Help me interpret results?: So after identifying... - Thyroid UK

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Help me interpret results?

Wileyrielly profile image

So after identifying with a multitude of hypothyroid symptoms I decided to get a thyroid test. The testing centre said that the only think that flagged up was low T3 but normal parameters were met with all other biomarkers.

I was hoping to get some advice from this sub as to interpret these results and also poissibly any tips/advice. I have avoided typical irritants for the last 4 years (Dairy, gluten, excess sugar etc) and also excersise regularly in an attempt to mitigate some of my depressive symptoms.

Is it as simple as taking a T3 supplemtnt (Cytomel?) I expect it's more complecated than that.

Any feedback is most appreciated. Below are my results. Thanks in advance.

ENDOCRINOLOGY

TOTAL THYROXINE(T4) 73 nmol/L 59 - 154

THYROID STIMULATING HORMONE 1.95 mIU/L 0.27 - 4.2

FREE THYROXINE 16.5 pmol/l 12.0 - 22.0

FREE T3 * 3.0 pmol/L 3.1 - 6.8

Thyroid peroxidase ab's <9.0 IU/ml 0 - 34

Method used for Anti-TPO: Roche Modular

Thyroglobulin Antibody <10.0 IU/mL 0 - 115

Method used for Anti-Tg: Roche Modular

18 Replies

With results like these I think your doctor should be investigating Central Hypothyrodism.

Your FT3 is woefully low for someone with a TSH of 1.95–I take it you haven’t previously taken any thyroid hormone replacement?

With an FT3 at that level I’d expect your TSH to be considerably higher—but it isn’t. Which is why I do think your doctor should be considering pituitary failure. The treatment would be the same—thyroid hormone replacement—but it would be as well to know what’s causing the underlying issue in case there are other knock on effects.

What’s your doctor said to these results? Many don’t understand the importance of FT3–you may need to find a GP who does...

Wileyrielly profile image
Wileyrielly in reply to Jazzw

I cut out huge amounts of various foods and have been eating a very restricted diet for the last 4 years; this is conjecture but perhaps removing known irritants like dairy, gluten, excess sugar and various plants, unhealthy oils etc has meant that I have mitigated a possible autoimmune reaction and hence lowered anitbodies.

What suggestions do you have for finding a GP who is adept at handling these results?

Thanks for your reply.

Jazzw profile image
Jazzw in reply to Wileyrielly

It’s not your low antibodies that’s made me answer the way that I did. It’s your low(ish) TSH that’s puzzling. With an FT3 result below the bottom of the reference range, your pituitary gland should be screaming at your thyroid to make more thyroid hormone. That “scream” is TSH—thyroid stimulating hormone, a hormone that’s produced by the pituitary to stimulate the thyroid gland.

But there’s no screaming. Your TSH is relatively normal—it’s not even high in range. That suggests to me that something’s amiss in the pituitary.

Diet won’t make any difference to that—I don’t think I’ve ever read about any nutritional remedy for getting the pituitary gland to produce TSH.

It might not be this—it could be a strange one off blip in your results—but I’d be wanting my doctor to investigate.

Your usual GP should be your starting point—I take you had these tests done privately?

Wileyrielly profile image
Wileyrielly in reply to Jazzw

Oh okay, I understand what you're saying - very well explained. Yes I had them dont my an independant organisation. I spoke to a GP this morning and he has advised me to write to my practise and to describe my symptoms and include the thyroid panel I received - I believe they will forward these on to a NHS endrocrinolgist who will review the case and hopefully accept me as a patient. Heres hoping.

Wileyrielly profile image
Wileyrielly in reply to Jazzw

Hey also no I havent previously been on any thyroid replacement therapy.

SlowDragon profile image
SlowDragonAdministrator

Welcome to the forum

First thing is are you currently taking any levothyroxine?

Or trying to get diagnosed?

Were these tests done by GP

Were tests done early morning?

NHS only tests Thyroglobulin antibodies if TPO antibodies are high. Your TPO antibodies are not high

Very low Ft3....but TSH is not reacting to this as it should do

First step is to check vitamin levels

What vitamin supplements are you currently taking

Depression can be caused by low Ft3

Are you taking any other medications?

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)

Is this how you do your tests?

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 antibodies and vitamins

medichecks.com/products/adv...

Thriva Thyroid plus antibodies and vitamins By DIY fingerpick test

thriva.co/tests/thyroid-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 down to £26.10 if go on thyroid uk for code

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

monitormyhealth.org.uk/

Also vitamin D available as separate test via MMH

Or alternative Vitamin D NHS postal kit

vitamindtest.org.uk

List of hypothyroid symptoms

thyroiduk.org/if-you-are-un...

Because TSH is low, you will probably need to see an endocrinologist to make progress

Email Thyroid UK for list of recommend thyroid specialist endocrinologists..........NHS and Private

tukadmin@thyroiduk.org

Hi,

Thanks for the welcome.

