Confused: Hi everyone I was diagnosed with... - Thyroid UK

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Confused

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Hi everyone I was diagnosed with hyperthyroidism two weeks ago.

I was admitted to a and e last week with chest pains heart rate was 127.

Blood tests taken there showed abnormal liver function tests

Also my cholesterol was only 2.9

I'm confused had another blood test in mid July which showed low TSH and high T4 and t3.

All other results were fine and my cholesterol was ,5.2

Just wondered how my liver results and cholesterol could change so much in two weeks.

16 Replies
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SlowDragon
SlowDragonAdministrator

Levels can vary a lot with Graves' disease (hyperthyroid) or with Hashimoto's (hypothyroid)

Both Graves and Hashimoto's are diagnosed by testing thyroid antibodies.

Also important to test vitamin levels too

Do you have any blood test results to add?

What medication are you on?

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

Graves' disease needs a TSI or TRab antibodies tested (not currently available privately)

Private tests are available for all the others. 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. This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip, GP will be unaware)

If TPO and/or TG antibodies are very high this is most likely Hashimoto's, (also known by medics here in UK more commonly as autoimmune thyroid disease). Though these can also be raised with Graves' disease

Link about thyroid blood tests

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

Link about antibodies and Hashimoto's

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

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

List of hypothyroid symptoms

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

Many Graves and Hashimoto's patients find strictly gluten free diet helps

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

chriskresser.com/the-gluten...

thyroidpharmacist.com/artic...

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

Hidden
Hidden
in reply to SlowDragon

Thanks for your comments

My TSH level is 0.01

My T3 free level is 15.1

My free T4 level is 25.2

I have been started on 15 my of carbizamole two weeks ago following further blood test increased to 20 my

Good old NHS consultant endocrinologist appointment urgent do they gave me October 29 a complete joke.

I'm soaked in sweat I can't swallow too well I can't get enough fluids down me and my chest feels as though it's about to burst.

Valarian
Valarian
in reply to Hidden

Were those the thyroid levels when you were first diagnosed, or after your trip to A&E ? Do you have the ranges (typically in brackets next to the result) ?

FT3 and FT4 are definitely elevated, probably the FT3 more so than the FT4. The pescribed dose of carbimazole is a moderate one, but probably in keeping with your thyroid results. the carbimazole suppresses production of new thyroid hormone, but doesn't do anything about whatever is stored, so your body will need to work through this. It can take eight weeks or more before results come into range. At that point, the worst symptoms should go, and you should begin to feel a lot better.

Are you taking any other medication ? if not. it might be worth talking to your GP about some betablockers, which should help with the heart rate. I remember the ultra thisrty stage, I started buying big bags of ice and making myself lots of long,cold, iced drinks.

At least they have started you on carbimazole, so hopefully, by the time you get to see the specialist, your results will be close to the reference range, and the specialist will be able to advise on the next steps. if you saw the specialist now, they would probably advise exactly the same as the GP (in fact, the GP may have discussd your results with them before prescribing the carbimazole).

Sometimes a thryroid condition can escalate very quickly. Tachycardia and low cholesterol levels arent unusual if you're hyper (although most people don't end up in hospital), the liver can also be affected (but Carbimazole can also affect this).

What did the guys in A&E say ? Did they retest your thyroid levels ?

Hidden
Hidden
in reply to Valarian

The lab results are TSH 0.01 lab range 0.4 to 4.9

T4 level 25.2 ab range 9 to 19

T3 level 15.@ lab range 2.6 to 5.7

I'm taking numerous eplipsesy medications I have checked with my neurologist and they have no interaction with the thyroid.

I'm taking atenolol for fast heart and blood pressure I think this is a beta blocker I have been on this for over a year but my heart rate and blood pressure remain high.

I was diagnosed two weeks ago and started on meds ten days ago 15 my a day.

A and e said high heart rate was caused by the thyroid even though I explained I had been on a beta blocker for ages and had never felt chest pains before. They must have contacted their endocrinologist as I had a letter three days letter saying I had to increase to 20 mg a day. I'm seeing you again tomorrow as I feel worse day by day and October 29 appointment seems so far away.

I've had two blood tests in two weeks and results are worsening very worrying

Valarian
Valarian
in reply to Hidden

Rapid heart rate is a common symptom of an overactive thyroid, partly at least because the thyroid is making your whole metabolism run fast. It can be pretty scary, and it might be worth revisiting your GP for a review of your existing meds .

