Thyroid Testing.

[Wolfman10]

Can anyone give me any advice on this testing? A dr did the test but never really addressed or talked about the thyroid numbers. Does anything stick out to you guys?

[greygoose]

It would be difficult for anything to stand out, because there are no ranges. Ranges vary from lab to lab, so we need the ranges that went with your results.

That said, you don't need a range for the TSH, and that is high. That TSH is saying you are hypo. Do you have a diagnosis? Are you taking thyroid hormone replacement?

There are also a lot of tests that don't give you any useful information: thyroxine, T3 uptake, Free Thyroxine index, rT3. All that interests us is the FT4 and FT3.

Your B12 is high. Are you supplementing?

Your Ferritin is high, but we need the range to see just how high. Same for the vit D.

[Wolfman10 in reply to greygoose]

Yes I’ve cut down on the vitamin B12 and D within the last month. I have never been given any thyroid hormone replacement. I guess I am getting another test this coming week to check the whole thyroid panel. But I read sometimes the numbers can be normal but someone still have thyroid issues. I can go months and feel fine, then a switch will flip and I am full of anxiety and depression. I’ve been through several different avenues over the years but it just seems that no drs can figure out what is wrong with me. Frustrating!

[greygoose in reply to Wolfman10]

Well, you're hypo, I can't see how that is difficult to figure out. Your TSH is saying you're hypo, and that is the cause of all your symptoms.

Yes, sometimes the number can be normal and someone still have thyroid issues, but your TSH is not normal. It is too high. However, I can't comment on the actual thyroid hormones without the ranges, I'm afraid.

[Wolfman10 in reply to greygoose]

I am getting it all tested again Monday so the results will be back by the end of the week. I will let you take a look at them.

What should the dr be doing to address this?

[greygoose in reply to Wolfman10]

Well, if you're hypo - as it would appear - the only thing he can do it give you thyroid hormone replacement. Usually levo (T4). Starting on a low dose of 50 mcg, and gradually increasing by 25 mcg ever six weeks until your symptoms have all gone and you feel well.

Are you getting your antibodies tested on Monday?

[Wolfman10 in reply to greygoose]

Yes I believe so. I wrote out the list of what I wanted tested and that was included.

[greygoose in reply to Wolfman10]

Well, let's hope they all get done.

[Wolfman10 in reply to greygoose]

I will get back to you next week. I appreciate the help!

[greygoose in reply to Wolfman10]

You're very welcome.

[SlowDragon Administrator]

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

With Hashimoto’s thyroid levels can swing up and down, especially in early stages before becoming increasingly hypothyroid

Ask GP to test vitamin levels and BOTH thyroid antibodies

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)

About 90% of all primary hypothyroidism in Uk is due to Hashimoto’s. Low vitamin levels are particularly common with Hashimoto’s. Gluten intolerance is often a hidden issue to.

Link about thyroid blood tests

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

Link about Hashimoto’s

thyroiduk.org/hypothyroid-b...

List of hypothyroid symptoms

thyroiduk.org/signs-symptom...

[Wolfman10 in reply to SlowDragon]

Looking back over last year’s lab work and so far this year I have had mostly just the TSH done. This is how the numbers have been this far:

January 2019- TSH 4.93

September 2019- TSH 2.56

October 2019- TSH 2.84

April 2020- TSH 3.3

June 2020- TSH 3.19

I have also had high LDL-P and high LDL-C. I have read that high cholesterol is a symptom of Hypothyroidism.

I believe my dr ordered a full thyroid panel which I will have done tomorrow. Should have those results by the end of the week I guess.

[SlowDragon Administrator in reply to Wolfman10]

TSH over 2 suggests thyroid is struggling

Median TSH graph

healthunlocked.com/thyroidu...

TSH daily variation

healthunlocked.com/thyroidu...

Very important what time of day you test TSH ....

researchgate.net/publicatio...

“According to the current TSH reference interval, hypothyroidism was not diagnosed in about 50% of the cases in the afternoon.”

“Further analysis demonstrated inadequate compensation of hypothyroidism, which was defined in 45.5% of the morning samples and in 9% of the afternoon samples”

ncbi.nlm.nih.gov/pubmed/252...

