Slightly elevated FT4 and thyroid nodules - next step?

[Abeja67]

Hi, newbie here, looking for some advice.

I went for a private thyroid blood test as I've been having quite a few symptoms associated with Hyperthyrodism (increased level of anxiety, restlessness, thumping heart, feeling hot/sweaty, diarrhea, weight loss, insomnia). Test result came back with slight elevation in FT4. Results were:

TSH: 2.17 (0.27 - 4.2)

T4 Total: 133.0 (66 - 181)

Free T4: 22.1 (12.0 - 22.0)

Free T3: 5.6 (3.1 - 6.8)

Anti- Thyroidperoxidase abs: < 9 (< 34)

Anti- Thyroglobin abs: 13 (< 115)

Cortisol: 541 (113 - 456)

As thyroid issues run in my family (I'm the only one so far not having been affected) and not wanting to wait for weeks for an NHS referral, I also went for a private thyroid scan. This revealed the thyroid to be normal size, but with multiple bi-lateral avascular, cystic/microcystic nodules with no sinister features.

Armed with this information, I now need to approach my GP, but I'm not sure what to ask for. As my FT4 is only slightly above the normal range, should I wait a few weeks and have another blood test or should I push straight for a referral to an endocrinologist?

Thank you!

[greygoose]

Your TSH is over two, and your FT3 is 67.57% through the range. And your antibodies are low. So, it's doubtful an endo would even agree to see you. He would say your results are 'normal'.

And your FT4 is only 0.1 over-range. So, those really do not constitute hyperthyroid results. And, the symptoms you cite could just as easily be hypo symptoms.

And, I certainly don't thing your GP would be interested. I think you would be better waiting at least six weeks and retesting. But, with the retest, get your nutrients tested, too. Vit D, vit B12, folate and ferritin. Low levels of nutrients can sometimes cause thyroid-like symptoms.

[Abeja67 in reply to greygoose]

Thanks greygoose for your advice. I'll have another blood test in a few weeks time and review. I had blood tests recently which included vitamins (all came back okay) and I regularly take B-vitamin, vit D, calcium and magnesium supplemants, so I'm reasonably confident that the symptoms aren't due to vitamin deficiencies.

[greygoose in reply to Abeja67]

Do you take a B complex? If so, did you stop it 1 week before the blood draw for those tests above?

Why do you take calcium? That is really not recommended.

[Abeja67 in reply to greygoose]

Yes, I take a vit B complex. The blood tests were unplanned, so I had no chance of stopping the vitamins beforehand. The calcium is for osteocare.

[greygoose in reply to Abeja67]

In that case, those labs are not reliable. They could have been affected by the biotin in the B complex. Any form of biotin should be stopped one week before the blood test. So, could very well be that your FT3 is not slightly over-range, after all.

What do you mean by 'osteocare'? Excess calcium does not prevent oseoporosis - or do you already have osteoporosis? Excess calcium will make your bones more brittle. Not only that, but calcium supplements are very badly absorbed, and tend to build up in the arteries and other soft tissues.

Calcium deficiency is very rare in the west - unless you have parathyroid problems. And, if you are taking vit D, that will increase your absorption of calcium from food. For that reason, you should also be taking vit K2-MK7, which makes sure calcium goes into the teeth and bones and doesn't build up in the soft tissues. Do you have your calcium checked regularly? It's very easy to over-dose.