Is it possible to be this hyperthyroid without ... - Thyroid UK

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Is it possible to be this hyperthyroid without symptoms?

HarrietJW profile image
42 Replies

My partner has recently used medichecks to do a thyroid panel (amongst other things, the panel has come back with these results. She has no symptoms of hyperthyroidism, could there have been a mistake?

TSH - 0.016 (0.27-4.2)

T3 - 20.9 (0.27-4.2)

T4 - 50.3 (12-22)

TP antibodies - 290

TG antibodies - 333

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HarrietJW profile image
HarrietJW
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42 Replies
SlowDragon profile image
SlowDragonAdministrator

Seems unusual

Has she had vitamin D, folate, B12 and ferritin tested?

Could be early stage Hashimoto’s?

She needs

Graves Disease antibodies test

medichecks.com/products/tsh...

Plus repeat full thyroid and vitamin testing in 6-8 weeks

HarrietJW profile image
HarrietJW in reply toSlowDragon

Ferritin, Vit D, B12 are all bottom of range but in range.

Thanks reluctant to use Medichecks if their testing is off. Have you had reports of weird results before on here?

SlowDragon profile image
SlowDragonAdministrator in reply toHarrietJW

What are actual vitamin results and ranges ?

Ferritin is often high in Graves’ disease

onlinelibrary.wiley.com/doi...

Hashimoto’s frequently starts with transient hyperthyroid results and symptoms

Hashimoto’s linked to low ferritin

What about cholesterol, has that been tested?

HarrietJW profile image
HarrietJW in reply toSlowDragon

Vit D - 61.4 (50-175)

B12 - 50.5 (37.5-187.5)

FOLATE - 10.74 (3.89-19.45)

FERRITIN - 25.6 (13-150)

HDL CHOLESTEROL - 1.15 (1.3-6.5)

Thanks for your help!

SlowDragon profile image
SlowDragonAdministrator in reply toHarrietJW

So...if you read posts on here regularly.....you will know these vitamins are all low

Cholesterol being low suggests possibly hyperthyroid

HarrietJW profile image
HarrietJW in reply toSlowDragon

I have just received bloods from NHS for my partner and they are as follows

t4 - 27 (9-19)

tsh - 0.05 (0.5-5.0)

How severe is this hyperthyroid? She doesn't have many symptoms but is wondering whether to delay fertility treatment.

Thanks

SlowDragon profile image
SlowDragonAdministrator in reply toHarrietJW

Strongly suggests early stage Hashimoto’s (Hypothyroid)

NOT Graves (Hyperthyroid)

Hashimoto’s frequently starts with transient hyperthyroid results and symptoms

So need to test TPO and TG antibodies for Hashimoto’s (can also be mildly raised with Graves’ disease)

Private tests are available as NHS currently rarely tests Ft3 or thyroid antibodies or all relevant vitamins

List of private testing options

thyroiduk.org/getting-a-dia...

Medichecks Thyroid plus ultra vitamin

medichecks.com/products/thy...

Medichecks often have special offers, if order on Thursdays

Thriva Thyroid plus vitamins

thriva.co/tests/thyroid-test

Blue Horizon Thyroid Premium Gold includes vitamins

bluehorizonbloodtests.co.uk...

To diagnose Graves’ disease essential to test TSI or Trab antibodies

Graves Disease antibodies test

medichecks.com/products/tsh...

Her vitamin levels are all very low too, including ferritin ....again typical of Hashimoto’s

Obviously vitamins should be optimal before conception

Active B12 under 70 is considered suspicious

viapath.co.uk/our-tests/act...

Ferritin very low

Iron and ferritin are complex. Ask for full iron panel test for anaemia

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

(Can’t eat liver when pregnant these days)

dailyiron.net

Links about iron and ferritin

irondisorders.org/Websites/...

drhedberg.com/ferritin-hypo...

This is interesting because I have noticed that many patients with Hashimoto’s disease and hypothyroidism, start to feel worse when their ferritin drops below 80 and usually there is hair loss when it drops below 50.

