Does this look like Graves to you?

[Hillz2000]

Hi all

If you read my profile you’ll see I have a long history of not getting a diagnosis (of anything) yet symptomatic for years (symptomatically under-active - seriously there is nothing hyper about my symptoms)....but docs think possibly Graves. Many of you have been very kind and responded a lot to my posts in relation to it being Hashimotos (which my GP confirmed, and since unconfirmed by 2 x NHS Endos) . The most recent Endo is throwing ‘hyper’ and ‘graves’ around yet won’t test the necessary antibodies for it....instead she just redid TSH, T4 & T3 & is sending me for a bone density scan - so seems to me she has made her mind up and is just assessing the level of damage caused so far. I am at my wits end & don’t understand why she won’t actually test appropriately to confirm her diagnosis.

So for those of you with a long history of or experience in hyperactive and Graves diagnosis, from my profile, my symptoms and my recent blood tests what are your thoughts? (Most recent bloods underlined)

Ps. I know all about medichecks and bluehorizon but don’t have the funds to go get private bloods so alas I am at the mercy of the NHS & am trying to educate/arm myself with enough insight to convince them to test me appropriately before throwing out a rash diagnosis.

[Nanaedake]

FT3 has never been elevated above the laboratory range in the test results you have given, indicating that you are not hyperthyroid. However, as you have TPO antibodies it's likely you have Hashimotos thyroiditis which can make your results fluctuate. Without being tested for TSI and TRAB, you can't rule out Graves disease but your doctor is unlikely to refer you to an Endocrinologist unless FT3 was elevated. I'm not sure that TSI and TRAB can be tested in primary care.

You could pay for your own blood tests to rule out Graves disease if you wanted to. Symptoms could be calcium deficiency in your diet or other vitamin deficiencies so your doctor might be wise to send you for a DEXA scan.

[Nanaedake]

Just noticed in your previous post that your calcium was below range. I think you should ask for a referral to an Endocrinologist knowledgeable about parathyroid conditions. YOu need to have PTH (parathyroid hormone) tested and this cannot be done in primary care. Your symptoms are likely to do with calcium homeostasis. A DEXA scan is a good idea but you need to follow up a referral anyway on the basis of low calcium result. Research your Endocrinologist carefully and make sure they have a specialism in parathyroid.

[Angel_of_the_North]

No, it looks like a Hashi hyper swing, if anything. But you can't be sure if you have Graves or not as TSI and TRab antibodies have not been tested. However (although it is impossible to tell without ranges) Free T4 and free T3 look as though they are in the normal ranges, so you might have a pituitary or hypothalamus problem, meaning that TSH will always be low compared to the actual thyroid hormones - either that or you were taking T3 when the test were done.

[Hillz2000 in reply to Angel_of_the_North]

Definitely wasn’t taking any T3 when those bloods were taken. I only took T3 for 3 days last week as an experiment and the bloods were taken 2 weeks before that. I’ve spoken to the Endo about Secondary/Pituitary hypo and she was very dismissive but I will be bringing it up again and again until I’m satisfied she has tested appropriately.