Looking for some advice from you knowledgeable people
I unfortunately seem to have went through an early menopause at 39 and have been on hrt for 6 months. I had bloods tested and the hrt doesn’t seem to be doing anything to my blood levels. I had some advice on a forum from a specialist endocrinology nurse from America who stated that my free T4 levels indicated hypothyroidism and I should start to take Levothyroxine. Everything I’ve read states because my TSH is normal this is not the case. I’m so confused. I have many of the symptoms Of hypothyroidism but they are similar to menopausal symptoms too.
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Baharah7
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Being hypo isn't just about the TSH level. TSH is not a thyroid hormone. It is a chemical messenger from the pituitary to the thyroid to tell it to make more hormone. But, sometimes, for various reason, the pituitary can malfunction and not produce enough TSH to stimulate the thyroid. When that happens, thyroid hormone levels drop. And, your FT4 is very low, only 22% through the range. It should be more like 50%. So, yes, you could very well be hypo. But, you would need to have your FT3 tested to confirm it. That's the most important number.
If you have a pituitary problem, that could be why you went through menopause early. Did they not test your pituitary at all?
Thank you for the response. The blood tests I paid for independently as the GP said my previous results were normal and was dismissive so I’ve decided to attempt to sort it out myself, so that’s why there are no tests for my pituitary. I have results for FT3 from a couple of years ago I will post when my health initially started to deteriorate. Again all results considered normal. I will attach them. Thank you
Results from a couple of years ago are no good now. Things can change very quickly.
Yes, I understand your results were considered normal, I was just explaining to you that they might not be. You need your FT3 tested now, and if that's low, too, then you need to start investigating what we call Central hypo - in this case, a suspected pituitary problem.
As Central hypo is not as common as primary hypo, the majority of doctors have never even heard of it, and therefore need prompting by the patient to research and investigate. It's not simple, but it needs to be done because the pituitary makes a lot of hormones, and if they're all low, you going to be in a lot of trouble, eventually. That's my advice, anyway.
For full Thyroid evaluation you need TSH, FT4 and FT3 plus both TPO and TG thyroid antibodies tested. Also EXTREMELY important to test vitamin D, folate, ferritin and B12
Low vitamin levels are extremely common, especially if you have autoimmune thyroid disease (Hashimoto's) diagnosed by raised Thyroid antibodies
Ask GP to test vitamin levels
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 as NHS currently rarely tests Ft3 or thyroid antibodies or all relevant vitamins
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