Blood tests are saying I am borderline hyperthyroid

[5219]

I have just had the results of my TSH FT4 and FT3 back from Blue horizon medicals and the Doctors report. I am a bit confused as it’s saying I’m borderline hyperthyroid. I am trying to get my levels optimal but it seems to be proving difficult. I had my thyroid irradiated 15 years ago. Have been putting weight on ever since. The report says that the symptoms of my results could be weight loss. I have put on weight not lost any. My anxiety is slightly worse but have felt better in myself. Hope you can make sense of it for me.

[greygoose]

No, they're not saying that at all. They're saying that you're not a terribly good converter.

You have to remember that the doctors that write these reports are just bog-standard GPs, and as we all know, GPs not only know nothing about thyroid, but don't know how to interpret blood test results.

Your TSH is suppressed, true and, unfortunately, that's all doctors really look at. And, for them, a suppressed TSH means hyper. But, your FT4, whilst high, is still in-range. And, your FT3 is only mid-range. So, you can't be 'hyper' - you couldn't be, anyway, without a thyroid - nor over-medicated.

Your TSH is suppressed because your FT4 is right at the top of the range. But top of the range FT4 and mid-range FT3 means poor conversion. Your FT3 is still too low for you, and that's why you're putting on weight. But, I wouldn't expect a GP to know anything about that.

[5219 in reply to greygoose]

Right ok so does that mean I should ask for another rise in Levothyroxine? My Gp will probably want me to explain why.

[greygoose in reply to 5219]

A rise in levo will definitely take your FT4 over-range. How much it will raise your FT3 is unknowable. It might make conversion worse. Ideally, what you need is a slight reduction in levo, and the addition of a little T3. But, who knows what your doctor would think about that idea.

[5219 in reply to greygoose]

Yes good question. I was put on a low dose of T3 reluctantly by my endocrinologist a few years ago. It didn’t work and he took me off it and he said I can’t do anything more for you. You can imagine how that made me feel. Because of my bad memory I can’t remember what dose and why it didn’t work without speaking to my Gp or accessing my medical records. I really do need to find this out so I can find a way forward and feel even better. Like they say knowledge is power.

[greygoose in reply to 5219]

It's so silly to talk about hormones 'not working'. Of course they work. It's not like taking an aspirin. The point is, you have to take the right amount of the right one, and you have to take it correctly. And, that's what doctors know nothing about. Rather than find out, they would far rather stop the hormone claiming that it 'doesn't work'. Which just goes to show how much they know about their own branch of medicine. Unless, of course, they do it deliberately - which I often suspect - and set the patient up to fail so that they don't have to keep prescribing something they know nothing about. And, they firmly believe that patients are all so stupid they won't suspect a thing! Well, times are changing - and so are patients - and now we do suspect their little games. They should be ashamed of themselves!

[jgelliss in reply to greygoose]

AMEN!!!! Dr's and BIG PHARMA take patients to be Very Ignorant . It's about time we prove them wrong .Hopefully sooner than later .

[pennyannie in reply to 5219]

Yes, a similar thing happened to me - evidentially I too was given a trial of T3 alongside a trial of HRT - back in 2007 - and like you can't remember the details.

I do know now, through reading and trialing the T3 myself that whatever dose I was put on was not enough, so saying " it didn't work " simply means that the doctor was not administrating the correct to dose to relieve your symptoms - and it's not that it didn't work, you weren't given enough to make a difference.

[jgelliss in reply to greygoose]

I most definitely agree with you greygoose . Great advice as always . Lowering the T4 and adding more T3 made a huge difference for me . I'm not from the good converters either .

[Hidden in reply to greygoose]

This reminds me of a doctor I once had (right at the beginning of my thyroid journey) who said that the thyroid is not that important when it comes to weight management and loss...but that exercise is...!

So no, we should not put too much faith in doctors when it comes to hypothyroidism

[greygoose in reply to Hidden]

Definitely not!

[jgelliss in reply to Hidden]

Oh So Agreed . A family member of mine who desperately needs thyroid meds was told by her Dr she is *Only* border line hypo . But he is sure that eventually she will need thyroid meds . Meanwhile she has all the hypo symptoms . You can't make this up . And to further add injury to insult he said people over 60 need thyroid meds . This family member is 70+ . It makes your head spin .

[Hidden in reply to jgelliss]

"he said people over 60 need thyroid meds"

So why doesn't he prescribe them then???

Or do you mean he said they do NOT need them? That would be a typical uninformed "Expert opinion".

Like the research paper I saw which claimed that for older people with "Subclinical" hypothyroidism thyroxine treatment is a waste of resources because there was no significant improvement when they were brought within range (TSH below about 5!)

[jgelliss in reply to Hidden]

The Dr said that people over 60 eventually will *Need* thyroid meds. The irony of the whole thing is it's not the age that matters but *Symptoms* . Symptoms are cellular reactions and results . Labs are just the results of the moment the labs where drawn . So I say are you going to believe *Me* or a piece of paper ????

