Thyroid Symptoms with normal blood tests

[livolive]

I have all the symptoms of mixed hypo and hyper thyroid including voice changes but every time I do blood tests results come out within normal range, so I'm so confused !

latest blood test results: --------------Reference range:

FT4: 18.90 pmol/L ------------------------12.00 - 22.00

FT3: 4.50 pmol/L --------------------------3.10 - 6.80

TSH : 1.24 μIU/mL-------------------------0,30 - 4.00

Anti Tg AB : 15 IU/mL ---------------------<115.00

Anti TPO AB: 15 IU/mL-------------------- <34.00

could anybody lend a hand and shed some light here?

Update:

ACTH (morning) 12.90 pg/mL---------7.20 - 63.30

PTH (Intact) (ECLIA) 46.00 pg/mL --------10.00 - 65.00

Vitamin B12 = 803.00 pg/mL -------------197.00 866.00

25-OH VİTAMİN D, Total, LC MS/MSa 45.41 ng/mL -----------25.00 - 80.00

SI 113.53 nmol/L --------------------------62.50 200.00

------------------------------------------------------------------------------------------------------------

Update 2

After being seen by an endocrinologist he ordered some new more (nonsense) blood tests mostly for blood nutertion levels (to waste my money) and he ordered Thyroid Ultrasound imaging and then he concluded with his final diagnosis :

1- You don't have thyroid, parathyroid or any other gland problems

2- You have mild phosphate deficiency and it's the only one deficiency you have

3- you don't have any physical health problems

4- You are in a good healthy shape

5- Your symptoms most probably caused by anxiety

6- It would be a good idea to go see a psychiatrist

I lost a lot of money to hear these useless findings and my symptoms still alive and intact

[livolive]

Thanks Paula I updated post

[BadHare]

My results are also in normal range despite >40 years of hypo symptoms. I found out 6 years ago that I have a pituitary tumour, & my research led me to this wonderful forum. All the endocrinologists I've seen are clueless about secondary hypothyroisism caused by the pituitary rather than the thyroid, then there's tertiary hypothyroidism caused by the hypothalamus. From reading the posts on here, most endo's don't seem to treat primary hypothyroidism effectively & ignore our glaringly obvious symptoms. I've been self-medicating for almost 4 years which has been life changing. I've had a few blips due to medication supply & changing what I take ineffectively, but overall it's been marvellous.

Maybe look up the Barnes Basal Body Temperature Test & try this. Get a good thermometer & take your temperature before you get out of bed every morning. Normal is 36.7 degrees celcius. My temperature was 35.2 for 4 months, only 3 days it was 35.3. Now it's usually around 36.2, & I can produce some body heat!!!

Make sure to read the posts re diet & supplements as everything lining up correctly is absolutely essential for making our bodies work for us.

[livolive in reply to BadHare]

Thanks for the enlightenment about the pituitary gland, maybe I should check that too

[BadHare in reply to livolive]

As I replied earlier, to another post, that requires a thyrotropin releasing hormone (TRH) test & nowhere does it. My prolactin levels were three times over that which indicates a tumour, but there’s other things that can go awry with the anterior or posterior pituitary that have different functions, or the stalk. Depending on what I’ve read almost 17% to 25% of us have growths on our pituitary gland, though there were no specifics as to cause, location or effect as they largely go unnoticed. The lower figure was mentioned in a book about hormones & depression, the higher figure was quoted in an American paper re tumours found in autopsies.

I haven’t done any research into hypothalamus conditions as I only researched pituitary & thyroid stuff when I had access to a medical library, & my brain fog doesn’t help my memory issues.

I have been happy with treating my symptoms effectively, though that may not have been so successful if I’d had a genetic issue or thyroid hormone resistance, etc.

So many things that can potentially go wrong with us! 🤕

[greygoose in reply to livolive]

Very unlikely you have a pituitary problem, because your FT4 is high. And your FT3 is almost mid-range. If it were secondary hypo, you would have low T4, low T3 and low TSH.

[livolive in reply to greygoose]

Are you saying my FT4 must go down?

[greygoose in reply to livolive]

Not at all. Why would I say that? I simply said that with an FT4 as high as that, you are unlikely to have a pituitary problem, because if you had a pituitary problem, your FT4 would be low. Not sure I can explain it any other way.

[DippyDame]

The word "normal", when referring to test results, is disliked by many here and can give a false impression...neither does it take into account how you feel!

Your TSH would be better at 1 or below.

I gather you are not prescribed levothyroxine (LT4) if not I think your GP needs to reconsider their diagnosis and offer you a trial of levo.

Your FT4 is 69% through the range (lowish) while your FT3 is only 37.8% - this should be at least 75%.

If this does not improve after the addition of Levothyroxine then you may need to consider the following...

It may be that you have a conversion problem which needs some support...have you had Folate, Ferritin, Vit D and Vit B12 checked - to support thyroid function these need to be at optimal level.

It may be that adding a little T3 to your LT4 will help but before considering this I would strongly suggest you check those nutrients and retest after around 6 weeks then post the new results for advice

Private test available at...

thyroiduk.org.uk/tuk/testin...

thyroiduk.org.uk/tuk/testin...

There is also a possibility that you may have a form of thyroid hormone resitance but that is only to be considered as a last resort.

Sadly medics know very little about the thyroid beyond the basics which leaves many of us suffering and struggling to be heard.

I've been there and this forum turned things round for me....

Post again if you need more help

Best...

