Could someone tell me what these mean please, I also have multi nodular goitre, which they did say they would take it out but my partner was too ill at the time to consider it, I had to look after him.
Please help xx
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walkinghurtingarms
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Welcome to the forum. Can you tell us a bit more about yourself and these results please?
Are you currently taking thyroid medication? If so, how much? How do you feel?
Are the results from two different blood draws - if so which was done when?
We can see you have a suppressed TSH result (in both tests) and free T4 is reasonably low too - 37.5% through range - and free T3 is very low at 16.7% through range - but to explain more about what these mean, we need to know a bit more of your situation.
Thanks for your response. I have had a multi nodular goitre for a long long time but over this last few years I have had thyroid symptoms cold hands and very cold feet (painful) pins and needles, heartburn, hard to move weight but not overweight... feel very low from time to time... so tired used to swim 40 lengths every day and walk 5 k, there is no way in the work I would be able to do that without sleeping for the rest of the day, but my worst symptom is my shoulders and right bicep, after exercise my shoulders cease up and the pain radiates down the right arm, its so depressing! they said its frozen shoulder but it isn't as it gets better and worse all appertains to the amount of exercise I do!!!!
Its sad as I have always been very fit, I dont drink, smoke and eat very healthy, well except for a few cheats occasionally lol xxx My my had a goitre aswell!
So your symptoms are "classic" hypo. Your free T4 and free T3 results also suggest you are hypo [ie they are lower in range than many people need] ... and yet your TSH is suppressed. Most doctors go only by the TSH and so they will NOT give you treatment for an under-active thyroid with a low TSH - they may even try and claim your thyroid is over-active, because of the low TSH - despite the low free T3 and low-ish freeT4 results.
I'm wondering if it might be central hypothyroidism rather than "normal"(ie more common) primary hypothyroidism.
jimh111 knows much more about this than me - so hopefully he can add some thoughts
walkinghurtingarms has low normal fT3 and fT4 with low TSH. This shows that TSH is not responding adequately to low hormone levels. It's not quite central hypothyroidism which is usually more severe, so I call it subnormal TSH secretion. There can be many reasons for this, a common one is a period of hyperthyroidism which the patient doesn't notice. This could happen with a goitre. In this case the low TSH is due to a 'down-regulated axis'.
These low normal fT3 and fT4 (both) lead to hypothyroidism, the low TSH can reduce T4 to T3 conversion, especially in the brain and skeletal muscles. Ideally walkinghurtingarms would be given some liothyronine but it is very difficult to get it prescribed. Some levothyroxine might help.
It is most important the low TSH isn't interpreted as hyperthyroidism, thyroid hormone levels are rather low not high.
I also have a multi-nodular goiter which I have had for about 12 years. I have no intention of having it removed unless it becomes cancerous or it interferes with my breathing. A lot of people live with nodules and eventually need treating if they cause symptoms. Are you having regular ultra-sounds to monitor it? Just to add a lot women struggle afterwards with getting the correct treatment if they have their thyroid removed. This is one of the reasons I didn't take my Endocrinologist advice 10 years ago when he suggested to have it removed or have RAI. I am glad I kept mine because at the moment I feel well.
Are you on any meds? I too had multi nodular thyroid but unfortunately for me, after quite a few years on carbimazole being increased and reduced every 2/3 months, I had to have a second partial thyroidectomy (having my first done when I was 28, I’m 66 soon) after recovery and what seemed like numerous blood tests and back into carbimazole, I felt that RAI was the only way to go. Even though I think I feel slightly better, I’m far from ok and am at the moment trying to make sense of it all. So I suppose what I am trying to say is sometimes there isn’t really a choice to ‘keep’ your thyroid when you have had years of feeling as if you’re going mad.
I am in my second remission so no meds at the moment. I might have to have mine removed in the future if it makes my breathing difficult but I am ok at the moment. My TSH is lowish at 0.38 and my T4 is high at 22 but this suits me and I feel very well.
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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