take care of my family.

Since August I have been taking bio identical progesterone and dhea as these were found to be rock bottom as were my testosterone levels when I went to a private clinic in desperation.

Thanks for reading.

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Can you add the reference ranges for your results please Anais, as ranges vary from lab to lab results can't be interpreted without them. The only one that we can understand is TSH and that doesn't indicate primary hypothyroidism.

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Thanks for replying Susie. The first October test ranges were TSH 1.096 range 0.27-4.2 t4 11.46 range 15-18 and t3 1.59 range 3.1-6.8

Last weeks results at the doctors lab were TSH 0.92 range 0.40-4.50 mu/L

T4 9.4 range 7.00-17.00pmol/L and t3 4.9 range 3.90-6.90pm/l

Regards

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She said my bloods for rufous were low to normal

Not quite sure what for rufous means (predictive text eh :) ) but I think your young doctor must have skipped the half day spent on thyroid disease!

Let's look at your results

Oct 17

TSH 1.096 (0.27-4.2)

FT4 11.46 (15-18) **

FT3 1.59 (3.1-6.8) **

** It doesn't take a genius to see that these two results are way below range so very far from normal, and as doctors are highly educated, have gone to university and have graduated with a degree, then spent quite a few years training, I sometimes struggle to understand how they fail to miss what some of us less educated people can see is staring us in the face (yes, sorry, I get a bit sarcastic, too much experience of being let down by doctors I'm afraid :( )

Last week

TSH 0.93 (0.27-4.2)

FT4 9.4 (15-18) **

FT3 4.9 (3.1-6.8)

** Again, a below range FT4 although your FT3 is in range (which is a big surprise!).

First thing to do, see another GP about these results, you wont get anywhere with this one so it's not worth wasting your time.

I am not medically trained, and I am not diagnosing, but what could be indicated here is Central Hypothyroidism. This is where the problem lies with the hypothalamus or the pituitary rather than a problem with the thyroid gland. With Central Hypothyroidism the TSH can be low, normal or slightly raised, and the FT4 will be low.

TSH is a pituitary hormone, the pituitary checks to see if there is enough thyroid hormone, if not it sends a message to the thyroid to produce some. That message is TSH (Thyroid Stimulating Hormone). In Primary Hypothyroidism the TSH will be high. If there is enough hormone then there's no need for the pituitary to send the message to the thyroid so TSH remains low.

However, with Central Hypothyroidism the signal isn't getting through for whatever reason. It could be due to a problem with the pituitary (Secondary Hypothyroidism) or the hypothalamus (Tertiary Hypothyroidism).

Your GP can look at BMJ Best Practice for information - here is something you can read without needing to be subscribed bestpractice.bmj.com/topics... and another article which explains it ncbi.nlm.nih.gov/pmc/articl... You could do some more research, print out anything that may help and show your GP.

As Central Hypothyroidism isn't as common as Primary Hypothyroidism it's likely that your GP hasn't come across it before. You may need to be referred to an endocrinologist. If so then please make absolutely sure that it is a thyroid specialist that you see. Most endos are diabetes specialists and know little about the thyroid gland (they like to think they do and very often end up making us much more unwell that we were before seeing them). You can email Dionne at tukadmin@thyroiduk.org for the list of thyroid friendly endos. Then ask on the forum for feedback on any that you can get to. Then if your GP refers you, make sure it is to one recommended here. It's no guarantee that they will understand Central Hypothyroidism but it's better than seeing a diabetes specialist. You could also ask on the forum if anyone has been successful in getting a diagnosis of Central Hypothyroidism, possibly in your area which you'll have to mention of course.

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For full Thyroid evaluation you need TSH, FT4, TT4, FT3 plus TPO and TG thyroid antibodies. Plus vitamin D, folate, ferritin and B12.

Essential to test thyroid antibodies plus vitamins

Private tests are available

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

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 ideally be done as early as possible in morning and fasting. This gives highest TSH and most consistent results. (Patient to patient tip, GP will be unaware)

If antibodies are high this is Hashimoto's, (also known by medics here in UK more commonly as autoimmune thyroid disease).

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

Did you have difficult pregnancy or very heavy bleeding during delivery of any of your children? Look at Sheehan's Syndrome

en.m.wikipedia.org/wiki/She...

TSH is not high, but your FT4 and FT3 are low.

Suggests central hypothyroidism. You could push for referral to pituitary endocrinologist

The fact your sex hormones are low might also suggest pituitary issue

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I would say u need thyroid meds. U have the symptoms of hypo. The thyroid is the engine to ur body and it functions everything from ur head to ur toes. My endo told me that. Doctors dont know it all. Hope u get better.

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