I am currently not on any medication and hope to get diagnosed as to find a reason for my many symptoms: (Low libido, poor sleep , thinning eye brows, depression/anxiety, goiter, tinnitus, loss of balance, fatigue after waking, no appetite, night sweats, intolerance to cold, hearing loss (Family history of this also) and Longitudinal nail ridges)

These tests were done at 10 am and before I had anything to eat/drink.

These tests were done by an independant testing centre: letsgetchecked.com/gb/en/

I believe my vitamins levels to be stable as I regularly supplemnt Vit D3 and also eat calfs liver often as to supply nutrients. I will ask my GP for a blood test however.

I will email for a list of recommended endocrinologists; what would be my next course of action after this?

Many thanks for your reply.

SlowDragon profile image
SlowDragonAdministrator in reply to Wileyrielly

First step is to check vitamin D, folate, ferritin and B12

Privately if necessary

Copy that. Will arrange to have them checked.

SlowDragon profile image
SlowDragonAdministrator in reply to Wileyrielly

What’s your diet like

Was there something specific that set symptoms off

Few links about Central hypothyroidism

bestpractice.bmj.com/topics...

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

endocrinologyadvisor.com/ho...

I eat very restricted low carb ketogenic diet without dairy, and gluten. Dairy and gluten are big triggers for me and also histamine rich foods. Seems I can only really tolerate fresh meat, nuts and greens so thats what I stick to. Ive gone through every usual method for treating these symptoms and I think I'm finially zero-ing on the cause with the thyroid.

Hearing that my T3 levels were low and identifying with the typical symptoms has actually been a relief; a quantified result to explain my symptoms. And with possible diagnoses, possible treatment seems possible.

If you were in my posistion how would you proceed? I'm going to arrange to have my nutrients levels checked but having gone down the nutrient dificiany route before hand, along with my strict regiment of supporting my nutrient levels with vitamin D, selenium, fatty sish, liver to provide the typical deficiancies in abundence; I fear that an anylysis will not reveal a deficiancy, and not reveal the route cause. I will be getting blood work done again however, even though I had bloodwork done less than 6 months ago which revealed no deficiencies.

I believe what with my sensitivites and my responsivness to a restricted diet, that my issue was caused by an autoimmune response that has since damaged my thyroid and hence my lower levels of T3, speculation ofcourse, just a possible route of pathogenesis.

I'm worried that my doctor will not prescribe T3 as I have heard that the NHS are "in the dark ages when it comes to thyroid treatment". If my doctor is unmoving, what is my recourse?

Thank you for your promt and thorough replies.

SlowDragon profile image
SlowDragonAdministrator in reply to Wileyrielly

A very calorie restrictive diet can be the cause of low Ft3

What were your vitamin results and ranges from previous testing 6 months ago

I'm not sure as I dont have the results handy - I remember the doctor saying that nothing was flagging up however. The low calorie diet is interesting and something I actively try to avoid - I really must be more proactive with getting in food.

SlowDragon profile image
SlowDragonAdministrator in reply to Wileyrielly

A doctor only tests for deficiencies .....that’s totally different from OPTIMAL vitamin levels

Vitamin D

Under 25nmol is deficient

under 50nmol is insufficient

Over 80nmol is good

Around 100nmol may be better (40ng/ml )

Serum B12 under 180 is deficient.

Over 550 is optimal

Folate under 3 approx is deficient.

Half way through range is minimum for optimal. Range is either 3-20 or 4-60 depending on lab.

Ferritin- minimum for good health is halfway through range - typically 70 -100

Deficient is under 14-18

So if your vitamins were as follows

Vitamin D 51

B12 260

Folate 3.2

Ferritin 23

Doctor would say they were “fine”

But they are all far from optimal

Why are you only eating very low carb

Low carb can significantly reduce conversion of Ft4 to Ft3

This is really interesting; is there anywhere that you would reccomend getting testing done? Or would it just be better to get another NHS test done. I eat low carb becuase its one of the most effective things I've found to mitigate feelings or lowmood/anxiety. Ive tried eating regular amounts of carb only for a return of mental symptoms. I also just generally feel much better eating lower carb, my exercise performance also increases.

I had typical hypothyroid symptoms before doing low carb so I dont believe them to be the cause of my symtoms, although I'm not adverse to exploring the possibility, I also have family member who exhibit similar hypo symtoms who also do not do low carb which again would suggest it isnt the route of pathology.

SlowDragon profile image
SlowDragonAdministrator in reply to Wileyrielly

Full details of private testing options in my first reply

Bearo profile image
Bearo in reply to Wileyrielly

I think it’s low carbs cause drop in T3, drop in T3 causes symptoms, rather than your diet causing symptoms directly.

SlowDragon profile image
SlowDragonAdministrator in reply to Wileyrielly

Very low calorie diet and it’s significant effect on Ft3

pubmed.ncbi.nlm.nih.gov/234...

medwirenews.com/thyroid/met...

virtahealth.com/blog/does-y...

And many more research papers with very similar results

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