Should I get a second opinion.

[Velma0821]

Tsh-.76 (.40-4.50)

Free t4-2.3(1.4-3.8)

T4-6.8(5.1-11.9)

T3 uptake-34%(22-35)

Experiencing weakness fatigue, heart palpitations, irregular heart rate, hoarseness after hot/ lukewarm showers, chest pains lost 30 pounds in last few months without trying.

Visited cardiologist stated T-shirt was low along with irregular heart rate. He referred me to Endo before putting me on a beta blocker for my heart rate endo was an ass and didnt listen to anything I said as soon as he saw my test results brushed me off saying if you feel weak the don’t take hot showers like that solved it. Physicians assistant stated I might be borderline hyperthyroidism. Should I get a second before I start the beta blocker?

[SlowDragon Administrator]

Presumably you are not currently diagnosed as hypothyroid or on Levothyroxine?

For full Thyroid evaluation you need TSH, FT4 and FT3 plus both TPO and TG thyroid antibodies tested. Also extremely important to test vitamin D, folate, ferritin and B12

Low vitamin levels are extremely common, especially if Thyroid antibodies are raised

Recommended on here that all thyroid blood tests should ideally be done as early as possible in morning and fasting. This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip, best not mentioned to GP or phlebotomist)

Last Levothyroxine dose should be 24 hours prior to test, (taking delayed dose immediately after blood draw).

[Velma0821 in reply to SlowDragon]

I’m in us. hyper is categorized as almost overactive or results under .5 hypo is categorized as underactive or results above 5.0. So borderline hyperthyroidism

[Hidden]

Assume you mean TSH, not T-shirt! Predictive is daft sometimes1

"Tsh-.76 (.40-4.50)

Free t4-2.3(1.4-3.8)

T4-6.8(5.1-11.9)

T3 uptake-34%(22-35)...

"Physicians assistant stated I might be borderline hyperthyroidism"

None of this makes sense to me (not you, but what the assistant said). Are you sure they said hyperthyroidism? Not sure what T3 uptake means, (Is that from the FT3 test?) but 34% seems low, and your FT4 is not very high. Even the TSH isn't below range.

In fact it seems that you are hypothyroid, not hyper.

Weakness fatigue, heart palpitations, irregular heart rate, hoarseness and chest pains are all possible hypo symptoms too. The only thing that doesn't fit is losing weight. But even that happens with some who are hypothyroid.

Not sure if beta blockers will help or hinder. Maybe you can advise here SeasideSusie ?

[Velma0821 in reply to Hidden]

I’m in US. hyper is categorized as overactive or results under .5 hypo is categorized as underactive or results above 5.0. So borderline hyperthyroidism

[Hidden in reply to Velma0821]

Except the symptoms don't fit.

That's the danger of going by TSH alone

[Velma0821 in reply to Hidden]

I’m okay if it’s not I just don’t want to jump the gun and start the beta blockers and it’s only treating the symptoms and not the problem the whole reason I’m asking should I get another opinion is because it’s either that or start a beta blocker which my cardio says is life long so would rather be completely sure it’s all from my heart being wonky and not from my thyroid. So bottom line is should I go to another endo or go back to cardio to start beta blocker?

[Velma0821 in reply to Hidden]

And actually symptoms I’m having are also symptoms of hyperthyroidism. Heat intolerance fast heart rate weakness anxiety irregular heart rate all all hyper symptoms.

[Velma0821 in reply to Velma0821]

So is an endo the one that would order those tests or would my cardio do so?

[SeasideSusie Remembering]

Velma0821

I agree with Hidden - those are not hypERthyroid results. Hyperthyroid is overactive and for that your TSH would have to be well below range and your Free T4 above range.

I take it you're not in the UK, we don't have T3 uptake test here so we don't really know what it is, and it looks like you have a Total T4 result - T4-6.8(5.1-11.9) - and although the Free T4 test is the most useful one, again you have very low Total T4 so doesn't indicate hypERthyroidism.

Those results don't support a diagnosis of hypOthyroidism either.

So it would be very helpful if you could tell us:

1) Do you have a diagnosis of hypOthyroidism

2) Are you on any thyroid medication

3) Have you had thyroid antibodies tested

[Velma0821 in reply to SeasideSusie]

No diagnoses of anything yet My cardio wanted me to go to an endo to check my thyroid before going on a beta blocker since I’m only 23. Would rather treat the problem if there is one then just treat a symptom. I’m in the US never had my antibodies checked. Not on any medications at the moment.

[SeasideSusie Remembering in reply to Velma0821]

OK, so going by your actual thyroid hormone level - that's the T4 (TSH is a pituitary hormone, it signals the thyroid to produce hormone when it detects there isn't enough)

Free t4-2.3(1.4-3.8) = 37.5% through it's range. You would have to be over range to be considered hyperthyroid.

T4-6.8(5.1-11.9) = 25% through range (even though we don't hold much store by Total T4 here), so again doesn't suggest hyperthyroidism.

As Hidden says, you can't go by TSH alone, you need the whole picture, and your thyroid panel as a whole doesn't suggest hyperthyroidism.

Maybe look at iron - get an iron panel and full blood count done. I would also look at B12, folate and Vit D.

[Velma0821 in reply to SeasideSusie]

So this is why I’m asking my heart is healthy but beating to fast at rest so it’s either my thyroid is making it so that or my heart being wonky. I am asking because if it’s not my thyroid then I’ll be put on a beta blocker that my cardio says is life long. So should I go see another endo or go back to my cardio and get put on the beta blocker.

[SeasideSusie Remembering in reply to Velma0821]

Symptoms of hypothyroidism thyroiduk.org/tuk/about_the...

Symptoms of hyperthyroidism thyroiduk.org/tuk/about_the...

Palpitations can be a symptom of both, as can fatigue, and anxiety, and heat intolerance.

There are other causes of palpitation/irregular heart rate. What investigations have been done for this.

Both SlowDragon and I have suggested testing vitamins, and SlowDragon has mentioned testing thyroid antibodies which is also important. I would get these done as a priority.

[SlowDragon Administrator in reply to Velma0821]

You need thyroid antibodies tested

TPO and TG thyroid antibodies for Hashimoto's and Graves' disease

TSI or TRab antibodies for Graves' disease

Would get vitamin D, magnesium, B12 and ferritin tested too

USA doesn't test folate for some reason

Low vitamin D is extremely common and low magnesium often with low vitamin D

[Velma0821 in reply to SlowDragon]

So this is why I’m asking my heart is healthy but beating to fast at rest so it’s either my thyroid is making it so that or my heart being wonky. I am asking because if it’s not my thyroid then I’ll be put on a beta blocker that my cardio says is life long. So should I go see another endo or go back to my cardio and get put on the beta blocker.

[SlowDragon Administrator in reply to Velma0821]

You haven't had enough tests to rule Thyroid problems in or out.

Essential to test thyroid antibodies and vitamins listed

Come back with new post once you have results

We see both hypothyroid and hyperthyroid patients with high heart rate and palpitations.

Low iron can cause palpitations

Low magnesium too. Magnesium is essential for good heart function

[Velma0821 in reply to SlowDragon]

Both of those came back normal

[AnneEvo]

Is your TSH .76?

[Velma0821 in reply to AnneEvo]

Yea.

[AnneEvo in reply to Velma0821]

I asked because of the minus sign in front that's all.

[Velma0821 in reply to AnneEvo]

Oh lol I put it to show a separation between the words and the numbers it’s a habit.