you didn't come back and reply to the questions asked. We don't know whether you were mixing up hypERthyroidism and hypOthyroidism. Your symptoms indicated hypOthyroidism yet you said "Even though my symptoms now indicate hypERthyroidism" and we were trying to find out if you could possibly have autoimmune thyroid disease (Hashimoto's) which is where you can get symptoms of both hypERthyroidism and hypOthyroidism.
However, your current thyroid antibody results are low and don't suggest this, but you can have Hashi's without raised antibodies.
What are the chances of my GP or private endo starting medication based on these results?
TSH 3.35mIU/L (range 0.27-4.2)
free T3 3.99 pmol/L (range3.1-6.8)
free Thyroxine 12.000 pmol/L (range 12-22)
That depends on your GP.
For Primary Hypothyroidism you would need a TSH of 10+ and low FT4. If your TSH was over range with a below range FT4 you may get a diagnosis and a prescription for Levo from some doctors.
There is another possibility here and that is Central Hypothyroidism which 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/below range.
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 (you can only read the Summary):
If you think this is a possibility 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
tukadmin@thyroiduk.org
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, looking at your results from last August and comparing them with your current results, it seems as though your TSH is rising and your FT4 is decreasing and this can be indicative of your thyroid failing. If your FT4 goes below range and your TSH is at the top of the range or over range then hopefully your GP would be wise enough to diagnose and prescribe.
Ferritin 70.7 ug/L (range 13-150)
Folate-serum 9.5ug/L (range >3.89)
vitaminB12-active 105.000 pro/L (range >37.5)
vitamin D 94.5 nmo/L (range 50-175)
On the whole these results are pretty good. Vit D is recommended to be 100-150nmol/L, folate I would want in double figures, Active B12 is OK (I'd want mine over 100) and Ferritin is just about OK, it is recommended to be half way through range and some experts say the optimal ferritin level for thyroid function is between 90-110 ng/ml. You can eat iron rich foods such as liver, liver pate, black pudding, etc, to help boost your ferritin level.
One other thing, as we need TSH to be as high as possible for diagnosis of hypothyroidism, we need to test no later than 9am and have nothing to eat or drink except water before the test. Is this how you have done your latest test?
I think in my previous post I wrote hyper when it should have been hypo. I may have been hyper in 2018 when I experienced sudden onset palpitations and high blood pressure and was referred to cardiology after months of recurring symptoms and periods of extreme fatigue, I began to have many of the classic hypo symptoms.
After battles with my GP who suggested Cf and a private endocrinologist, who insisted that I was not hypothyroid, I gave up and decided that I would 'heal myself'! this hasn't happened and I am gradually becoming worse, no matter how hard I try to overcome it. I am now at the point of returning to my GP and finding another endo to seek answers to my continued ill health. I supplement with vit D and B12 and my bloods were taken fasting at 8am.
Thanks for the link to further information and I'll do my research.
Technically, you are hypo when your TSH reaches 3, and in some countries they would diagnose you at that level. But, the NHS likes you to suffer until your TSH goes over 10 - probably for economic reasons - which is why it's so hard to get a diagnosis in the UK.
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