We see many early stage Hashimoto’s patients misdiagnosed as Graves’ disease on here

Always insist on all antibodies tested

HarrietJW profile image
HarrietJW in reply toSlowDragon

Thank you very much.

Antibodies are:

TP antibodies - 290

TG antibodies - 333

So it looks like early Hashis, wow how unlucky we both have that.

SlowDragon profile image
SlowDragonAdministrator in reply toHarrietJW

So she needs TSI or Trab tested

GP probably can’t order it

Medichecks Graves antibodies test is not DIY fingerpick...has to be blood draw

There are quite a few members whose partners also have Hashimoto’s

Personally I wonder if that’s more than coincidence

HarrietJW profile image
HarrietJW in reply toSlowDragon

That’s Interesting? Can Hashis be brought on by diet and lifestyle?

SlowDragon profile image
SlowDragonAdministrator in reply toHarrietJW

Infection connections to Hashimoto’s

hypothyroidmom.com/hashimot...

MichelleHarris profile image
MichelleHarris in reply toSlowDragon

SlowDragon I think I got Hashimotos from a blood transfusion. I woke up after the hour long procedure feeling very ill. I could hardly walk. Virus after virus ever since and feeling under the weather. No one else even in my extended family has Thyroid issues x

SlowDragon profile image
SlowDragonAdministrator in reply toHarrietJW

For example H pylori and Hashimoto’s can be linked

endocrine-abstracts.org/ea/...

healthline.com/health/h-pyl...

Nanaedake profile image
Nanaedake

If it were me I'd take results to GP and ask them to run their own tests. It's possible that symptoms might lag behind results. I'd want to find out which thyroid condition. Is it Hashimotos or Graves disease or some other factor causing overactivity of thyroid hormone? You will need a referral to an endocrinologist to rule out Graves disease as those antibodies tests are not done in primary care.

HarrietJW profile image
HarrietJW in reply toNanaedake

Thank you. Our GP will only do T4 and TSH, but it will be good to get their help.

mistydog profile image
mistydog in reply toHarrietJW

It's shocking but not unusual because GPs generally are ignorant in thyroid management. You may wish to try another GP or practice.

Valarian profile image
Valarian in reply toHarrietJW

It’s not necessarily ignorance on the part of the GP, sometimes FT3 and usually TRAb can only be ordered by a specialist. However, if a retest shows TSH and FT4 similar to those above, it should be enough to warrant further investigation, all the more so since your mention of fertility tests suggests you have had problems conceiving. btf-thyroid.org/pregnancy-a...

HarrietJW profile image
HarrietJW in reply toNanaedake

I have just received bloods from NHS for my partner and they are as follows

t4 - 27 (9-19)

tsh - 0.05 (0.5-5.0)

How severe is this hyperthyroid? She doesn't have many symptoms but is wondering whether to delay fertility treatment.

Thanks

Nanaedake profile image
Nanaedake in reply toHarrietJW

Well, you actually need FT3, FT4 and TSH checking all together because it's the FT3 result that informs how overactive your thyroid is. Check with whoever did the test for the FT3 result.

As you can see by comparing with your previous results at top of post FT4 is dropping but still a little raised. GP will probably want to retest but essential to get FT3 result and if still raised or rising you are likely to need a referral to an Endocrinologist. Do you have results for thyroid antibodies? Was anything else tested like CRP or inflammation markers? These are things you could discuss with GP. An infection can imbalance thyroid among other factors. You do need to rule out Graves disease.

HarrietJW profile image
HarrietJW in reply toNanaedake

Thank you. We have no new results for antibodies. Previous ones showed:

TP antibodies - 290

TG antibodies - 333

No CRP either.

She’s being referred to an endocrinologist but imagine that will take a while!

Nanaedake profile image
Nanaedake in reply toHarrietJW

Do you have ranges for antibodies? It's hard to say without lab ranges but they look like they could be raised. If so, then it's autoimmune thyroid disease and could be Graves disease or Hashimotos.

