I am hoping you can help me and give me some advice. I recently started getting panic attacks while driving, they came from nowhere. I went to the docs who ordered a blood test and it came back with suppressed TSH with normal FT3/4.
Not sure how to read these tests but here goes:
TSH 0.02 mu/L 0.27 - 4.20 mu/L
Serum free T3 level 5.9 pmol/L 3.10 - 6.80 pmol/L
Doc said I’m showing signs of over active thyroid and gave me propranolol. I had another detailed thyroid test on Friday and get the results next week.
I have been showing signs of over active thyroid for years. Heart palpitations have been a big thing, depression, hair loss. But I put it down to peri menopause. I’ve also been struggling with vision loss and have just been prescribed prism lenses due to double vision.
Your thoughts please? Should I insist on a referral to an endo? I just want to feel normal!
Thanks, any advice much appreciated.
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Jules99929
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Your FT3 is 75.68% through the ranges, so whilst higher than average, it's not hyper. Hyper would be an FT3 well over-range.
Your TSH is suppressed, but that in itself doesn't make you hyper - despite what your doctor may think.
What you need to do is ask for your antibodies to be tested. TPO antibodies. It could be that you have Hashi's, where levels FT4/3 can swing from high to low in a short space of time, but the TSH takes longer to catch up.
Panic attacks can be due to both hyper and hypothyroidism.
There is no detail regarding the FT4 result. Just says normal range. I had another blood test yesterday and think it was a detailed thyroid function test so I will see what comes from that.
I wonder if this test includes the antibodies test as well?
Possibly. Possibly not. They don't tend to test them because they don't realise the importance. But, do post your results when you get them, with the ranges.
So happy to have found thus forum. I will post my results when they arrive. Just hope I can get to the bottom of this as I really don’t feel myself these days.
I will check in the week what they tested on Friday and then get the rest checked, even if I have to do it privately. I’ve had enough of feeling so crap.
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
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
If you can get GP to test vitamins and antibodies then cheapest option for just TSH, FT4 and FT3 £29 (via NHS private service )
If TPO or TG antibodies are high this is usually Hashimoto's, (also known by medics here in UK more commonly as autoimmune thyroid disease). But can be due to Graves' disease too
About 90% of all primary hypothyroidism in Uk is due to Hashimoto's.
Low vitamins are especially common with Hashimoto's and Graves. Food intolerances are very common too, especially gluten.
So it's important to get TPO and TG thyroid antibodies tested at least once .
This is great, thanks. I didn’t realise early morning and no eating or drinking. I had a blood test on Friday at 11am at the docs ! So annoying as I had a coffee and breakfast! Grrrrrr !!!
I have had panic attacks for year due an over active thyroid. My advice is to try and cut back on caffeine or rule it out completely as it makes the pack attacks worse. Good luck
I have been showing signs of over active thyroid for years. Heart palpitations have been a big thing, depression, hair loss.
I wouldn't agree that you are hyper. In someone who is truly hyperthyroid the Free T3 is likely to be very high - a level of over 20 would be quite common.
Like the other people who have replied to you I would suspect Hashimoto's Thyroiditis before hyperthyroidism since your Free T3 is well in range.
There are quite a few things that can cause palpitations that aren't necessarily connected with your thyroid.
1) Low iron and/or ferritin (iron stores) - this is the commonest nutrient deficiency in the world, and is particularly common in people with thyroid disease of any kind. Unfortunately, supplementing iron is not straightforward and iron testing is essential before even considering supplementation.
Low iron can cause anxiety and depression, as well as palpitations and tachycardia (fast heart rate), plus lots of other symptoms.
2) Low magnesium - this is a major issue for many, many people, irrespective of thyroid status. If your kidneys are reasonably healthy then supplementing magnesium is generally considered safe because any excess gets excreted by the kidneys. Supplementing with advanced chronic kidney disease is not safe. The usual dose of magnesium is around 300mg - 400mg per day.
3) Low sodium (which is normally derived from salt in the diet) and low potassium can also affect the heart. These are two electrolytes which are best acquired by eating potassium-rich food, and by including some salt in the diet. Another way of getting some electrolytes quickly is by using rehydration salts that are sold for people suffering from vomiting and/or diarrhoea e.g. Dioralyte.
This is really interesting humanbean, so thank you very much. How do I know if I am lacking in any of these? I see iron should be tested first but how?
You don't need blood tests for magnesium, potassium, or sodium unless you have a known problem with any of these or have been told by your doctor to avoid them.
Assuming you have no known problem just try supplementing when you get palpitations and see if they help.
1) Buy yourself some magnesium supplements. There are lots of different kinds, some better than others. Read the drjockers link I gave earlier for advice, and search the forum as well. Another link :
Many of us, including me, supplement magnesium daily, but don't exceed the dose given on the bottle. Obviously if you supplement with magnesium daily then you shouldn't supplement again if you get palpitations.
