I have a lot symptoms that seem Thyroid related, specifically Hyper... my GP said my TSH is "in range".. last year it was 2.34.. this year she didn't tell me.. she won't do a full thyroid panel. Is it possible to have hyperthyroidism with a normal TSH? I'm thinking of paying for a private thyroid test including antibodies.. everything else has been ruled out now so I think this could be it..
Extreme brain fog, Palmar Erythema on palms, weakness, constant head pressure & headaches, weightloss/gain, yellow fatty stools/undigested food suggesting fast transit, abdominal pain, back pain, dizziness, visual changes, raised liver function test, poor nails, irritability, personality change, raised cholesterol, raised ferritin, frequent tinnitis, internal vibration throughout body.. my memory is non existent and cant focus or concentrate on anything, feels like ive got dementia... im 31! .. been going on for 2 years now.. have so many tests, colonoscopies, endoscopy, liver biopsy, 2 x abdominal ct with contrast, brain MRI, calprotectin and nothing shows up in my bloods apart from cholesterol and ferritin. Hemochromatosis ruled out.
I feel so poorly at this point and this is why im tempted to do private test as GP won't do any more testing.
Thanks for reading!
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ktan49
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I don't believe it is possible to have hyperthyroidism with a 'normal' TSH. But, it is possible to have hypothyroidism.
I imagine you're thinking of hyperthyroidism due to the weight-loss, but not all hypos gain weight. Some lose it. The rest of your symptoms look very much like hypo symptoms. Especially the high cholesterol, which is more than likely caused by low T3.
The Palmar Erythema could very well be due to autoimmune disease, so you do need your antibodies tested, whatever your doctor may think. But, I would imagine you're more likely to have Hashimoto's Thyroiditis than Graves. Hashis starts out with a 'hyper' phase, and after that, tends to swing between 'hyper' and hypo. With some euthyroid periods in between. Which would account for your 'normal' TSH.
Your TSH last year was 2.34 - which reallys does rule out hyperthyroidism as it's too high for that - and, whilst being in the so-called 'normal' range, is far from euthyroid. It indicates that your thyroid is struggling. But, as you've already understood, the TSH alone doesn't tell you much. The most important number is the FT3, which the NHS usually refuses to test, anyway! But, your GP could at least test your FT4, if she were so inclined. So, getting private tests does sound like a very good idea, to me.
Raised ferritin doesn't have much to do with thyroid, I don't think. But, it could be high due to high inflammation, which could be caused by autoimmine thyroiditis. And the internal vibration could have something to do with the adrenals. Hypos frequently have problems with adrenals.
So, if you're going to get private testing, these are the tests you need:
TSH
FT4
FT3
TPO antibodies
Tg antibodies
ferritin
vit D
vit B12
folate
That will give you a more complete picture of what is going on.
Thank you for your great response, much appreciated.
I should have mentioned my vitamin D was 39umol, folate 4.5, b12 350. Ferritin staying around 400.
Gastro ruled out IBD and just fobbed me off with IBS with mildly elevated calprotectin which I was prescribed meberverine which does NOTHING and he discharged me.
I should also mention.. by which I'm not proud of, I took anabolic steroids couple years ago and I read this can affect the thyroid.
Your nutrients are all much too low - except the ferritin - but as I said, that's probably due to inflammation. They all want supplementing - vit D should be about 100, folate half-way through the range, and B12 over 550. But, it's just typical of hypothyroidism to have such low nutrients. You probably have low levels of stomach acid.
IBS is a hypo symptom.
Anabolic steroids can affect the thyroid, yes, but they won't cause Hashi's. And, what you have sounds like Hashi's, to me.
Yeah I wasn't sure in which way steroids affected it just thought I'd mention it. Again thank you for your input.. been more helpful and knowledgeable than my GP.... i will be so happy if this full thyroid panel shows something, I'll get it ordered as soon as I can.. ive been suffering for 2 years and feelw like I have dementia... its a scary place to be. Thank you again
GPs know next to nothing about thyroid. They just don't learn much about it in med school. But what they did learn is that TSH has to be over 10 before a diagnosis of hypo can be given. And, they don't know enough about it to understand just how stupid that is! You are hypo when your TSH reaches 3, and in some countries would be treated at that level. But not under the NHS!
But, if you have raised antibodies, and an over-range TSH, NICE says you should be treated.
Very doubtful you have dementia, although I know it can feel that way. It's just that the brain needs a lot of T3, so if it's not getting enough, you can get all sorts of brain-related symptoms, like brain-fog and anxiety, etc.
Doesn’t mean that you aren’t sensitive to gluten. You can have non coeliac gluten sensitivity. About the only way of finding out whether going gluten free would benefit you would be to try going strictly gluten free.
Do you have the lab reference ranges for those blood test results you posted? Your Vit D looks like it could be on the low side, as does your folate and B12 level.
According to Izabella Wentz the Thyroid Pharmacist approx 5% with Hashimoto's are coeliac, but over 80% find gluten free diet helps, sometimes significantly. Either due to direct gluten intolerance (no test available) or due to leaky gut and gluten causing molecular mimicry (see Amy Myers link)
Changing to a strictly gluten free diet may help reduce symptoms, help gut heal and slowly lower TPO antibodies
Trying gluten free diet for 3-6 months. If no noticeable improvement then reintroduce gluten and see if symptoms get worse
The predominance of Hashimoto thyroiditis represents an interesting finding, since it has been indirectly confirmed by an Italian study, showing that autoimmune thyroid disease is a risk factor for the evolution towards NCGS in a group of patients with minimal duodenal inflammation. On these bases, an autoimmune stigma in NCGS is strongly supported
In summary, whereas it is not yet clear whether a gluten free diet can prevent autoimmune diseases, it is worth mentioning that HT patients with or without CD benefit from a diet low in gluten as far as the progression and the potential disease complications are concerned
Despite the fact that 5-10% of patients have Celiac disease, in my experience and in the experience of many other physicians, at least 80% + of patients with Hashimoto's who go gluten-free notice a reduction in their symptoms almost immediately.
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