Help interpreting results please.

[Aesm]

Test..... 1/6/18 (Range )........25/7/18..... 12/9/18

FT3 ....2.29 pg/mL (2.2-4.2).....2.63 .....2.21

FT4. .....0.75 ng/dL. (0.8-1.7)....... 0.87. .....1.06

TSH. 2.49 .....mUl/mL. (0.3 3.6)......3.25......0.89

Also on 12/9/18 antibody tests

TPO Ab. 88.74. IU/mL (1.0-16.0)

TG Ab 93.26 IU /mL (5.0-100.0)

I started on levothyroxine after the first set of results and following the second was increased to 75mg (just for interest....they prescribe it in liquid form here in Italy where I live permanently).

Do the latest set of reults show that I need to increase my does again? Does it indicate Hashimotos? Does it show poor conversion? Central/secondary?

I am so confused and my doctor does not seem to know an awful lot about thyroid disease..... although he is open to discussion.

I would be grateful for any comments and suggestions. Thank you.

[greygoose]

You certainly need an increase in dose. Your FT3 is very low. But, you won't know for sure if you have a conversion problem until your TSH gets down to one. As for Central hypo, it does look rather like that, your TSH wasn't very high at its highest. So, how did you get diagnosed with a TSH of only 2.49? Did you have lots of symptoms? Or was it due to the high antibodies? Because, yes, you do have Hashi's.

[Aesm in reply to greygoose]

Thank you for your reply grey goose. My last TSH is below 1 at O.89.

I had been having lots of problems which I put down to menopause.... I’m 56y!

I had a benign tumor removed from the left side of my neck 4 years ago and when they did a PET scan at the time they said watch the thyroid but then I moved to Italy and forgot all about it until I felt particularly unwell earlier this year and subsequently asked the doctor for thyroid testing... no trouble here getting FT3 and FT4 testa. I guess in the U.K looking on this site, they would have just done TSH and said no problem. I am booked in for a neck ultrasound for the first week of October. Many years ago I had a MRI brain scan ,and a microadenoma was incidentally noted on my pituitary gland. Maybe I should get this rechecked too?

[greygoose in reply to Aesm]

Well, it warms my heart to know that in Italy, they do have an ounce of common sense! You're right, in the UK, they would have only tested the TSH and said it's 'fine'. And, it's getting more and more like that here in France, from what I've heard - didn't use to be.

So, you got diagnosed, now you just need someone who knows how to treat you! Your TSH should come down a bit, and your FT3 come up a bit for you to feel well. So, you do need an increase in dose. And, it would be a good idea if you could get that brain scan to see what's going on with your pituitary. Because, the problem is that the pituitary doesn't just make TSH, it makes lots of other hormones, as well. And they could also be low. So, they do need testing, too.

[Aesm in reply to greygoose]

Thankyou grey goose, that’s really useful.

[Aesm in reply to greygoose]

Just to say thanks for your kind advice. I saw the doctor, who really isn’t thyroid aware.... he said my TSH was a bit low and so he wasn’t happy to increase my levo. He said that yes, I had had Hashimotos (but not necessarily still had) . He said he would expect my TSH to be high if I was hypothyroid, and he didn’t seem to understand that my FT4 and especially FT3 was still too low, he was just focusing on the TSH... anyway due to this forum I had the courage to push him and he did indeed increase my dose to 100mcg. I am having a thyroid ultrasound in the first week of October. I didn’t push him for a pituitary scan at this time as I think it may have been a step too far. On the way out I apologized for being a bit pushy.... he said it was actually quite refreshing for a patient to be aware of their own health issues.! ( I should say that I used to be a midwife so I am quite medically aware and can be a bit pushy when it comes to medical stuff... but it’s difficult in a foreign language... I’m not great at Italian.... the doctor speak a bit of English so between us we just about manage!) Anyway thanks again for your help..... watch this space!

[greygoose in reply to Aesm]

If a few more patients got pushy, and medically aware, we might not be in the state we are now! It's really time doctors realised they aren't god, and that patients have rights. Your doctor sounds like a nice man. And, of course, he would have learnt in med school that the TSH was all that counted. But the only way you would no-longer have Hashi's is if your thyroid is now completely burnt out. The scan will show that. Let us know how you get on.

[Aesm in reply to greygoose]

Hi again. ok... so I went and have the thyroid scan. It shows multiple nodules...in excess of 15 mainly on my right lobe and a cyst on the left node. Also evidence of inflammation due to swollen lymph nodes. Are you able to give advice on the next course of action.. if any? I have to take the results to discuss with my GP.. should I be asked to be referred to an endo specialist, or for a biopsy? I am now on 100mcg levo (liquid)’ still not feeling well. Also I have terrible dry, sore skin on my face , particularly around my mouth and eye lids and a lot of puffiness under my eyes. I also have rosacea, I wake up looking like I’ve done ten rounds with Mike Tyson! Is this related do you think.? ......thanks.

[greygoose in reply to Aesm]

Nodules are not a problem unless they are larger than a certain size (not sure how big they have to be to warrant a biopsy). Almost everyone has nodules, whether they have a thyroid problem or not. But, you're especially likely to have them if you have Hashi's. They would tell you in their report if you need a biopsy.

Not so sure about the cyst. If that gets too big it could impair your breathing, but cysts are normally benign, and hypos are particularly prone to cysts - I have one on my brain! I don't know anything about lymph nodes.

Rosacea can be a symptom of hypo, and you're are under-medicated, so not surprising if you still have symptoms. What you need to ask for is an increase in dose.

[Aesm in reply to greygoose]

Thankyou. Your advice is reassuring. I’ll see what the doctor says. 😎

[greygoose in reply to Aesm]

You're welcome. But don't be surprised if he tells you're just 'fine'.