My step-daughter has had a blood test as part of her care for Type I Diabetes. She has been feeling more tired than usual for many months, and suffers with an itchy rash over much of her body. Pruritis, apparently, for which she was prescribed steroid cream. Her Endo feels this is not to do with Diabetes given that she has no other Diabetes-related complications, although the Dematologist disagrees. Results are as follows (ranges in brackets):
Free T3: *2.8 (3.6 - 6.4)
Free T4 10.7 (9 - 24)
TSH 2.7 (0.2 - 5.0)
No treatment has been offered, presumably because her TSH is "in range". We are quite concerned about her, she is in her late 30's and has two children to care for, as well as a job to hold down. Can anyone advise please?
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AiryFairie
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Her TSH is inconsistent with her fT3 and fT4. There can be many reasons for a TSH coming out low including starvation, depression, concurrent illness, a trauma to the head etc. Someone with these fT3 and fT4 levels will be very hypothyroid and not in a good place to advocate for good care. I don't know if it will affect her rash, it could well do but it will affect her in many ways. I'd strongly urge you to seek out a good specialist to sort out her thyroid condition. If her endocrinologist has seen these results and done nothing they are the wrong person to care for her. Many endocrinologists are into diabetes and have little understanding of thyroid disorders. Make sure you stand up for your step-daughter.
That looks rather like Central Hypo, where the problem lies with the pituitary (Secondary Hypo) or the hypothalamus (Tertiary Hypo), rather than the thyroid itself (Primary Hypo). GPs know nothing about that, and are incapable of recognising it from blood tests. You do need an endo that knows about thyroid.
But, in answer to your question, yes. That is what hypo is, low thyroid hormones. Doctors only tend to look at the TSH, which is a pituitary hormone, and is not a very good indicator of thyroid status, when you really come down to it. But, they don't know that.
Don't they get puzzled when, even if the TSH is in range, their patients still keep presenting with a list of symptoms? But I suppose they're not paid to "think outside the box"... Thanks for your input greygoose, at least we can do some research on Central Hypo.
They're not capable of thinking outside the box, most of them. They know nothing about symptoms, and are as likely as not to 'diagnose' CFS or fibro, when patients keep complaining. That is their 'goto' diagnosis for anything they don't understand. Doctors are supposed to be half scientist and half artist, but these days they are neither. They're half robot and half… god knows what!
The skin condition could be linked to gluten sensitivity ... As T1 is auto- immune it would be a good idea to have Thyroid anti-bodies tested to rule out Hashimotos - Anti TPO & Anti Tg are the required tests.
Good advice, Marz. I will advise about gluten, although the poor girl has so many restrictions to her diet already, testing her blood a dozen times a day! Her sister has Hashimoto's, so there is likely to be a family link.
Just to add to the info you've been given, pruritis has a number of causes, including diabetes, hyperthyroidism, and hypothyroidism .... hopefully, for your daughter in law, the consultants will stop debating the issue and get on with investigating her symptoms and blood test results.
BTW if it is central/secondary hypothyroidism as greygoose suggests, something as simple as "just" whiplash can cause it.
This explains a little more about what has been discovered in such type of injuries - that it's the shearing of the cervical spine in 1/10 second rather than hyper-flexion or hyperextension movement as previously thought; the thyroid being pushed into a state of hypothyroidism from injury-induced inflammation; negative effects within the HPA axis etc.
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