Hypothyroid?

[Daleema]

Hi, do i have a problem?

Tired all all the time, cold all the time, hair loss, body aches and pains, weight gain, foggy brain.

Blood results

Tsh 1.92 (0.27-4.20)

Ft4 12.1 (12.0-22.00)

Free t3 4.1 (3.10-6.80)

Recently had hysterectomy and im on HRT

[ABro]

I’m not an expert but am hypothyroid and recognise that your t4 needs to be nearer top of the range. You have all the symptoms of hypo. Good luck with treatment

[Daleema in reply to ABro]

Thanks for the reply, my doctor says says they are normal and will not treat my symptoms

[ABro in reply to Daleema]

Suggest a change of doctor as you clearly do need treatment

[Hashi-Monster]

I think the low FT4 is a indicator that something is wrong. My results were similar 18 months ago and I was told my thyroid was normal but I still felt terrible.

Then 6 months ago I was tested again and my TSH was 18.5 and I was diagnosed with Hashimoto.

If I was you I would get a private test from medichecks that also includes the thyroid antibodies.

Menopause can trigger the autoimmune response. The estrogen in HRT also binds the thyroid hormones making them less available to your body’s cells

[Daleema in reply to Hashi-Monster]

My tests were done with medichecks as my doctors wouldn’t test me

THYROGLOBULIN ANTIBODY <10

THYROID PEROXIDASE ANTIBODIES <9.0

[Hashi-Monster in reply to Daleema]

well that’s good news then no hashi

Did you test your vitamins ?

[Daleema in reply to Hashi-Monster]

No I didn’t, which vitamins should I get tested?

[Hashi-Monster in reply to Daleema]

Vitamin D, B12, folic acid and ferritin(iron) are all critical for thyroid and energy

[Hashi-Monster in reply to Hashi-Monster]

How long have you been on the HRT? it might be that your body needs to adjust to the new sex hormone levels

[jimh111]

Daleema, Your fT4 and fT3 are both low normal, it is usual for them to be both mid-interval or at least fT3 around the 5.0 mark. The pituitary responds to both fT3 and fT4, your TSH is only 1.92 which is too low for the combiined effects of your below average fT3 and fT4. All this suggests your pituitary is not secreting sufficient TSH which leads to lower fT3 and fT4 and so hypothyrodism. Doctors tend to treat the TSH, fT3, fT4 blood tests as being independant when in fact they are inter-related.

A low TSH can be caused by strict dieting and depresssion as well as a previous period of hyperthyroidism (which you may not have noticed). As an aside hypothyroidism can cause menstrual problems such as heavy bleeding. Obviously I don't know much about this but it's important for women to be aware of these complications in order to avoid an unnecessary hysterectomy.

How to proceed is difficult. You really need to persuade your doctor that having symptoms and an fT4 of 12.1 is not normal. You could run another thyroid blood test in the hope that the fT4 falls below the lower limit, having the blood taken in the afternoon would increase the chance of this happening, or at least give a lower fT3 and TSH and thus highlight the unusual low TSH, fT3, fT4 pattern. Other options would be to seek an appointment with a different GP or try asking for an endocrinologist appointment.

[greygoose]

If you've recently had a hysterectomy, it might be a good idea to wait a while, let your body recover, and then test again.

[Daleema]

Many thanks for your reply, I’ve had all of these symptoms for many months, it was my hairdresser who actually recommended the test because af my hair loss.

The doctor had only previously tested tft and tsh and that was 18 months ago

I will get it tested again as you recommend

[Marz in reply to Daleema]

Having tagged greygoose she will now see your reply. 😊

[greygoose in reply to Daleema]

Yes, I don't doubt you have had symptoms for many months, and as jimh111 says above, your 'need' for a hysterectomy was possibly due to you having thyroid problems. But, having had a major operation, you do need to give your body time to settle.

He also talks about your pituitary being the cause of your low thyroid, and I agree with him. And, his suggestion to get your next test in the afternoon, is a good one. However, one cannot predict the reaction of your doctor. If your TSH goes very low, he might even be stupid enough to think it's subclinical hyper! lol But, you can but try. Doctors are welded to the TSH and have difficulty seeing beyond it. And the majority of GPs know nothing about the pituitary. So, if you get really drastic results next time, you will have to insist on a referral to an endo who - hopefully! - will know more about it.

[jimh111 in reply to greygoose]

Good point, I forgot that a major truama such as an operation can lower pituitary output for a while. I suspect it hasn't but it makes sense to give at least a month or so.

[greygoose in reply to jimh111]

Indeed it does.

[Daleema]

Many thanks for your replies, I’ll wait for a month and get retested and see what my results are then

[SlowDragon Administrator]

For full Thyroid evaluation you need TSH, FT4, TT4, FT3 plus TPO and TG thyroid antibodies and also very important to test vitamin D, folate, ferritin and B12

Low vitamin levels can cause symptoms in their own right or upset Thyroid

Private tests are available. Thousands on here forced to do this as NHS often refuses to test FT3 or antibodies or vitamins

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. When on Levothyroxine, don't take in the 24 hours prior to test, delay and take straight after. This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip, GP will be unaware)