Subclinical Hyperthyroidism

[Nat89]

Hi all. I've just my results back from the hospital of my CT scan (iodine) and he said the nodule i have is causing it to produce more hormone. He said to me about iodine treatment but in turn could make me underactive. I'm 30 years old and planning to have a baby, will this affect fertility? What other treatments are there? I have attached my blood results. I've been tested for antibodies and negative. I don't want any treatment as i feel i don't have any symptoms but he said in the long term if untreated it can effect my heart and make my bone thin?

I am not on any medication for my thyroid at the moment.

T3 level - 5.40 pmol/L - Normal range: 2.63 - 5.70

T4 level - 10.80 pmol/L - Normal range: 9.01 - 19.05

Any advice would be great

[humanbean]

Do you have the reference ranges for your T3 and T4 results? If you do could you add them to your results, please.

Regarding the dangers of developing osteoporosis, these risks have been massively overhyped. See these links :

healthunlocked.com/thyroidu...

healthunlocked.com/thyroidu...

healthunlocked.com/thyroidu...

healthunlocked.com/thyroidu...

You could also do some searches for "Low T3 and the heart"

This is a good website to search in :

scholar.google.co.uk/schhp

[Nat89 in reply to humanbean]

thank you for the links

I have added in the normal ranges.

[greygoose]

Well, those labs don't look to me as if the nodule is producing extra hormone. Your FT3 is in range and your FT4 is low.

Admittedly, your TSH is very low, but there could be other reasons for that, like a pituitary problem.

Which antibodies were tested?

I would hold off with any decisions at the moment, and see how this thing works out. Keep testing. Personally, I certainly wouldn't let them zap my thyroid based on these results, because you're not hyper at the moment.

[m7-cola in reply to greygoose]

I totally agree with this advice.

[Jazzw in reply to greygoose]

Nat89 Also agree totally with GG’s advice. 👍

Something doesn’t quite add up here. I’d also be wanting them to check that there isn’t a pituitary problem.

[greygoose in reply to Jazzw]

Exactly. I really don't hold with this 'subclinical hyperthyroidism' malarkey, just based on the TSH. There are reasons why the TSH would be so low with Frees in-range, and negative antibodies. It's just the biased opinion of a TSH worshipper, not a medical diagnosis.

[Nat89 in reply to greygoose]

This is interesting, yes exactly what i thought I'm not just going to let them take it out because it's the easiest and cheapest option for them! So ill be off there list. I will go back to my GP and ask for more testing. I was tested for graves disease and TPO.

[greygoose in reply to Nat89]

OK, so Grave's and Hashi's. BUT, something doctors don't seem to know, you cannot rule out Hashi's on the basis of one negative blood test. Antibodies fluctuate, so just because they were low on that particular day, doesn't mean they always are. Plus, you can have Hashi's without ever having raised antibodies.

And, to complicate things further, there are two antibodies for Hashi's: TPO and Tg. Either of both of them can be raised and indicated Hashi's.

[Nat89 in reply to greygoose]

Ive had (TRAb) tsh receptor antibody test which was normal. It's very complicated 😩

[greygoose in reply to Nat89]

Yes, TRAB is for Grave's.

[kmf0503 in reply to greygoose]

Just want to say, I have nowhere near the knowledge as the wonders on this site , but I agree. I would not let them knock out my thyroid at 30 years old over bone loss. Take vitamin D and do some weight bearing exercises. At 30 you can do lots to keep your bones healthy and you can build bone. I have had a suppressed TSH for 12 years and 2 bones scans and both were normal. It seems they are a lot more concerned about Graves but the problem is once you are hypo they don't have the same motivation to treat and you might end up like the rest of us. There is certainly little motivation to treat sub clinical hypothyroidism...?? Be mindful but don't act yet. Once you lose a body part you cannot put it back

[Nat89 in reply to kmf0503]

Thank you, so true 😊 i won't be making any decisions to have it out until i am older.

[humanbean in reply to Nat89]

If your TRAB level was normal, I was under the impression that meant you don't have Graves' Disease.

If either or both of your TPO and Tg antibodies were raised then you have Hashimoto's Thyroiditis. If both were negative then you don't. The NHS rarely tests Tg antibodies.

