My doctor called me very weird case: I got my... - Thyroid UK

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My doctor called me very weird case

Justiina profile image
17 Replies

I got my cholesterol tested in walk in lab, just out of curiosity, also got TSH and ft4 as they were practically free of charge, no ft3 as it wasn't offered without referral.

My cholesterol is 3.4 <5

TSH 2.61 (0.5-3.8)

Ft4 12 (10.2-21)

He says I am very weird case as the cholesterol is low when it should be higher with low thyroid. I am not on cholesterol medication.

Also my ultrasound was clear, my antibodies were not elevated and he can't find a cause for my thyroid fluctuation. He is fascinated tho, he says I am very uncommon with all my weird labs, low leucocytes, sometimes high transferrin saturation but not high iron/ferritin.

So, I am officially weirdo. Kinda cool. Not. 😄

He referred labs for hormones as he thinks those can be off too. I agreed to wait for another set of tests as I am getting very curious too why my labs are so all over the place but nothing specific is ever found.

He also said it's technically possible I am still living on that "hyper fun hormones" from last spring and my labs could change any day. But its also possible my cholesterol has been far lower and its now elevated and that bugs him because then my cholesterol would truly be a problem or more so indicating bigger problems with hormones.

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Justiina profile image
Justiina
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17 Replies
MissGrace profile image
MissGrace

I think your GP needs to get out more. Even when I was severely hypo, my cholesterol was fine. I guess it is down to individuals, maybe genetic luck too? Also, not everyone who is hypo has Hashimoto’s (where antibodies are raised and attack the thyroid gland.)

I’m sure others on here, with more knowledge than me will be along to comment and give advice. I would say be a bit wary of this GP though, I don’t think ‘hyper fun hormones’ (WTF?) is a medical term! The treatment of thyroid issues is notoriously poor at times as you see on this forum. You’ll find all you need to know on here.

Good luck with getting well. 🤸🏿‍♀️🥛

Justiina profile image
Justiina in reply to MissGrace

No it's not medical term, it's term I used😄 He said hyper phase can technically still affect which is why he isn't jumping into conclusions and wants to test my steroid hormones to be sure as steroid hormones are made of cholesterol. And some of my symptoms does indicate wider hormonal issue.

He is very good at thyroid problems and could prescribe thyroxine trial now, but we agreed to rule out other hormonal issues and fix them as well not just thyroid.

shaws profile image
shawsAdministrator

A higher cholesterol level can be due to being hypothyroid but as our dose of thyroid hormones are increased, cholesterol will reduce. So many doctors prescribe for high cholesterol levels instead of being aware that thyroid hormone replacements will reduce it.

DippyDame profile image
DippyDame

Well that's not very polite!!

He wouldn't instil confidence in me I'm afraid

Cholesterol isn't a problem, your result is good..

Why does he think your cholesterol has been far lower?

Do you have labs to this effect?

"Thinking" is not a diagnosis!

Is he looking for problems where none exist

I suggest his focus is on the wrong thing!

If he really wanted to understand thyroid hormones/function he would need FT3 labs.....thyroid function cannot be properly evaluated without FT4 and FT3

Your FT4 is only 16.67% through the ref range.....it should be close to 75%!

Did he not pick up on this?

Your TSH should be lower than 2.61 (that, because you are hypothyroid).

It should be close to 1 or lower....indicating the body has adequate hormone

However the NHS are reluctant to medicate much below 10 by which time you could be on your knees !

The NHS have some mad idea that TSH is the gold standart thyroid test. Not so!

TSH is a pituitary hormone not a thyroid hormone and responds to thyroid hormone levels. The lower the hormone level the higher the TSH

FT4 and FT3 are the important readings

Medics are very poorly educated in matters thyroid, the posts on here are evidence of that

What do you/ he mean by "hyper fun hormones". That is weird!

You are hypothyroid and need levothyroxine.

I agree with MissGrace your GP needs to get out more!

Best...

DD

Justiina profile image
Justiina in reply to DippyDame

Hyper fun hormones was mine a bit sarcastic term as it isn't so much fun fun 😄

He used more medical term when he said the hyper phase can technically still affect some of my labs as we all are individuals. But we don't know what is my baseline cholesterol with normal thyroid, it could be even lower.

Problem with cholesterol is that steroid hormones are made from cholesterol and if cholesterol is low then other hormones can be low too. As I have mixture of symptoms he suspect low cholesterol could be bad and I am lacking other hormones.

He does know ft3 is relevant number and he always tests it, but this time I got tested by myself in a lab that doesn't do ft3 without referral. After seeing my results he made referral to full panel.

DippyDame profile image
DippyDame in reply to Justiina

Sorry, but I get the impression that this endo is not up to speed.

Have you had antibodies tested for possible Hashimoto's.....are you experiencing Hashi flares

thyroiduk.org/hypothyroid-b...

You cannot swing between hyperthyroid and hypothyroid ....it is your symptoms that can alter during Hashi flares.