If magnesium doesn't help, then move on to step 2.
2) Supplementing potassium can be done in various ways as I mentioned earlier. I buy potassium supplements and take one dose as given on the bottle when necessary for fast heart rate and/or palpitations. It isn't something I supplement daily. For more info :
Other alternatives - eat a banana or drink some coconut water - they both contain potassium.
If potassium doesn't work within 10 minutes then move on to step 3.
3) Salt is easy to supplement. Stick quarter of a teaspoon of salt in a glass of water, stir, and drink it. Or drink a vegetable stock drink of the type I linked to earlier (other brands are available but they must include some salt fairly high up the ingredients list). Or buy some Dioralyte sachets, make one up with cold water, and drink it.
4) Iron is not something that should be supplemented at any time unless you know you need it. The best private test I know of is this one :
If you decide to test this, copy the results and reference ranges into a new post and ask for feedback. Just being in range is not enough - optimal is always preferable.
Humanbean is spot on. Read 'The Magnesium Miracle' - get it from a library. It is an eye opener! The author talks about Magnesium and other electrolytes as being critically low in many with autoimmune issues. The mechanisms are complex, but she's a qualified doctor who's worked in cardiology and I have improved massively in following many of her recommendations.
In an emergency when getting panic attack symptoms there are "Zero" tablets and their equivalent which cyclists and runners use when they get shaky after exerting themselves. They contain electrolytes in the right balance. However, better than that is to just increase your overall levels of these electrolytes, not just in your serum (levels are usually pretty constant in the vast majority of us so blood tests are pretty redundant) but in your cells (in the muscles and in your bones an RBC test is the only one that works) as humanbean points out. This can take a while to fine tune.
I was stuck on propranolol for almost twenty years .....only by reading The Magnesium Miracle did I realise propranolol lowers Parathyroid hormone levels and magnesium
Although I was very low in vitamin D I couldn't tolerate any vitamin D supplements until improved my obviously extremely low magnesium levels
The importance of magnesium was key to my finally making full recovery
I was offered Propranolol when first diagnosed with Graves' disease and refused to take it because it can make the heart too slow in some people which can be scary. My husband was given it for anxiety and ended up his hospital because his heart rate was too low. The GP did not take into to consideration that he was a long distance runner and already had a very low heart rate.
Thanks Lora7again. The propranolol seems to be helping with the heart palpitations and will keep an eye on my heart rate.
I don’t have the T4 result but will be getting more results next week so once I have them I’ll post on here. It’s like a minefield !!! So happy to have found this forum which such good advice.
I have heart palpitations all the time especially if over do it. My heart is fine btw I would be careful with the drug because it is addictive and you have to wean yourself off it when you stop. That is another reason I didn't take.
I read your post with interest. I have had a terrible nearly 11 months, and a lot of your symptoms coincide with mine.
My thyroid has been deemed "normal", but after a cold/chest infection, which then led on to possible pleurisy and then constacondritis (which has worsened over the months), and ectopic heartbeats. I have had ECGs, been up A&E 5 times thinking it was a heart attack (shooting pains down chest), panic attacks, and my periods have been odd too. I had a 24 hour ECG and yesterday had an echocardiogram, and another long 2 weeks wait for results (which do nothing for my anxiety).
I have been reading up on perimenopause and just hoping this is "all" it is and that maybe HRT patches will be given to me. I am exhausted and weak every day, my moods all over the place, and spend most of my time crying.
I so hope you find out what is wrong - and keep us posted on here. Best of luck x
Sounds like it'd be worth starting a new post with those issues....
You may have thyroid hormone resistance which is why ostensibly you are 'fine' with serum results when clearly you are not. Forum members have posted on how this problem is sometimes found in things like ME/CFS (which I have had) which is why it's such a b****r to treat, as standard lab results look 'normal'. However, if they dig a bit deeper then they usually find a lot of deficiencies and issues with the HPA axis and thyroid hormone resistance.
I recommend you look at Dr Sarah Myhill's website for more information.... and read up on adrenals especially and other hormonal issues.
we definitely sound very similar. I went to see a menopause specialist as my symptoms were getting me down, especially the heart palpitations and was put on patches as it seems I am peri menopausal but now I am wondering if it is my thyroid??? Since my symptoms are getting worse. Note I am only 45 so it’s quite early for me to be experiencing this. I am going to take all the good advice on here and see how I get on. Thanks for your message.
Hey guys, quick update. I did a medichecks blood test before I had all your advice and got the results today. Plus GP contacted me as my test results are back with them and I need to go and see them. Will create a new post with my results.
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