Hyperparathyroidism and T4 levels?

[LuxN]

Hi

Does anyone here have Hyperparathyroidism (PHPT) and has found that their TFTs are suddenly weird?

A usual result for me is TSH anywhere between 0.7 and 2.5 (0.3 to 5), a fT3 of 3.1, range (3 - 6.9) (poor converter) and a fT4 of 18.5 (12-22).

The previous 2 tests I had done, both times they did not give me a fT4 result. Once was a ruined sample, the other was just ignored. TSH was done both times though and was approx TSH 0.7ish, fT3 of 4.1. Apparently, I can suddenly convert?!

So I finally got a fT4 this week after a third time of them saying the sample was unusable. Had it redone and the results were TSH 0.42, fT3 4.2 and fT4 of 27.7! My GP considers this normal and no further action needed.

I've tried various other ways of dealing with my hypo over the years, including NDT and T4/T3 combo. When I am on 100mcg of Levo though my fT4 is always about 18.

I had an ultrasound scan and then a sestamibi scan that confirmed I had a parathyroid adenoma on the bottom right. My thyroid has been atrophied on the left since at least 2015.

Any ideas what might be going on?

[SlowDragon Administrator]

Looking at previous posts you have Hashimoto’s

So conversion often poor

How much levothyroxine are you currently taking

Do you always get same brand levothyroxine

What vitamin supplements are you currently taking

When were vitamin D, folate, ferritin and B12 last tested

Are you on absolutely strictly gluten free diet

If you have parathyroid tumour why isn’t it being removed

[LuxN in reply to SlowDragon]

I will answer in order.

Yes conversion often poor.

100mcg

No, but not a brand I haven't had before, and did not caused results like this.

The vitamins I take are complex because I am low in VitD but supplementing it made me sicker (as it often does with people with PHPT). I added magnesium about a month ago.

Vit D is still just in range at the mo, folate is low, ferritin is above range (absorption issues?), B12 is top of range. My results have been like this for at least the last couple of years

Yes. Gluten free for years due to multiple food intolerances nobody can get to the bottom of but research suggests may well be linked to my PHPT.

Thanks for your reply. I am not expecting you guys to be able to help. I just wondered if anyone else here had experience of this? I guess not. My search for an answer continues

[SlowDragon Administrator in reply to LuxN]

Why is parathyroid not being dealt with

Have you definitely had parathyroid tumour diagnosed

If yes when is it being removed

parathyroid.com/low-vitamin...

Parathyroid tumors cause low Vitamin D, not the other way around, and low Vitamin D cannot cause a high calcium.

Please add latest vitamin D, calcium and parathyroid results

Or download calcium app and put results in there

Will give diagnosis

calciumpro.com

Gluten intolerance is common with Hashimoto’s

[LuxN in reply to SlowDragon]

Hi - yes, I definitely have it and yes it is being dealt with. I am on the waiting list for an op.

[bantam12]

Thyroid and parathyroids are not connected and have different functions so one doesn't effect the other.

[LuxN in reply to bantam12]

Thanks Bantam. Obviously, I wasn't referring specifically to the relationship between thyroid and parathyroid, more to the effect excess calcium or something else from PHPT might have on my thyroid function. For example, I wondered if anyone here knew if people with PHPT are more prone to Hashi's flares? Judging by the responses here, nobody knows.

[bantam12 in reply to LuxN]

I had Hpth and very high calcium but it didn't ever effect my thyroid levels, I don't see why or how it would as they are in no way connected.

[LuxN in reply to bantam12]

One simple way is via Vit D levels and Magnesium? As you can see from the first response to my post, whether we have had these vits and minerals checked is almost the first question we are asked here with regard to thyroid function. Vit D cannot be converted without magnesium and the over conversion of Vit D due to the excess parathyroid hormone depletes us of both VitD and Magnesium. Those can impact thyroid function...yes? Anyway, as I said before, I just wondered if anyone had experience or knowledge about this. When I next have a chance to get in contact with my parathyroid specialist I will ask. If I learn anything that might help others here, I will share. Thanks

[LuxN in reply to LuxN]

A very quick google reveals that thyroid function can affect calcium levels, so they are linked. I will need to research further with regard to what is happening to me, but here's just one example from UCLA Endocrine Center - "In rare cases of severe thyroid disease, blood calcium levels can become imbalanced."

[SlowDragon Administrator in reply to LuxN]

Here’s link to the article

uclahealth.org/endocrine-ce...

Have you had kidney function and GFR rate tested.

[tattybogle in reply to LuxN]

"In rare cases of severe thyroid disease, blood calcium levels can become imbalanced."

I would think this is because the thyroid gland produces calcitonin in response to high calcium levels , (as part of the regulating mechanism for calcium ) so in a very severely damaged thyroid gland maybe the release of calcitonin is impaired ? hence causing the imbalance in blood calcium levels..

(An interesting connection that i'd not thought about before ... i wonder what happens about the production of calcitonin in people who've had a complete thyroidectomy ?)

I don't know if this could have any effect on frequency of 'Hashimoto's spikes' in thyroid hormone levels.. i would have thought a continuously high calcium level would cause a continuously high calcitonin release.... so surely if it did affect thyroid hormone production in some way , the effect would also be continuous rather than spikes ?

"A very quick google reveals that thyroid function can affect calcium levels, so they are linked.".... yes, but i don't think that can be taken to mean calcium levels affect T4 production .

The vitamin tests asked about so often here , (unless i've grossly misunderstood which is always possible !) ...are because hashimoto's can result in us having lower levels of these vitamins by various means...not because the thyroid needs these vitamins to function properly .