Confused hypothyroid diagnosis: Sorry for yet... - Thyroid UK

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Confused hypothyroid diagnosis

lt1806 profile image
9 Replies

Sorry for yet another post I was diagnosed today with hypothyroidism. They have ruled out antibody issues as test came back negative. So if this is the case why have I got it. I have tried looking online and it’s all very confusing, but one thing that has really flagged with me is my eyes. I have been seeing an ophthalmologist and an orthoptist for the last year trying to work out why my eyes are having double vision and my left eye is not working well with the right eye. I have never mentioned this prob to my gp as was referred to the hospital by optician whom I have not mentioned all of my thyroid symptoms to as did not see the relation. With the info I have read today could this prob be linked to my hypothyroidism as my pituitary gland came back higher than normal range or is that only for hyperthyroidism?

Grasping at straws for an explanation. I don’t want to go back to go as I worry they will think I’m just a hypochondriac! Go has out me on low level of thyroxine and orthoptics have given me 2 different prescriptions to try and get my eyes to work together, with a view to adding a prism in 6 weeks time if no improvement. Should I inform both the gp and the eye specialist or is it not possible for it to be the pituitary gland / a tumour?

My main concern is how I’ll I have been feeling yet despite blood test coming back as positive for hypothyroidism they were only slightly out of range, which does not correlate to how rubbish I am feeling. Sorry for the ramble!

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lt1806
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greygoose profile image
greygoose

Sorry, but they cannot rule out autoimmune thyroiditis on the basis of one negative antibody test for three reasons:

1) antibodies fluctuate all the time, so just because it was negative today, doesn't mean it will be next week, or the week after that.

2) there are two types of antibody for Hashi's: TPO and Tg. The NHS only tests TPO, but if the Tg are high, that will also indicate Hashi's, even if the TPO are low.

3) not everybody with Hashi's has high antibodies. It is possible to have Hashi's and still have low antibodies because the antibodies are not the disease.

But, even if you don't have autoimmune hypo, there are many other things that can cause you to be hypo. And, it's very rare that anybody with non-autoimmune hypo finds the cause. So, don't worry about it.

With the info I have read today could this prob be linked to my hypothyroidism as my pituitary gland came back higher than normal range or is that only for hyperthyroidism?

Could you explain a little more clearly what you mean here? How did they test your pituitary? And why did they test it? That is not a routine test. And, why would your pituitary be linked to your eye problems? Or, perhaps, are you talking about your TSH? But, if so, what has hyperthyroidism got to do with an over-range TSH?

It is very possible that your eye problems are linked to your thyroid problem. Every single cell in your body need thyroid hormone, and if there's not enough to go round, any part of your body can be affected, even the eyes. Being hypo can affect vision and many hypos start needing glasses when they didn't before, because their eyesight diminishes. So, yes, you should tell your optician that you have been diagnosed as hypo, and tell your GP about your vision problems.

You must not think of yourself as a hypochondriac. Your symptoms are real. And, whilst your doctor may consider your results to be 'only slightly out of range', he is in fact wrong:

Serum Tsh level 6.41miu/l (0.27-4.20)

Serum t4 level 11.1 pmol/ l (12-22.0)

Given that you are hypo when your TSH gets to 3, it is the range that is wrong, here. And, 6.41 is substantially above 3! Your FT4 is below range! In a healthy person it would be more like mid-range. Once again, the range is too wide. Besides, we cannot quantify symptoms. You feel what you feel and it's very rare that symptoms correspond to blood test results. I have seen people on here with a TSH of 100 who claim not to have any symptoms, but other with a TSH of 2 who suffer enormously. So, don't judge yourself too harshly. Hypothyroidism does not play by anybody's rules but its own! :)

lt1806 profile image
lt1806 in reply to greygoose

Thank you very much for your reply. I hadn’t connected my eye issues at all until I looked to find a reason for why I’m hypo. Alarm bells rang when I read about the pituitary gland, one of the symptoms being double vision and eyes not working together. My prescription is very small it’s the weakness in my left eye and double vision when trying to focus is what’s the main concern . The orthoptics team have given me exercises as my left Eye flicks away rather than to the midddle when trying to get eyes together. But they have simply stated that if I use the mild prescription when driving it might let my eyes rest!

I just feel fobbed off and worried that I’m now on the wrong treatment if it was indeed a problem coming from the pituitary gland rather than directly from the thyroid. Sorry I hope this makes sense. I have also had a fizzing sensation in the back of my head for the last 3 years so now I’m totally paranoid😂.

Will start the meds today and call the orthoptics team to ask if they will inform gp of my eye issues.

Many Thanks

greygoose profile image
greygoose in reply to lt1806

I just feel fobbed off and worried that I’m now on the wrong treatment if it was indeed a problem coming from the pituitary gland rather than directly from the thyroid.

Well, you didn't answer my questions about the pituitary, so I don't really know what you're talking about. Why do you think you have a pituitary problem? What tests were done?

If you have secondary hypo - which is a pituitary problem - there's no treatment you can have apart from hormone replacement. There is no treatment for the pituitary itself. But I don't know what sort of pituitary problem you think you have.

AnneEvo profile image
AnneEvo in reply to greygoose

I don't want to hijack this post but I thought Hashimotos was defined by high antibodies, if not, how is it diagnosed as different to 'general' hypothyroidism - not questioning you greygoose, just what I'd previously understood.

greygoose profile image
greygoose in reply to AnneEvo

It usually has high antibodies, yes. But not always. And it would be diagnosed by an ultrasound of the thyroid, which would show any damage done by the immune system attacks. But, if you're on a steady dose of thyroid hormone and your levels suddenly shoot up, then that has to be Hashi's.

AnneEvo profile image
AnneEvo in reply to greygoose

Thank you.

greygoose profile image
greygoose in reply to AnneEvo

You're welcome. :)

MaisieGray profile image
MaisieGray in reply to AnneEvo

AnneEvo Izabella Wentz describes it this way:

"Can you have no thyroid antibodies but still have Hashimoto’s?

Yes, this is known as seronegative autoimmune thyroiditis, or serum negative Hashimoto’s.

80-90% of people with Hashimoto’s will have TPO antibodies, TG antibodies or both. However, some people will never test positive for thyroid antibodies, yet may have full blown Hashimoto’s. In serum negative Hashimoto’s, the person will still have the hypoechoic pattern on their thyroid gland upon ultrasound examination that is seen with Hashimoto’s and thyroid antibodies but will not have measurable circulating thyroid antibodies.

Rotondi and colleagues have determined that seronegative autoimmune thyroiditis is a less aggressive form of Hashimoto’s, but nonetheless, the person may still develop hypothyroidism and even progression to other autoimmune conditions, which may or may not have respective positive antibody blood markers (such as seronegative rheumatoid arthritis).

People who do not have thyroid antibodies will likely have smaller thyroid glands and are less likely to have goiter compared to people with Hashimoto’s antibodies.

Serum negative Hashimoto’s should be treated the same way as serum positive Hashimoto’s, of course with the exception of tracking thyroid antibodies."

AnneEvo profile image
AnneEvo in reply to MaisieGray

Thank you.

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