I’m posting this on behalf of a close friend. She has been suffering with anxiety feelings and unable to sleep.
She’s had a thyroid blood test recently which show her T4 is over range but her TSH is within range. No T3 was done.
Has anyone had this issue. I think she may be heading towards hyperthyroidism. Her Dr said she has no issue and prescribed medication for anxiety. Which she says she has nothing to be anxious about but feels hyper all the time.
Her signs and symptoms are more important. It would be useful to measure her pulse, preferably by hand to see the rate and strengh. Also, I would suggest getting a cheap finger prick test for TSH, fT3, fT4. She could also try holding out her hands to see if there is a fine tremor.
Her blood test results are normal in that a few healthy people will have figures outside the reference interval but her symptoms seem consistent with hyperthyroidism.
Her GP should have checked her pulse and requested fT3 but she may as well do it herself and save time. If fT3 and fT4 are both high or high normal and she has a rapid pulse she should insist on an endocrinologist referral.
I wouldn't take the medicine for anxiety, unless it is a beta blocker (in which case the GP should have considered hyperthyroidism).
Unfortunately her GP is only doing telephone consultations so can’t check her pulse. Snd they won’t check T3 either but that’s no surprise really.
She just sent me details that her sedimentation rate is high snd over the range as well as her lymphocyte count being high above range.
When I was very ill with my thyroid my sedimentation rate was also high.
She just sent me details that her sedimentation rate is high snd over the range as well as her lymphocyte count being high above range.
The ESR - Erythrocyte Sedimentation Rate is raised when someone has inflammation. It does a similar job to the CRP - C- Reactive Protein, although they are calculated completely differently.
labtestsonline.org.uk/tests...
labtestsonline.org.uk/tests...
To see more info on the above links click on the + signs (apart from the first one which takes you back to the menu).
Her lymphocyte count being raised is also an indication of infection which often accompanies inflammation :
labtestsonline.org.uk/tests...
Hope this is of interest.
Suggest she gets a Fitbit or equivalent that records her resting heart rate
Good idea. Thank you.
I think her TSH would be suppressed if she was hyperthyroid and her T4 would be a lot higher. I wonder what her T3 is because that would give us a better idea of what is going on. What does she mean by feeling hyper? When I was very hyper I hardly slept and I was full of excess energy. I couldn't stop talking all the time and I was very thin. My periods stopped and I kept on having palpitations all the time because my heart was beating too fast.
She’s lost a stone in weight quite rapidly, she can’t sleep although not worrying about anything, has unexplained anxiety snd can’t eat.
She has abnormal result too for sedimentation rate and lymphocyte count. She’s just told me this.
I actually couldn't stop eating when I was very hyper but couldn't keep the weight on. I think she should ask her doctor to do further investigations to make sure there isn't another cause for her lack of appetite. Just to add I don't understand why doctors put everything down to anxiety when there could be a underlying health problem. My mother was told she was suffering from her nerves when she started to lose a lot of weight. Unfortunately she was found out to have cancer and her GP kept fobbing her off all the time. Not that I am saying this is the case with your friend but her doctor should find out the reason why she is losing weight and has no appetite.
I agree completely with what you’ve said. She spoke to her Dr this evening, all they said was that her results were normal but obviously they are not. And all they want to do is prescribe antidepressants. It’s so frustrating. So very frustrating. I told her just before to ask for antibody tests for her thyroid to rule it out. She’s going to try with them again tomorrow. She was very hyper and couldn’t stop talking earlier. She’s normally quite shy and quiet.
I don't think antibody tests will be much use (possibly a very high TPO would be useful). I would suggest she gets a cheap TSH, fT3, fT4 assay as described here thyroiduk.org/getting-a-dia... , this is the test monitormyhealth.org.uk/thyr... .
I don't think doctors take antibodies seriously mine are 4000 and I had them tested privately because my surgery doesn't do it. I showed my doctor my Medicheck results and he just brushed them aside but I did insist he put them on my GP medical records and surprisingly he did.
My sister had very high antibodies. Her Endo said she had no thyroid issues. She was quite unwell. She requested a change in hospitals and went to see an ENT Dr. They did a fine needle aspiration snd found thyroid cancer. Hers was removed 2 weeks later. I have no faith myself in GP’s or NHS Endos.
I wonder if she is suffering from this:
Silent (painless) thyroiditis
Silent thyroiditis is very similar to postpartum thyroiditis, but it can affect men and women, and is not related to giving birth.
Like postpartum thyroiditis, there may be a phase of high thyroid hormone levels (thyrotoxicosis) causing symptoms of an overactive thyroid gland. This may be followed by symptoms of an underactive thyroid gland, before the symptoms go away in 12 to 18 months.
