Hi, I am new on the forum and I have been struggling with bad fatigue plus at least five of the recognised symptoms for hypothyroid for at least five years now (I am 62) I work part time and try to lead as much of an active life style as I can. afternoon naps and literally crawling up to bed early are the norm for me.I cannot arrange anything for the evening unless I can have a nap in the afternoon! my aunt had a goitre , my sister has hypothyroidism, my niece had a partial thyroidectomy. it runs in the family. My gp has told me there is nothing wrong with my thyroid results and so did a private consultant. i was so near my wits end with my symptoms that I recently even paid quite a lot of money privately to get a more in depth picture of my levels. they seem to be near the low end of the normal scale plus i have a high ferratin reading now. I have been taking supplements like zinc, vit D B12 magnesium etc. in a desperate attempt to alleviate symptoms. My Gp has now told me that my tiredness and fatigue will just have to be put down to unexplained fatigue syndrome. I am so fed up . I used to have a much more active lifestyle, walking holidays, cycling holidays, walking in the mountains every weekend. I want my old life back!The tiredness is ruining my life. Can anyone throw any light on the results below or am I imagining it? Has anyone struggled like this to get a diagnosis and help? If so, any tips on where to go now and what to do? Thanks so much.
Reverse T3 - 16 ng/dl (10 - 24)
Total T3 1.7 nmol/L (1.3 - 3.1)
Free T3 4.3 (3.1 - 6.8)
Total T4 94 nmol/L (59 - 154)
Free T4 12.58 (12 - 22)
TSH 2.130(0.27 - 4.20)
TSH receptor antibody <0.4 ( 0.0 - 0.4)(not sure what this means?)
Ferratin 232.4 ug/l \9 ( 15.00 - 150.00) although some advice given is that the normal level for over 60 female is up to 300 not 150???
vitamin levels have all come out pretty ok really.
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mayjack
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Both T4 and T3 are thyroid hormones. T4 being the inactive one and has to convert to T3. T3 is the active thyroid hormone and is needed in all of our T3 receptor cells to enable our metabolism to be normal.
Others will respond re your other results.
Did you have your blood test at the very earliest, fasting (you can drink water) and if on thyroid hormones (levo) you have to allow a gap of 24 hours between last dose and test and take afterwards? If not this is recommended to give us the best possible results.
Thanks so much for your response. I had looked at that chart previously and it did appear that all was not well, although I know that due to how I feel. Your inofrmation is really useful for me and may help my case, when I get up enough courage to badger my GP again!
I see quite a few posts on the forums with results like these. Your fT3 is a little low and your fT4 low within its interval. Since the pituitary responds to the combined effects of T3 and T4 you would expect the TSH to be much higher. Usually as fT4 falls towards its lower limit TSH rises and this stimulates more conversion of T4 to T3 thus maintaining fT3 levels. This is how some patients with quite high TSH levels can still be fairly OK. This is not happening in your case which suggests your pituitary is underperforming. When TSH is really low it is described as 'secondary hypothyroidism'. Unfortunately doctors tend not to recognise a low TSH that is not extreemly low and so miss the diagnosis. I guess the best you can do is explain it to your doctor and say you want a trial of thyroid hormone. I'm not sure it will succeed but you have nothing to lose.
This sort of 'down-regulated axis', i.e. a TSH that is lower than expected can be caused by trauma to the head, serious concurrent illness, severe dieting or depression. The TSH receptor antibody (TRAb) is used to detect Graves' desease which usually presents with an overactive thyroid, you definitely do not have this. It's possible you have autoimmune hypothryoidism ('Hashimoto's') which can be tested by measuring TPO and TBG antibodies. Personally I wouldn't spend more money on testing this as it probably won't help you get a diagnosis. I would put all my energy in persuading your doctor to give you a trial of levothyroxine. Maybe take someone with you to act as your advocate.
Thanks so much for this helpful info. When I feel up to it, I will see my Gp again. However, she is set on the track that my fatique is down to "unexplained fatigue syndrome" I think they are discouraged from prescribing due to the cost to be honest! However, your suggestion of taking an advocate with me is a great one and may help my case, thank you.
I believe that it is due to poor training of young doctors and endocrinologists regarding thyroid hormones and dysfunctions of the thyroid gland. On paper it seems easy i.e. take Blood Test and if TSH is above range (in UK top is 10) in other countries its around 3+. The fact that we used to be diagnosed on our symptoms alone, we seem to have gone backwards instead of more accurate.
Levothyroxine is not expensive - Liothyronine is in the UK.
Maybe send the following to your GP. It is by one of our Advisers to TUK:
Once again, thanks! However, I can see my Gp taking umbridge! I don't think she will appreciate the fact that I am "trying to do her job" by sending her the info. I may have to asking to see another gp who would be more willing to listen to advice such as the suggestions and info in the letter, which is so informative and comprehensive by the way. It wears you down doesn't it? Cheers!
You can tell her that because you aren't improving at all and, that you feel much worse (I did on levo), you have become a member of Thyroiduk.org.uk who are a support group and you've found it helpful. (being a member is optional but the more the merrier as the saying goes). Just in case you want to:-
We would not be on the internet looking for information if we were improving and symptoms resolved. There are thousands who are hypo but not looking for info as they feel well on their dose of levo (I hope).
You may already know this but I'll state - just in case:
All blood tests for thyroid hormones have to be at the very earliest, fasting and allow a gap of 24 hours between last dose of levo and test and take afterwards. Also ask for B12, Vit D, iron, ferritin and folate to be tested.
The aim is a TSH of 1 or lower with FT4 and FT3 in the upper part of the ranges. Always get a print-out of the results with the ranges for your own records and post if you have a query.
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