As suggested before, your FT4 isn’t too far above range, but your FT3 is very high, and it’s good that they’ve increased the Carbimazole. As this won’t work on existing thyroid stores, it will take at least three weeks to work through those, and perhaps another five or more for the thyroid levels to drop within range. You don’t need to worry about TSH at this stage - it’s effectively a signalling system telling the thyroid to make more hormone, which clearly you don’t need at the moment. It should bounce back once your thyroid levels have been back within range for a bit.

At some point around then, you will probably begin to feel a lot better, and it quite often happens very suddenly - one day, you’ll just realise that a lot of your symptoms have subsided.

In the meantime, you will probably veer between bursts of energy which leave everyone around you feeling exhausted, and then flopping with exhaustion yourself.

One thing- try to avoid stress. I know this will be easier said than done, but most of us find stress makes things so much worse.

SlowDragon

Graves' disease needs a TSI or TRab antibodies tested (not currently available privately)

Medichecks does this test :

medichecks.com/thyroid-func...

which is a TRAb test according to this page :

btf-thyroid.org/information...

Quote :

The main thyroid antibodies are thyroid peroxidase antibodies (TPOAb), thyroglobulin antibodies (TgAb), and thyroid stimulating hormone receptor antibodies (TSHR Ab formerly known as TRAb).

SlowDragon
SlowDragonAdministrator
in reply to humanbean

Wow, how Interesting......that's very very useful info for many Graves patients

Hidden
Hidden
in reply to SlowDragon

How do you mean?

SlowDragon
SlowDragonAdministrator
in reply to Hidden

We see many patients on here who's GP or endo "assume" high FT4 and/or high FT3 thyroid blood test means they have Graves' disease (over active)

Even if main symptoms are suggesting hypothyroid

But early stage Hashimoto's (under active) can cause high FT4/FT3 blood tests

Testing TRab antibodies for Graves' disease is extremely useful

Like many thyroid tests, many patients just can't get full testing on NHS

Valarian
Valarian
in reply to SlowDragon

The NICE Clinical Knowledge Summary I posted the other day definitely suggests TRAb tests should be done as part of secondary care.

If hyperthyroid people aren’t being offered this test (except perhaps where other thyroid tests, eg atom investigate nodules) are being done first, they could point their endos at that site.

Hidden
Hidden

I'm seeing you tomorrow to see what else he can do I can't really wait till Oct 29 to see endocrinologist.

I'm getting worse each day do you think it would be worth getting a further blood test tomorrow

Valarian
Valarian
in reply to Hidden

In the initial stages, testing is normally recommended every four to six weeks - it does take a while for the levels to begin coming down. If you feel worse, it might be worth asking for the next test to be brought forward, in case your current dose isn’t enough to get things under control. A starting dose of 40mg/day isn’t uncommon, and some people here started on 60, although generally these doses have been given to people with higher thyroid levels than those from your recent test. (and you don’t want to be taking more Carbimazole than you need , because of potential side effects).

The thing causing you most concern at the moment seems to be the impact on your heart, so it’s definitely worth seeing whether anything can be done to relieve this.

The symptoms of being hyper/having Graves’ are real, and can be extremely scary. It doesn’t help either, that one of the symptoms is increased anxiety . Don’t think for a second that I’m saying you’re worrying about nothing, because I’m not - I’ve got Graves’, and can remember what it’s like to have a thumping heart rate, muscles that refuse to work etc etc, all of which can be very frightening.

The good news is, there are a lot of us here who have come through the other side, and are now (fingers crossed) on the way to recovery ! Hopefully, you’ll soon be joining us.

Hidden
Hidden
in reply to Valarian

Hi again want to doctors this morning he's going to try and bring my appointment forward from October 29. He's not really interested until I have seen the consultant. My body was 162/99 and my heartbeat was 102. I'm having an ECG tomorrow. He weighed me I have lost over a stone in a month. Good job I'm not a thin guy.

Valarian
Valarian
in reply to Hidden

GPs don't have much to do with Graves', as it is usually referred to a specialist. The weightloss isn't unusual - mainly due to your metabolism running fast, so needing more food. Just be warned, most of us put the weight back on pretty quickly as our thyroid levels come down !

Hidden
Hidden
in reply to Valarian

Weight loss is fine. The thing that drives me mad us the sweating and the constant thirst . Gp promised me ECG yesterday or today nothing yet. He mentioned if I got sore throat it can be dangerous

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