Extremely important to differentiate between the two as treatment should be different according to diagnosis. To rule out Graves disease you need TSI and TRab antibodies testing. TPO antibodies can be present in both Hashimotos and Graves disease I believe.

Read thyroid UK website to learn more.

If possible get referred to a thyroid specialist NOT a diabetic specialist and not someone with an 'interest' in thyroid. Contact thyroid UK for a list of Thyroid specialists if you can't find one with Google.

FT4 is not too elevated at the moment and dropping so don't panic if appointment takes time due to present situation.

If symptoms appear get retested and GP can prescribe something to help in the interim if FT3 levels rise again.

jimh111 profile image
jimh111

What were the symptoms that prompted her to do a thyroid check? These results are indicative of quite severe hyperthyroidism. There could be some sort of error, her doctor would want to run another NHS test. If they come back much the same she should get an endocrinologist referral. I wouldn’t agree to any definitive treatment if she has no symptoms, there are rare genetic conditions that give strange blood test results.

HarrietJW profile image
HarrietJW in reply tojimh111

it was actually part of a fertility check, so no symptoms as such. we will ask the Dr for more tests, thank you!

mistydog profile image
mistydog in reply toHarrietJW

Out of range thyroid can be detrimental to fertility/pregnancy. Please resolve this before proceeding.

Valarian profile image
Valarian

The T3 in particular(I assume it’s FT3 ?) looks very high to be symptom-free.

I wonder if your partner is really symptom-free, or whether she has symptoms she simply hasn’t noticed or hasn’t connected with being hyper ? When I was first diagnosed, my GP was very surprised that I hadn’t noticed my thumping heart rate - she came to the conclusion that I’d probably got used to it. I’d actually gone to see her because of a persistent cough.

Hopefully your GP will order a repeat test, because if your partner is hyperthyroid, she needs to know what is causing it.

HarrietJW profile image
HarrietJW in reply toValarian

Thanks for your thoughts!

vocalEK profile image
vocalEK in reply toValarian

My sister-in-law felt great when she went hyperthyroid. She had all kinds of energy, needed very little sleep, and was accomplishing great things in the business she owned and operated. Unfortunately, she began berating her family for being so lazy. I'm not sure how her condition got diagnosed, but after her TT, her life changed dramatically.

Hookie01 profile image
Hookie01

I agree with Valarian, I didn't actually realise I was hyper. I also was used to the thumping in my chest as I lay in bed at night, I kept saying i was hot and people just used to say that maybe i was going through the change (plus it was summer) Losing weight and eating loads was a bonus, (I was also going to boot camp so thought it was that) didn't realise my memory was going as it all creeps up on you so slowly you just don't realise. I only went to the drs because I kept getting a pain in the right hand side of my head which started to scare me!

HarrietJW profile image
HarrietJW in reply toHookie01

Interesting! thank you. She says that she does sometimes feel a racing pulse. will get it checked out!

Valarian profile image
Valarian in reply toHookie01

I was waiting for diagnosis from Feb-April. Everyone got very fed up with me turning the heating off and opening windows all the time, but my heating bill was very cheap !

in reply toHookie01

Hookie - so interesting what you say about pain in the right hand side of your head. I have had a horrible time - first started when I switched to a T3/T4 combination and body didn't adjust well to the T3 - started with bouts of exhaustion, dry mouth, heart beating like crazy at night and pain on the right side of my head - so bad I couldn't sleep on the right side! Numbers didn't show out of range for many months and doctor did not realize it was thyroid. Ended up having another doc give me MORE T3 because he thought that was the problem and I have suffered horribly for going on 2 years. I am told now it takes 18 months for this to work it's way out and I am at 15. Anyway, long story for you but it is extremely comforting to hear someone else say this about the pain on the right side of head. If I had ONLY known back when it started I could have saved myself so much suffering. Amazing what being under or over does to a body!