DD

[MaisieGray in reply to DippyDame]

I'm not sure it's correct to say that a healthy person not medicating with Levothyroxine should have a TSH of below 1, nor that FT4 should necessarily be in the upper quadrant. As Seaside Susie wrote yesterday in another thread, "in fact your results are just about right for a 'normal healthy person' which is expected to be TSH no more than 2 and FT4 around mid-range (yours is 52%)". The results posted here are FT4 69.00% through range and FT3 37.84%. I'd say that the OP isn't perhaps converting as well as she might, which 'might' be the cause of symptoms, rather than there being an issue with her TSH and FT4 at this stage.

[DippyDame in reply to MaisieGray]

Thank you MG.

I did point out that poor conversion is a possibility.

Opinion seems to differ regarding best point in scale for FT4...

Like all things thyroid I expect there are variations amongst individuals

Otherwise....point taken,

Good to know replies are being checked for inaccuracies.

DD

[MaisieGray in reply to DippyDame]

Not checking, just reading the thread as my eye was caught by the similarity to the earlier post from yesterday I believe; and which are generally a challenge to advise on in the absence of extremes of test results indicating clear problems of one sort or another.

[DippyDame in reply to MaisieGray]

Not a criticism.....correct info is important.

[MaisieGray in reply to DippyDame]

Definitely agree

[livolive in reply to MaisieGray]

I agree with the most of your post except the last part. since i was having mixed symptoms of hypo and hyper thyroid I tried kelp for four days to see if it's hypothyroid but there was no effect, then I tried bugleweed for three days to see if it's hyper but again did not notice any change.

most days since more than 18 months I suffer everyday but one or two days a month I feel really well and most of my complaints are gone .

[MaisieGray in reply to livolive]

Generally, to think in terms of hypo or hyper symptoms is unhelpful and often confusing, since so many are non-specific and evidence themselves not only in both hyper and hypo thyroid activity but in so many other non-thyroidal conditions. For instance I'm hypothyroid but generally run so hot that sweat literally runs off my face and down my spine on a regular basis, I have tremors, AF, palpitations etc - normally considered hyper symptoms. But taking kelp or bugleweed for three or four days is unlikely to achieve any demonstrable proof of thyroid disorders. Kelp contains iodine and supplementing with iodine can trigger symptoms of both hypo and hyperthyroidism, and indeed was used in solution in the days before drugs were developed, as an antithyroid drug to treat hyperthyroidism. If you feel really well for a few days regularly each month, have you had your sex hormones tested?

[livolive in reply to MaisieGray]

for more than a year I was researching my symptoms day and night for few hours almost every single day, just wanted to know if my condition was hypo or hyper thyroid but the more I read the more I get confused even from scientific resources. At the end I realized that even Endocrinologists themselves are confused too. I read so many times on so many websites that a person can never have both hypo/hyper thyroid illnesses at the same time but through my own experience and based on naked logic I can comfortably say that was not true specially since thyroid gland secretions have the final word and it can do both (little -more) secretions at the same time so a person is hypo today and hyper tomorrow in accordance with the gland activities.

regarding the sex hormone test that has never occurred to me , maybe I should start considering it

[livolive]

Tomorrow I'll get the results of PTH,ACTH, Vit B-12, 25(OH)D and CBC blood tests. I have never taken medication for thyroid but I have tried vit B-Complex with additional B-12, selenium, kelp, bugleweed, melissa, and vit D supplements for few months with no improvement . my symptoms include hand tremors anxiety,mood swings, occasional depression, palpitations, occasional shortness of breath, muscle weakness, extreme fatigue, cold and heat intolerances, sweating etc.

[DippyDame in reply to livolive]

I suggest you are not adequately converting the inactive hormone T4 to the active hormone T3 which is required in trillions of cells in the body. Your FT3 is far too low.

[livolive in reply to DippyDame]

if so , the blood test would've revealed it

[DippyDame in reply to livolive]

By "it" do you mean poor conversion?

[humanbean]

Have you had your basic nutrient levels checked? Ferritin, iron, vitamin B12, folate and vitamin D?

I would suggest that poor nutrient levels are far more common than any form of thyroid problem. And low nutrients can share lots of symptoms with thyroid issues.

[livolive in reply to humanbean]

Tomorrow I'll get my vit B12, folate, and vit D results and see what are they like but i was taking supplements of these vitamins for months sometimes in high doses without any noticeable improvement

[humanbean in reply to livolive]

This could be for lots of reasons...

1) Dose too low. What a doctor thinks is a suitable dose for all sorts of nutrients is often rather useless in raising actual levels in the body/blood. E.g. for vitamin D a standard prescribed dose would be 800iu per day of vitamin D3 (or vitamin D2 which is worse). If I take that level of vitamin D supplement my levels actually drop. I normally take 2000 iU - 5000 iU per day depending on time of year.

2) Wrong form of supplements taken e.g. sprays instead of tablets or capsules, or vice-versa. Another issue is that you may need methylated (active) B12 and folate - not cyanocobalamin and folic acid. Also, if you have B12 deficiency or pernicious anaemia you might need injections.

3) Gut issues leading to poor absorption. In the case of fat-soluble vitamins like vitamin D they must be taken with your fattiest meal of the day.

4) Do you take any PPIs or antacids that block or reduce stomach acid?

5) You could have various gut problems like coeliac disease, crohn's disease, ulcerative colitis, gluten intolerance, which would all reduce absorption of nutrients and would make you feel terrible.

[livolive in reply to humanbean]

I take antacid regularly but mostly at bed time