Low TSH and Low fT4

[milupa]

I am asking for my friend.

She is 43, two children. Mother has Parkinson’s, sister has Hashimoto’s.

She is very active, runs, does yoga, up early until late. But also crushing fatigue in the afternoons.

She saw a few docs, iron low, hormones low except oestrogen, saliva cortisol (morning only) is lowish; only action progesterone/testosterone cream. She has been on Anthony William’s liver programm since having her fillings removed in summer.

A thyroid specialist told her of several lumps and cysts on the thyroid, nothing to worry about, come back in a year. The blood results are (no food, but was kept waiting three hours for blood draw, 12:30):

fT4 1.09 0.90-1.70

TSH 0.98 0.30-4.20

TPO-AK 13 <34

Thyreoglobulin-AK 6 5-100

With a fT4 so relatively low, how can she have enough fT3? Is that possible?

My guess is she is running on adrenaline. I think she should get a full thyroid panel done privately?

Thank you everyone,

Have a Very Merry Christmas

[greygoose]

It is possible but she'd have to have it tested to know. She needs the FT3 tested anyway, because as both her FT4 and TSH are low, we have to suspect Central Hypo. And, to back that up, she needs at least an FT3, but also the pituitary investigated. So, private labs as a starter, yes, good idea.

[milupa in reply to greygoose]

Thank you for your reply, GG!

She will go for the suggested labs — how is the pituitary investigated though?

I have a pituitary adenoma and go for the occasional MRI, but have focussed so much on thyroid/adrenal issues that I put that one aside for now.

Joyeux Noel!

[greygoose in reply to milupa]

MRI is one way. But, as the pituitary produces many hormones apart from the TSH, it's a good idea to get them tested, too.

[milupa in reply to greygoose]

That’s what I thought but endo will only check prolactin.

I am having surgery soon so will add this to my pre op work-up.

And my friend, too, says thank you for your help.

[greygoose in reply to milupa]

You're both very welcome.

[SlowDragon Administrator]

Plus testing vitamin D, folate, ferritin and B12

Is her low iron being treated?

[milupa in reply to SlowDragon]

Thank you for replying - no, no treatment or further investigation of low iron.

I will suggest full thyroid and iron panels plus co-factors?

Luckily we can walk into any lab here in Germany, get blood drawn and choose which tests to do. Have to pay privately of course.

Happy Christmas!!

[SlowDragon Administrator in reply to milupa]

Come back with new post once you get results

Eating liver or liver pate once a week, plus other iron rich foods like black pudding, prawns, spinach, pumpkin seeds and dark chocolate, plus daily orange juice or other vitamin C rich drink can help improve iron absorption

Links about iron and ferritin

healthunlocked.com/thyroidu...

healthunlocked.com/thyroidu...

drhedberg.com/ferritin-hypo...

restartmed.com/hypothyroidi...

Post about iron supplements

healthunlocked.com/thyroidu...