[Hidden in reply to jgelliss]

At least he does recognise there may be a need. Because of the so common ignorance (as in the research paper I mentioned) I thought maybe he was denying even that!

But as you say it's the symptoms not the age that is the main thing

[Hidden in reply to Hidden]

I have come across doctors like this...claiming that, as I get older, I could try to get off my meds and see if I still need them (I have Hashi's). I've had doctors compare thyroid meds to HRT; something you only need for a few years and that you can wean off once your symptoms improve. They simply don't get it.

[Hidden in reply to Hidden]

Shocking! Yet there are doctors out there who know that they don't know that much about something like thyroid problems.

I've recently been blessed with finding one. The last blood test showed low TSH (0.05) and I was STILL granted an increase in thyroxine! Could hardly believe it. when I rang for the results the receptionist said there was already a prescription for an increase waiting for me!

So let's not give up. Good doctors, who don't blindly accept the "Received wisdom" and are humble enough to admit they don't know all the answers, do exist

[Hidden in reply to Hidden]

It's good to be reminded of that from time to time because there are depressingly many accounts here about useless doctors who, best cast scenario, don't make matters worse...so glad you were allowed to increase when obviously that's what you needed.

[Hidden in reply to jgelliss]

Yes, it's incredible when the average patient knows more about a disease than the doctor...! Totally crazy. I have more or less given up hope when it comes to doctors and thyroid treatment. I wish I did not have to say this but unfortunately it's true...

[jgelliss in reply to greygoose]

Wow !!!! So well explained . Many Dr's just *Don't Get It*. And us patients pay the price too.

[greygoose in reply to jgelliss]

Thank you.

[pennyannie]

Hello again 5219

No, you are not hyperthyroid - you have been treated with RAI , and your thyroid burnt out and destroyed is situ rendering you hypothyroid.

You do not have a fully functioning working thyroid and your TSH is a totally useless, unreliable measure and shouldn't be used in your monitoring and dose adjustments.

As previously explained there are no guidelines for Graves Disease patients post RAI ablation. and believe we are seen by doctors as " simply being hypothyroid " .

The Professor Toft article from 2017 entitled, Thyroid Hormone Replacement - A Counterblast To Guidelines referred to in my previous post to you encapsulates the situation we currently find ourselves in.

You would undoubtedly feel better with a higher T3 but in order to get " that " you need your T4 higher - but your conversion will probably be compromised as you have had RAI treatment.

You will probably " do better " dropping a little T4 and adding a little dose of T3.

You will probably " do better " switching over to Natural Desiccated Thyroid.

I found finding a doctor offering these alternatives difficult and am now self medicating.

I have trialled both the suggestions as mentioned above, and they both worked for me.

I know it's not a good place to be, but ultimately, it's your health and your decision.

[5219 in reply to pennyannie]

Thank you. You would think that everyone’s health would be at the forefront but this is not the case. Knowledge is power and I think if I can go to my Gp with information I may get somewhere. If not may have to look elsewhere. Not sure going private would help.

[pennyannie in reply to 5219]

I think it depends who you " see privately " - there is a list of recommended endos held at Thyroid uk and these are the specialists who will be sympathetic to your needs.

Simply paying to see somebody does not guarantee understanding or acceptance of your unique situation.

I have been " there " and got the T shirt - and paid 185 pounds to be told by the Head of the Endocrinology Department that he was happy to monitor his patients on T3/T4 combo or Natural Desiccated Thyroid but that I would have to buy the thyroid hormone replacement myself, basically DI myself, but I could pay to see him for monitoring and support.

Sorry about delay in answering you but my little laptop stopped working yesterday, and have found this old one, but am not too confident in what I'm doing at the best of times !!!!

[5219 in reply to pennyannie]

Thank you. I thought as much. I don’t have much faith in the endos at my hospital as the one I saw said he couldn’t do anything more for me and have a friend who saw all of the others and they weren’t much better. I would see them if i went to my private hospital so why would I pay for the same treatment.

I feel there is not enough awareness of our condition out in the public domain. I only found out how many of us suffer with this and not being properly looked after in recent years. I was diagnosed 15 years ago and took everything the doctors said. If I knew then what I know now probably would have asked more questions but you put your faith in these people don’t you?

[pennyannie in reply to 5219]

Ditto !!!

[Hidden in reply to pennyannie]

Very true!!! Many of us have no choice but to self treat and medicate. I found that thought very scare at first but then realised it can be done and that my quality of life is so much better because of it.

[5219]

Can I get anything official from Thyroid U.K. written down that I can show my Gp or do I go to her with what I know and hope she will do something?

[Lora7again in reply to 5219]

You can print off stuff from that site. I did to show my Gp and he brushed it aside and would not even look at it.