TSH levels showed a statistically significant decline postprandially in comparison to fasting values. This may have clinical implications in the diagnosis and management of hypothyroidism, especially SCH.

[Wolfman10 in reply to SlowDragon]

These were all taken first thing in the morning and fasting. I am going for another test this morning. I will post when I get the results.

What should a dr do when it appears you are hypothyroid?

The hormone dr I am going to first started me on Testosterone Therapy for Low T. I felt great for awhile but then went downhill. No I’m kind of on a roller coaster ride.

[SlowDragon Administrator in reply to Wolfman10]

Low testosterone common hypothyroid symptom

thyroidpharmacist.com/artic...

[Wolfman10 in reply to SlowDragon]

If I am taking testosterone and the doc decides I’m hypo, what will the next action be to address the thyroid? My anxiety is at a high level currently.

[stockman27]

To me it looks as though your hyop you free thyroxin is very low. Your body has no thyroxin to feed from. I would say you need a more thyroxin.

[Wolfman10 in reply to stockman27]

It is strange. My mental state is up and down and everywhere. I can sometimes go weeks or months and feel “normal” then bam out of no where it’s like a switch flips and I am in panic, depression, obsessive thinking about what’s wrong with me. Then again out of no where it can switch back to normal. I feel like I have no control of what is happening to me. I honestly have a great life. I have a great family. I really have nothing to feel this panic and depression. I know there’s something off in my brain or somewhere. Most docs in the past have focused on antidepressants. I just feel there’s something more to this.

[HLAB35]

In your shoes I'd be asking for an antibody panel to check if it's Hashimoto's. As Hashi's is autoimmune you'll sometimes find comorbid issues e.g. Addison's disease, Rheumatoid Arthritis, Sjogren's, Pernicious Anaemia and some Iron Disorders.

Your Ferritin is suspiciously high (can't see a range though). I'd ask for an Iron panel to check if either a) you're putting all your iron into Ferritin (low serum iron, high ferritin) which could suggest Arthritis or, b) you are completely overloaded with iron (hemochromatosis) which is dangerous if left unchecked. Hemochromatosis can coexist with Hashi's and only shows up after menopause in many women.

Iron panels are available from private companies if your GP doesn't help (but they should!)

[Wolfman10 in reply to HLAB35]

I am a male by the way. I am 5’9” and weigh 188. I work out all the time and I really do not have any issues with my bones and joints or anything like that. I usually run several miles a week and lift weights. I do it even when I feel miserable. I’ve learned to keep going through it all but believe me it’s not easy. I’m just curious to see if maybe it could be my thyroid giving me issues because none of my drs have addressed it. It’s like none of the ones I’ve been to can figure my situation out. I rely on God to get me through. I hope it’s Him that’s telling me to look into the thyroid. I pray! I have 4 children who need me.

[HLAB35 in reply to Wolfman10]

Hashi's is more common in women, but it's not exclusive to us and Hemochromatosis and Rheumatoid Arthritis is found in males too. Some aspects of rheumatic illness do not effect joints and it's not just a bone problem (that's osteoarthritis which is due to wear and tear and age). I'd go and get those blood tests done as high ferritin is a 'red flag' as well as high TSH. Despite our best efforts, we cannot avoid external triggers like stress due to family responsibilities which can eat away at our reserves (adrenals and thyroid) nor can we always avoid our own genetic predispositions to certain things. I feel that I have dodged a bullet, so far, as both my parents had cancer, but I am hyper vigilant which is also anxiety inducing.. Nature is my place to relax - gardening, walks with dogs etc. It's always good to have something to lift us spiritually.

N.B. Mood swings are extremely common in Hashi's. Many of us were put on anti depressants at some point in the past prior to diagnosis.

[SlowDragon Administrator]

Depression is extremely common symptom of Hashimoto’s

Other Mental issues including Bi-polar and Hashimoto's

drknews.com/when-hashimotos...

holtorfmed.com/mental-illne...

thyroidpharmacist.com/artic...

drknews.com/when-hashimotos...

hypothyroidmom.com/miss-dia...

ncbi.nlm.nih.gov/pmc/articl...

ncbi.nlm.nih.gov/pmc/articl...