Your labs suggest that you need replacement hormone (T4)

What reason does this medic have for not initiating a trial of levothyroxine, tested and increased as necessary every 6 weeks until the frees are around 75% through ther ref ranges.....and you feel well.

You say, " I feel quite awful and my doctor agrees my ft4 is also a problem as it stays on lower side". So why doesn't he treat you!

You say, " but as I have mixture of symptoms he suspect it is not just thyroid and wants to test it all before we try thyroxine". Why? He appears to be putting the cart before the horse!

Is he aware of the extensive list of symptoms associated with hypothyroidism?

You feel awful... you are clearly hypo,

Once you are optimally medicated that is likely to resolve your, " mixture of symptoms"

You say, "He is very good at thyroid hormones".....I hope your trust is rewarded!

Good luck

shaws profile image
shawsAdministrator

I think I'd be more worried about my FT4 being at the bottom of the range. I'd like to know what my FT3 was. How do you feel at present?

Justiina profile image
Justiina in reply to shaws

I feel quite awful and my doctor agrees my ft4 is also a problem as it stays on lower side, but as I have mixture of symptoms he suspect it is not just thyroid and wants to test it all before we try thyroxine so we can try to avoid failure of thyroxine trial caused by other hormones.

greygoose profile image
greygoose

If he wants to know what's going on, he needs to test your FT3. That is the most important number. Even though your TSH says your thyroid is struggling, and your FT4 is low, your FT3 could still be at a 'normal' level in the blood. Very often, when the thyroid 'knows' it is failing, it produces a higher level of T3 than T4, to keep you alive. We see this quite often.

Also, cholesterol levels are linked to T3 levels, not T4 and not TSH. So, he really needs to brush up on his thyroidology.

That said, I was the same, when I was very hypo - just before diagnosis - my cholesterol was just 0.1 over the top of the range - enough to start my GP screaming about 'blocking up my arteries', though! lol Cholesterol is made in the liver, so very often low cholesterol is due to liver problems. When I discovered that (me! not my doctor!) I asked for my liver to be tested, and that was ok. So, no idea why my cholesterol continues to be too low - which it is, now that my FT3 is optimal (for me). Last time I had it tested, the lab flagged it up as being a possible cause of heart attack. Response from doctors? Cholesterol can't be too low!!! Sometimes the lab techs do know more than the doctors. Sigh.

Justiina profile image
Justiina in reply to greygoose

Yeah he always tests ft3 and it's in next set of labs, I just took the TSH and ft4 with the cholesterol to see are there any change to previous results 6 weeks ago. And they costed 2 euros so why not 😄 My ft3 so far has been decent and yeah he has told me the same than you, it often is that way.

He is just puzzled about the cholesterol because it affects other hormones. I have symptoms of both low thyroid and low over all hormones. So he'd rather test all hormones than just cholesterol and thyroid as he says we can't know do I swing between hyper and hypo because we can't test thyroid every day. If I swing between hyper and hypo then it's not odd at all my cholesterol can go even lower as he said it's very sensitive indicator to thyroid, especially ft3.

greygoose profile image
greygoose in reply to Justiina

OK, well, that sounds better than the way you explained it before. So, he suspects Hashi's, does he?

Low cholesterol affects adrenal hormones in that the adrenals need cholesterol to make them. Which is one of the arguments against statins.

But, has he checked your liver?

Justiina profile image
Justiina in reply to greygoose

Yeah he suspects hashi, he says there clearly is thyroid issue and that should be fixed, but something troubles him a lot when he looks at the big picture. So I am weird case 😄

Its a bit slow progress as he has so many patients but it's my choice to stick with him as GP ignores my thyroid tests and symptoms.

greygoose profile image
greygoose in reply to Justiina

Have you had a thyroid ultra-scan? Presumably your antibodies are negative, or he'd know. But has he tested both TPO and Tg antibodies?

When you start becoming hypo, your body does everything it can to maintain T3 levels. It's the level of T3 that is associated with cholesterol levels, so you might still have decent FT3 even though your FT4 is low in range.

jjf255 profile image
jjf255

My husband just had his annual physical. He is hypothyroid and at the time of blood work was on 120mg of Armour. His TSH came way down from his previous bloodwork but is still just a bit high and his T3 needs to come up a bit, so his Dr. just added 15 mg to his dose of 120mg of Armour. What was quite low was his cholesterol , which is good for the LDL, but his HDL is also unusually low. He has had this issue most of his adult life and all of his Drs. feel it's genetic and don't ever seem too concerned. I am the one who is concerned about his low HDL, since this keeps your arteries clear. I only use olive or avocado oil for salads and cooking and cook salmon and other fish that should help raise his HDL, but it doesn't seem to help. I haven't found much in my online searching as to why he has this issue.

Justiina profile image
Justiina in reply to jjf255

Yeah, my HDL is just in the range (1.2 and range is >1.2) and that also worries me a bit, my family is like a text book example of clogged arteries.

Low cholesterol is so poorly studied its hard to find proper information!

Marymary7 profile image
Marymary7

If it was a walk-in lab did you fast for the cholesterol test. It's my understanding you are supposed to fast.

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