If low thyroid hormone levels are causing severe symptoms, medicine may be needed until the condition gets better. Occasionally, the low thyroid levels can be permanent.
I’ll explain it to her tomorrow. Thanks for your time snd input it is really appreciated. If it wasn’t for this site and kind people like yourselves I don’t know where we’d be. Thank you!
I agree .. if I hadn't joined Elaine Moore's site 10 years ago I don't know where I would be now ... probably dead. I was left untreated for over 2 years and was told I was suffering from the menopause by my GP. Without sites like this one I dread to think how a lot of people with hypothyroid would end up.
I’m so sorry to hear of your story. Mine is similar. I was left under medicated for 11 years struggling. God knows how I got through. Then suddenly I couldn’t sit up let alone walk. The NHS failed me on everything. I went private after advise from an administrator on here and was diagnosed within two consultations. I’m a very poor converter T4 to T3. I also have DIO2 gene positive. Now privately prescribed T3 it has turned my life around completely. I feel 20 years younger.
I do hope you’re feeling ok at the moment. Like you I think I’d be dead without this forum. Thank the Lord we have it.
Unfortunately there are lots of women like us who are struggling and are offered antidepressants instead of treatment. Everywhere I go I see women who look like they might have thyroid disease and I don't know why the NHS doesn't treat them. I was sent for 2 uterus biopsies and a cervix biopsy when all I needed was treating for my thyroid disease. I even paid £150 to see a dermatologist who told me I had female pattern baldness. Not one of those doctors spotted I had a suppressed TSH. After over 2 years of no treatment I looked like the walking dead my hair was thin and some of my nails had dropped off. I had to go out and buy size 8 clothes because none of mine fitted properly. At one time my family thought I had undiagnosed cancer. Someone actually asked me if I had cancer because of my thin hair and I told them "No, just thyroid disease".
Oh my god that sounds horrendous. I’m so sorry for what you’ve been though. It’s really unbelievable how thyroid patients are undiagnosed and left struggling so badly for so long. What is wrong with these Drs and why is the training so poor. There are so many horror stories.
I ended up unable to walk for over a year. My partner had to spoon feed me at times. I couldn’t lift my arms up. We felt abandoned by the NHS. Even though my bloods said I needed T3 my NHS Endo would not prescribe it. We drove 400 miles to see a private only Endocrinologist and then my journey turned a corner at last. By now I’d lost my job and honestly thought I was going to die. Going to bed I often thought I wouldn’t wake up. Now I’m fitter than ever and have fully recovered on T3.
I was the opposite to you in terms of weight. I put on 2st in a few months and was already overweight from years of being under medicated. I’ve now lost 4st and look like I use to before Hashimotos came into my life.
I’m so pleased for you that you are better now. What I try to do now is help others on here in any way I can. Thank you for responding once again. I will speak to my friend tomorrow. We’ve been friends for 50 years and I just want to help her as her Dr isn’t interested.
Thank you so much.
Hi mcpammy❤️
Same here I had ever test except my thyroid blamed menupause 😠 I had a diagnosis of thyroiditis in 2014 then in 2015 it said in my records possible hyperthyroidism? After bloods were taken when I was admitted to hospital bleeding from my rectum😠 but because the endo said bloods were normal,, What ever that means!!! I was left to struggle on until finally diagnosed in 2018 with hyperthyroidism graves lost my thyroid because of their incompetence, and just recently I had a conversation with a new endo who went on to tell me I had ever test possible and should be glad they did these...... WELL.. I very nicely told him their would have been no need for those tests if they had recognised my symptoms and re - done THYROID BLOODS... THEY WASTED THE NHS MONEY NOT ME..... 😠 what a cheek,
She may be suffering from polymyalgia. When I had this condition, I had anxiety, could not sleep, palpitations and was losing weight, high inflammation markers but my doctor kept saying I had a mystery illness.
Thank you. I will pass your reply on to her.
More likely early stage Hashimoto’s
For full Thyroid evaluation she needs 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 have autoimmune thyroid disease (Hashimoto's) diagnosed by raised Thyroid antibodies....or if it is Graves’ disease
Suggest she Ask GP to test vitamin levels and thyroid antibodies
Or just test privately
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)
As you know already .....
Private tests are available as NHS currently rarely tests Ft3 or thyroid antibodies or all relevant vitamins
List of private testing options
thyroiduk.org/getting-a-dia...
Medichecks Thyroid plus vitamins including folate (private blood draw required)
medichecks.com/products/thy...
Thriva Thyroid plus antibodies and vitamins By DIY fingerpick test
Thriva also offer just vitamin testing
Blue Horizon Thyroid Premium Gold includes antibodies, cortisol and vitamins by DIY fingerprick test
bluehorizonbloodtests.co.uk...
