Help...odd thyroid results...

[fred1e]

Help! Low end fT4 (12) with low end TSH (1.2)....plus high end TPO(33)

All with in normal ranges, but only just for fT4/TPO......could it be Hashimotos.....my symptoms work, and already coeliac...

But why hasn't my TSH gone up ?

Any ideas?

[SeasideSusie Remembering]

fred1e

Could we have some more information please?

Are you diagnosed hypothyroid and on thyroid hormone replacement?

You say your TSH has gone up, do you have any previous test results that you can post?

As reference ranges vary from lab to lab, it's important that you include the reference ranges that came with your results please.

Have you had nutrients tested - Vit D, B12, folate and ferritin?

[fred1e in reply to SeasideSusie]

Hi..sorry..didn't want to overload on my first post!,

No..not diagnosed, not on any thyroid supplement

My TSH has NOT gone up....one previous test of 1.4 a couple of years ago

Full results : TSH 1.2 (range 0.27-4.2)

fT4 12.8 (12-22)

fT3 5.2. (3.1-6.8)

TAb. 71.6. (<115)

TPO Ab. 33 (<34).

VitD 90 (50-175) was very low 2 years ago when diagnosed coeliac, take > 5000iu to kept it up to a reasonable level

B12 active 131 (>37.5)

Folate 17 (>3.8).... both this are significantly better than before I went on gluten free diet. .

Ferritin 220 (13-150)..... this is steadily rising, but my blood cells/ iron levels are fine...assuming inflammation.

Thank you

[SeasideSusie Remembering in reply to fred1e]

My TSH has NOT gone up

Sorry, my fault, I read that wrong.

TSH 1.2 (range 0.27-4.2)

fT4 12.8 (12-22)

fT3 5.2. (3.1-6.8)

I am not medically trained, and I am not diagnosing, but what could be indicated here is possibly Central Hypothyroidism. This is where the problem lies with the hypothalamus or the pituitary rather than a problem with the thyroid gland. With Central Hypothyroidism the TSH can be low, normal or slightly raised, and the FT4 will be low.

TSH is a pituitary hormone, the pituitary checks to see if there is enough thyroid hormone, if not it sends a message to the thyroid to produce some. That message is TSH (Thyroid Stimulating Hormone). In Primary Hypothyroidism the TSH will be high. If there is enough hormone then there's no need for the pituitary to send the message to the thyroid so TSH remains low.

However, with Central Hypothyroidism the signal isn't getting through for whatever reason. It could be due to a problem with the pituitary (Secondary Hypothyroidism) or the hypothalamus (Tertiary Hypothyroidism).

Your GP can look at BMJ Best Practice for information - here is something you can read without needing to be subscribed bestpractice.bmj.com/topics... ( we can only see the Summary)

and another article which explains it ncbi.nlm.nih.gov/pmc/articl...

and another one

endocrinologyadvisor.com/ho...

You could do some more research, print out anything that may help and show your GP.

As Central Hypothyroidism isn't as common as Primary Hypothyroidism it's likely that your GP hasn't come across it before. You may need to be referred to an endocrinologist. If so then please make absolutely sure that it is a thyroid specialist that you see. Most endos are diabetes specialists and know little about the thyroid gland (they like to think they do and very often end up making us much more unwell that we were before seeing them). You can email Dionne at

[e-mail]

for the list of thyroid friendly endos. Then ask on the forum for feedback on any that you can get to. Then if your GP refers you, make sure it is to one recommended here. It's no guarantee that they will understand Central Hypothyroidism but it's better than seeing a diabetes specialist. You could also ask on the forum if anyone has been successful in getting a diagnosis of Central Hypothyroidism, possibly in your area which you'll have to mention of course.

However, these results:

TAb. 71.6. (<115)

TPO Ab. 33 (<34)

make me suspicious about Hashi's. Your TPO antibodies are definitely so close to the limit on that test that I believe they would be over range at some time. Plus your Tg antibodies are quite high although within range. So I certainly wouldn't discount Hashi's.

So you have two possibilities there, and Hashi's does cause strange levels at times so I could be way off thinking about Central Hypo, but who knows!

VitD 90 (50-175) was very low 2 years ago when diagnosed coeliac, take > 5000iu to kept it up to a reasonable level

If 5,000iu D3 is your maintenance dose then stick with it, it's actually my maintenance dose after severe deficiency with a level of 15nmol/L 4 years ago.

The Vit D Council/Vit D Society recommend a level of 100-150nmol/L.

Do you also take D3's important cofactors - magnesium and Vit K2-MKy?

D3 aids absorption of calcium from food and K2-MK7 directs the calcium to bones and teeth where it is needed and away from arteries and soft tissues where it can be deposited and cause problems such as hardening of the arteries, kidney stones, etc.

D3 and K2 are fat soluble so should be taken with the fattiest meal of the day, D3 four hours away from thyroid meds if taking tablets/capsules/softgels, no necessity if using an oral spray.

Magnesium helps D3 to work. We need Magnesium so that the body utilises D3, it's required to convert Vit D into it's active form. So it's important we ensure we take magnesium when supplementing with D3.

Magnesium comes in different forms, check to see which would suit you best and as it's calming it's best taken in the evening, four hours away from thyroid meds if taking tablets/capsules, no necessity if using topical forms of magnesium.

naturalnews.com/046401_magn...

drjockers.com/best-magnesiu...

afibbers.org/magnesium.html

We should test Vit D twice a year when supplementing. This can be done with a private fingerprick blood spot test with an NHS lab which offers this test to the general public:

vitamindtest.org.uk/

B12 active 131 (>37.5)

Folate 17 (>3.8).... both this are significantly better than before I went on gluten free diet. .

Both are good levels.

Ferritin 220 (13-150)..... this is steadily rising, but my blood cells/ iron levels are fine...assuming inflammation.

Yes, could be inflammation or infection.

Was this a private test with Medichecks or Thriva? Was CRP tested? That's also an inflammation marker.

[fred1e in reply to SeasideSusie]

Hi

Thank you so much for your comprehensive reply.....I'd come to much the same conclusions....my CRP was tested...totally within normal limits if not low! And I do take K2/Mg,.

I was thinking about trying to get a referral to the London Bridge thyroid centre.....looks to be a multidisciplinary thyroid specialist team which I think I might need?

Dr Paul Carroll....if anyone has any feedback, I'd be grateful!

[fred1e in reply to fred1e]

......oh. Yes...this was via Medichecks, as the NHS would only do TSH as it was "normal"

[SeasideSusie Remembering in reply to fred1e]

I was thinking about trying to get a referral to the London Bridge thyroid centre.....looks to be a multidisciplinary thyroid specialist team which I think I might need?

Dr Paul Carroll....if anyone has any feedback, I'd be grateful!

It would be a good idea to make a new post about that, put the name in the title to attract attention of anyone who has seen him. Ask for replies by private message.The post will have to be closed to replies as we can't discuss individual doctors on the forum but it will remain visible.

You can also send for the list of thyroid friendly doctors from Dionne at Thyroiduk and see who's on there, again ask for feedback on the forum.

Email Dionne: [e-mail]

Good that your CRP is nice and low.

[fred1e in reply to SeasideSusie]

Thank you again....have put up new thread....just a quick question.....where/how do I find the private messages!!??

[SeasideSusie Remembering in reply to fred1e]

You will get an email notification of any private messages and you click on the link in the email, it will take you to the message. Also, at the top of the forum page there are two speech bubbles and the word "Chat". If there is a red dot next to that with a number in that is another notification of a message, just click on the red dot.

[fred1e in reply to SeasideSusie]

You are very kind!