Possible to be hypothyroid with low TSH and high Free Thyroxine?

[DaveT81]

Just a quick question - is it possible to be hypo with low TSH and high/normal free thyroxine? I've posted on here before, and read a few pieces and articles on Thyroid UK, amongst other things but I'm finding a lot of conflicting information.

Results: TSH - 1.14 (mIU/L 0.27 - 4.20

)

T4 - 17.100 (pmol/L 12.00 - 22.00

)

FREE T3 - 5.68 (pmol/L 3.10 - 6.80)

Active B12 - 75.500 (pmol/L 25.10 - 165.00)

Folate (Serum) - 6.95 (ug/L 2.91 - 50.00)

Vitamin D - 64.4 (nmol/L 50.00 - 200.00

I gave up on my NHS GP and saw a private one and, although many of my results are 'normal' or at least in normal range, he wanted to try treatment anyway as I'm displaying so many of the symptoms. I've attached a PDF of my symptoms from Thyroid UK, and will add gastro issues and a new-found intolerance to certain types of foods so I'm currently gluten free.

GP gave me has me on Levo 50mg a day, vit D and folate. He also prescribed omeprazole for the reflux I'm suffering but I'm aware this can affect uptake of Levo so I'm reducing as much as possible.

Thanks

[look_at_the_big_picture]

Folate and Vit D seem rather on the low end.

Have you done an adrenal saliva profile? To see what your cortisol levels are like over a 24 hr period?

There is the potential for a resistance issue at the cellular level.

I don't have knowledge of omeprazole so can't comment on that. There is a connection between acid reflux and hypothyroidism.

Dr P told me to switch to T3 only due to a resistance issue. If you don't get on with a higher dose of T4 meds; consider a switch to try NDT or T3 only perhaps?

I'm not medically trained and it is all very complicated due to us all being individuals with so many variables involved for all of us.

What is your gut feeling regarding your health and what you thing you should do?

[DaveT81 in reply to look_at_the_big_picture]

I have not done the saliva profile, no. I may suggest this next time I see my Dr. Actually, I'll see if this is something MediChecks do and get a full profile done at the same time. He discussed this with me, but to be honest a lot of it went in one ear and out the other. Not due to a lack of understanding, but I'm suffering quite a lot at the moment so memory is a bit of an issue as well!

I imagine his plan will be to move me up through the increased doses, then possibly try T3 if there's no improvement.

I'm not too sure. I'm leaning toward thyroid not being the issue but I'm also not medically trained, and although many people are suggesting that's not the issue (due to my results) I seem to tick a lot of boxes and, failing that, not sure what else it could be! My private doc also diagnosed autoimmune disorder at the same time and is utterly convinced (apparently it was his specialty before joining the private place as a GP).

[look_at_the_big_picture in reply to DaveT81]

What type of autoimmune disorder did they diagnose?

Perhaps record your appointments. That way you can replay what was said. It is very difficult being in an appointment with concentration issues. I recently had an appointment which got delayed so much, it was time for me to have my next dose of T3 medication. The shock on the endo's face as I took 80mcg of Liothyronine in front of him. He must have been so shocked as he even mentioned it in a letter to my GP.

[jimh111]

You don't have low TSH or high fT4, they are both normal, as is your fT3. It looks like your thyroid and pituitary are doing very well. That's not to say you can't be hypothyroid, possibly due to peripheral resistance to thyroid hormone. The only way to find out is a trial of thyroid hormone and an honest assessment of how you respond. Do you start to get better, or start to show hyperthyroid signs. Hypothyroidism can cause reflux. If your reflux is not too bad I would hold off the omeprazole and see if the reflux resolves when you take the levothyroxine. You should see a benefit in a week or two if the reflux is a consequence of hypothyroidism.

If you are hypothyroidism with your normal hormone levels you will probably need some T3 at some stage to get fully better but I would see how you go with levothyroxine first. If you are hypothyroid you will see an improvement quite soon but it will take many months to get better, possibly a year or two.

[tinkerbell22]

Have you checked for thyroid antibodies?

[DaveT81 in reply to tinkerbell22]

I have not! That's on my list of things to have checked prior to seeing my doctor next visit. If those are normal then we really will have hit a wall..

[tinkerbell22 in reply to DaveT81]

Yes best to check them, DaveT81. Make sure they test all the right antibodies! There's the Thyroid peroxidase antibody test as well as the Thyroglobulin antibody test. My Thyroglobulin antibodies were very high, and my peroxidase normal... so my GP wouldn't accept that I have Hashimoto's! Ridiculous!

Also, you might want to try a hair analysis test as this can show if you have toxins like heavy metals in your system which can cause symptoms of thyroid problems (or root causes of thyroid problems). They also show if you have metabolism or adrenal problems. I use this company as they use the best lab and send you a detailed chart of your results.

mineralstate.co.uk

Hope this helps

[DaveT81]

So will too little acid cause reflux/gastritis like symptoms too? I'd read that but wasn't too sure. I'd had a lot of gas and bloating too, and tried apple cider vinegar before a meal which seemed to help so not sure what my actual issue is in that regard.