Lora7again profile image
Lora7again

I actually felt very well when I was first overactive but eventually you will start to feel ill and get symptoms. My family wondered why I was so full of energy and I didn't need much sleep after several months of bursting with energy my hair started to drop out and my nails lifted off their beds. I also had palpitations, sweats and one of my eyes started to bulge. This went on for over 2 years because my doctor did not spot my TSH was suppressed at 0.002. After going so long without treament I looked and felt dreadful I was a size 8 and my clothes were hanging off me and some of my friends and family thought I had cancer. I was an extreme case and most doctors can see when a TSH isn't in range. I would ask to be referred to a Endocrinologist recommended by this site.

HarrietJW profile image
HarrietJW in reply toLora7again

Thank you, that sounds like a good idea to me.

pennyannie profile image
pennyannie

Hello Harriet

My initial symptoms of Graves were insomnia, exhaustion and dry gritty eyes, and had thought, for many years that I was hypothyroid but was only ever offered anti depressants.

We are all different, and since you bothered to get tested privately presume some symptoms were upsetting you, and thought your own doctor wouldn't listen or Covid got in the way.

I believe this needs further investigation by your NHS doctor and the test will probably be rerun and if, it is Graves Disease, you do need to be proved positive for the TSI / TRab antibody.

Both Graves and Hashimoto's can start off with similar symptoms but the treatment for each is very different and it is essential you know what antibody you carry, and what you are dealing with.

HarrietJW profile image
HarrietJW in reply topennyannie

Thank you, we will look into them further.

diogenes profile image
diogenesRemembering

This does look like hyperthyroidism, given the low TSH. However, there does exist an unusual group of patients who have a different kind of albumin from the norm. This unusual form binds on to T4 and often T3 much more strongly than with normal albumin. For most FT4 and FT3 assays, this results in abnormally high FT4 and FT3 results which are artefacts. Though as I wrote before the TSH is very indicative of thyroid disease, if no symptoms are present one could see whether you do have abnormal albumin. Professor Halsall in Addenbrookes Hospital,Cambridge has recently published his work on this phenomenon and if all else fails and there are still no symptoms, I'm sure he and his team would be interested. The paper is:

Familial dysalbuminaemic hyperthyroxinemia interferes with current thyroid hormone immunoassay methods

doi.org/10.1530/EJE-19-1021

jimh111 profile image
jimh111 in reply todiogenes

I attended a presentation by Halsall he was very sensible and placed emphasis on symptoms not just blood tests.

Valarian profile image
Valarian in reply todiogenes

Interesting, although the paper notes that FT3 results were elevated, but to a lesser extent than FT4, which does not appear to be the case here...although there may be a typo with the range.

@harrietjw, can you check the TSH/FT3 ranges in your original post, as they appear to be identical, which looks a bit odd.

humanbean profile image
humanbean

This is a bit of a stretch, but does your partner take any supplements which contain biotin? It is usually found as a supplement on its own or in B Complex supplements or in "hair and nails" supplements or in multivitamins, but really could be in any supplement at all.

Biotin is known to interfere with testing and give strange and unreliable results in machines made by certain manufacturers. Unfortunately the manufacturers don't give away information about how their testing machines work, so its best to avoid biotin for a week before testing anything at all.

For information on biotin and testing problems :

healthunlocked.com/thyroidu......

healthunlocked.com/thyroidu...

HarrietJW profile image
HarrietJW

Not as far as I know, but will check all of the vitamins she takes.Thanks!

SlowDragon profile image
SlowDragonAdministrator in reply toHarrietJW

If taking vitamin B complex, or any supplements containing biotin, remember to stop these 7 days before any blood tests, as biotin can falsely affect test results

endo.confex.com/endo/2016en...

endocrinenews.endocrine.org...

MichelleHarris profile image
MichelleHarris

Hi HarrietJW,

I would ask Medichecks to test again for free. They have done this before for people when results were strange.

Otherwise she should ask her GP to check these results.

Would you please let us know if they are correct or not x

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