Hypo symptoms but tests are normal

[CuriousGuy1]

Hello, I recently got my blood results and my TSH was 0.93 mIU/L and the reference range was 0.3-5.00 mIU/L. The Free T4 was 18.1 pmol/L and the reference range was 9.0-19.1. These tests say that my thyroid is normal but I have so many hypo symptoms, I have pressure on my neck and chest, I can’t wear anything around my neck as when I do it’s like there is a mild burning, whenever I drink water my neck has these sensations like I can feel the blood rushing in it, low energy, depressed, lack of sweat. Is there anyway I could still have hypo even though my TSH is low and the Free T4 is high? Thank you.

[Marz]

Have you been tested for Hashimotos ?

[CuriousGuy1 in reply to Marz]

Hello. No it has not been. Just the two tests , but my neck feels like it’s burning to be honest. Can you have normal thyroid results and have hashimotos?

[Marz in reply to CuriousGuy1]

Yes you can - I did. TFT's in range - anti-bodies TPO and Tg were HIGH ...

[CuriousGuy1 in reply to Marz]

Oh really? To be honest I’m not too familiar with hashimotos, what happens if you have high TPO and TG?

[Marz in reply to CuriousGuy1]

You have Hashimotos ! - Auto-immune Thyroid. There are almost 3000 posts under the heading TOPICS to the right of this post if you are on a PC. If not then scroll down ... and down ... until you come to same heading where you will find HASHIMOTOS. So lots of reading !

[CuriousGuy1 in reply to Marz]

Thank you very much.

[Marz in reply to CuriousGuy1]

You may need to have Private Testing as the NHS only test one of the anti-bodies - TPO and rarely acknowledge Hashimotos and yet it is the most common thyroid problem globally. Feeling uncomfortable could mean your thyroid is inflamed - which happens with Hashi's.

[CuriousGuy1 in reply to Marz]

I see. I will look into these tests so and get them done, is neck pressure and tightness something in Hashimotos?

[Marz in reply to CuriousGuy1]

It is possibly connected to inflammation which can come along with hashimotos. Inflammation causes swelling of the thyroid which in turn creates pressure. There are lots of websites dealing with Hashimotos - also the main website of this Forum - see below ...

thyroiduk.org

[CuriousGuy1 in reply to Marz]

My CRP was 4 mg/L and the reference range was 0-5.00 mg/L. I will look at that.

[sunsetalley]

Your level of Free T3 must be tested aswell, you might have conversion problem...

[CuriousGuy1 in reply to sunsetalley]

Can you tell me more please?

[sunsetalley in reply to CuriousGuy1]

T4 is the inactive thyroid hormone so your body has to convert it to t3 which is the active thyroid hormone that cells of body use it as energy...but some people can't convert T4 to T3 and despite taking thyroid meds they still have all symptoms of hypothyroidism...

[CuriousGuy1 in reply to sunsetalley]

And can you have a low TSH and high enough T4 and still have this conversion issue ?

[sunsetalley in reply to CuriousGuy1]

Unfortunately I don't know much about TSH levels when someone can't convert properly, but having high levels of T4 doesn't mean you're getting optimal treatment...

[CuriousGuy1 in reply to sunsetalley]

I’m in not treatment. But my TSH was low and T4 was in the normal to high range.

[sunsetalley in reply to CuriousGuy1]

Having high levels of thyroid hormones with symptoms of hypothyroidism might be due to autoimmune thyroidits, when immune system attacks thyroid cells, too much thyroid hormone releases into bloodstream...as Marz said you might have hashimotos...

[Angel_of_the_North in reply to CuriousGuy1]

Yes, definitely.

[CuriousGuy1 in reply to Angel_of_the_North]

So I can have low TSH and high but normal T4 and still have a conversion issue that causes hypo?

[Angel_of_the_North in reply to CuriousGuy1]

Yes, it's very common. Poor conversion can be cause by genetic defects in the DIO2 gene, or by less than optimal co-factors (like B12 and folate). High T4 can be converting to rT3 instead of T3, you can't tell without a free T3 test. Low t3 (for the individual) is what causes symptoms. Once on meds, TSH isn't a good guide to thyroid status - it assume that your pituitary and hypothalamus are working in a textbook-perfect way for a healthy person (which they usually aren't). So some people on levo need over range ft4 and suppressed TSH in order to make enough ft3 to feel ok.

[CuriousGuy1 in reply to Angel_of_the_North]

Well I am a 21 year old male, but my sister has had a goiter in the past. My B12 is very high and folate is normal. I will get the T3 and TPO and TgA checked.

[greygoose]

All this was explained to you in your last two posts. Did you not understand the explanations?

[CuriousGuy1 in reply to greygoose]

Not entirely, I’m new to this and will probably ask some stupid questions. Sorry.

[greygoose in reply to CuriousGuy1]

Not stupid questions, just the same questions. If you don't understand, say so.

[CuriousGuy1 in reply to greygoose]

Cheers. Being honest I still don’t understand entirely but gradually am. Thanks.

[greygoose in reply to CuriousGuy1]

Good.

[CuriousGuy1]

Thank you