If you can get GP to test vitamins and antibodies then cheapest option for just TSH, FT4 and FT3
£29 (via NHS private service ) and 10% off if go on thyroid uk for code
thyroiduk.org/getting-a-dia...
monitormyhealth.org.uk/thyr...
Hashimoto’s frequently starts with transient hyperthyroid results and symptoms
Thank you Slowdragon I really appreciate your reply. I agree with what you have said. I will speak to her tomorrow and hope she will be able to get her GP to do the tests you’ve suggested.
You are very kind and without yourself I don’t know where we’d be.
Hi mcPammy❤️
Yes I'm having the same problem 😔 my first T4 dose after full thyroidectomy was 175mg..this was to high I had hyper symptoms (and I know what hyper is I had it for over 2 years before being diagnosed of course my last year was the worst and I went in to thyroid crisis) I was reduced till finally on 50mg same hyper feelings🤷♀️ my bloods showed TSH at 0.01, T4 18.4,T3 was in range can't remember of the top of my head what it was but I think it was 3.24? But on this I feel hyper, upshot I'm lactose intolerant so after 8 months😠 gp took me off and with endos help I was put on T3 lactose free.. At 20mg again I was hyper, everything added up.. 1 fast heart rate 2 tremor, 3 insomnia 4, going to the loo all the time, 5,itching ,6 jittery feeling and finally bad sweating and nauseated 🤢 all the symptoms I had when my thyroid was in my neck!!! I've spoke to the gp and he and myself have agreed to try 10mg T3 split in to 5mg one in the morning one in the afternoon, here's my problem I'm feeling fine at the moment slight hyper symptoms but I know as soon as I take this 5mg table I'm going to start feeling the hyper symptoms come on worse, I've never felt hypo EVER!! So how can this be I would have thought 5mg was not a large dose 🤷♀️ I'm just about sick of this now and just feel like never talking a tablet again 😔😔😔😔
I have normal high TSH (4.6); high fT4 (33) and high normal fT3 (6.7). I was hyperthyroid and put on low dose propranolol. I’m awaiting referral to Cambridge for further tests. It has taken two years to get this far, despite me losing over two stone (20% of my body weight) in six months while eating normally. The doctors remain baffled, as do I, but I’d just like to point out that, with the thyroid, things are not always clear cut. I only made progress when I complained to my GP practice manager.
I decided against Propranolol because it is hard to wean yourself off it. I was given Carbimazole and then PTU. Just to add my husband was given it for anxiety and ended up in hospital because his heart rate became very low. The GP didn't realise he already had a very low heart rate because he was a long distance runner for many years.
bnf.nice.org.uk/drug/propra...
I know beta blockers do not work for everyone, but I feel so much better on them (10mg three times a day). I test my blood pressure myself at home and it is in a good range and my pulse rate is okay too. I’m not on any thyroid drugs and never been prescribed any.
That's good but they are addictive and difficult to stop if you are on them long term. I used to work in a hospital pharmacy and I always check every drug that my doctor prescribes to me. One of the GP's at my surgery injected me with Pethidine without checking my notes that showed I am allergic to it. I collapsed and was then rushed by ambulance to hospital which was very scary and I thought I was going to die. I don't trust doctors and I always question them about everything because of past experiences.
Wow, that must have been scary. I’ve been on the beta blockers for about nine months now and did ask my consultant in September whether I could come off them. She said I need to stay on them until I see the specialists at Addenbrookes, so I’m following that advice and hoping my appointment happens sooner rather than later.
Unfortunately everything is being delayed because of the corona. At the moment my T4 is near the top of the range at 22 but because my T3 is in range I feel well. I am taking nothing at the moment and I hope this time it last longer than 4 years.
Yes I had this. The problem is doctors look at the parameters rather than ask the patient how they feel. I slightly reduced my dosage, went from 125 daily to alternating 100/125. It made a massive difference.
Thank you everyone for taking time to reply to my friends plight. I just bumped into her while out on a walk. I guess it was fate. And I hope I can help her.
I had my thyroid removed in 2016. I have studied thyroid numbers and IMO your Dr is not being thorough enough.
It looks to me like your body is not converting the T4 to T3 hence your symtoms. With T4 that high...your TSH should be much lower if you are converting T3 which it does not appear so.
Your Dr must check your free t3 to confirm.
This is exactly why I use dessicated thyroid which my Dr lets me and he does my labs. I have never felt better.
I went through 3 Dr before I found the right one.
I felt terrible on synthroid...had tremors....high blood pressure and heart rate.
Best of luck to you
Thank you. My friend is trying to get an appointment with her GP for more thorough tests. Something is definitely wrong. Thank again.
Elevated TSH, T4 low, T3 normal
Below range T4 - normal TSH - Pituitary?
normal t4 but high tsh
Post parathyroidectomy T4/TSH....