If you have a nodule of some kind there is the possibility that it could grow bigger or you could develop more nodules. But based on the results you've given I see no justification at present for either removing your thyroid or getting it killed off with radioactive iodine. It would be a good idea to have your thyroid scanned occasionally in future if you have a known nodule.

One thing to bear in mind - I can't see that anyone else has mentioned it - if you have Hashi's it can cause people to have T4 and T3 levels which appear to be mildly hyperthyroid in the early course of the disease. This situation (having mildly hyperthyroid results with Hashi's) is temporary and results fluctuate, sometimes quite dramatically. The high levels of thyroid hormones sometimes seen in Hashi's are not as high as those in Graves' Disease. Hashi's is cumulative in terms of the damage it does to the thyroid and eventually the thyroid is unable to produce sufficient hormones under any circumstances, and the patient becomes permanently hypothyroid.

[Nat89 in reply to humanbean]

Thanks for you advice. I do have a nodule in front of my neck which only swells up with stress I've had several biopsies on it and its benign. I am just going to keep an eye on it and get tested few times a year and go from there.

[SlowDragon Administrator]

Suggest you get full Thyroid and vitamin testing

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 you have odd thyroid levels. Your FT4 is low

Recommended on here that all thyroid blood tests should ideally be done as early as possible in morning and before eating or drinking anything other than water .

This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip, best not mentioned to GP or phlebotomist)

Private tests are available. Thousands on here forced to do this as NHS often refuses to test FT3 or antibodies or all vitamins

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

Medichecks Thyroid plus ultra vitamin or Blue Horizon Thyroid plus eleven are the most popular choice. DIY finger prick test or option to pay extra for private blood draw. Both companies often have special offers, Medichecks usually have offers on Thursdays, Blue Horizon its more random

Before considering TTC your vitamin levels need to be optimal

[Nat89 in reply to SlowDragon]

Thank you, i will ask for these tests. I have just recently starting to take preconception multivitamins and omega 3 fish oil.

[Ginny52]

I absolutely don’t believe you have subclinical hyperthyroidism. How have you been since this post? That sounds a bit rude- what I mean is, I think you are being misdiagnosed, and would like to discuss this. The same thing happened to me, and I think I might be able to help.

[Nat89 in reply to Ginny52]

Hi Ginny, I have just seen this (9 months later) but here i am again. I have just been referred to an endo again as i am having trouble with fertility and they are questioning if its to do with my thyroid. Nothing has been solved...my last treatment was a year ago and i had the iodine test which was all fine. What is happening with you?

[Ginny52 in reply to Nat89]

Hi Nat! I’ve had years of battle with nhs endocrinologists in trying to get them to accept that my low tsh is a pituitary problem rather than a response to ‘subclinical hyperthyroidism’. Human bean from this forum pointed out to me that the combination of low tsh with low t3 and t4 points to hypothyroidism from failure of the pituitary to produce enough tsh to stimulate the thyroid rather than suppressing overproduction as in hyperthyroidism, and that when this happens in the context of pituitary damage following an obstetric haemorrhage, it is Sheehan’s Syndrome- I wondered if you’d ever had this happen? Isolated failure of tsh producing cells in the pituitary also happens, but you mention fertility problems, which sounds more like a more extensive pituitary problem. I’ve been lucky, I found an nhs endo who is more open minded than most, but I did have a really bad time when dimmer ones kept withdrawing my levothyroxine because they insisted that low tsh always means hyperthyroidism. I still can’t get my gp to prescribe my levothyroxine, and the current situation is not helpful- I am even less able to ask her to read stuff than I would have been before!

[Nat89 in reply to Ginny52]

It's all so confusing, there's so many possibilities what it could be. I do have more symptoms of hypo than hyper. I have never heard of Sheehan's syndrome before, I did get mine check and was in normal range? PROLACTIN - 223mIU/L - Normal range: 109 - 557mIU/L. Are you on any medication? I have never been on any medication.

[Ginny52 in reply to Nat89]

I get levothyroxine- I was so ill without it. It’s frustrating that I can’t get my gp to accept the consultant’s prescription, and a bit worrying for the future. My prolactin was normal too, and I think it’s a good sign for possible conception.