hi there, can anyone help with my niece's blood results. she recently had a baby and has not been well. she has all the classic symptoms and she is being referred to an endocrinologist and there was mention of RAI which she doesnt want as she has three children all under the age of 6
TSH - 0.010 (RANGE 0.2 - 4.5)
T4 - 33 (RANGE 9 - 21)
T3 - 4.9 (RANGE 0.9 - 2.4)
her liver marker is very high and her blood sugar is high.
do you know if she can recover in time or does she definitely need surgery
any suggestions would be helpful - thanks
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thyroidnodules
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I very much doubt she needs surgery. She's hyper at the moment, as often happems after childbirth. But, it's more likely to be Hashi's than Graves.
Before anything else is done, or any decisions made, she needs her antibodies tested. She obviously has a cluless doctor who knows nothing about thyroid. So, she should just ignore all referrences to RAI until more investigation has been done - and even then, it's probably not the best way to go, and certainly not something to be rushing into. These doctors make me so angry! They don't seem to realise what a huge step that is.
So, she wants:
TPO and Tg antibodies to see if she has Hashi's
TRAB or TSI antibodies to see if it's Graves.
Only then can anyone decide what the next step should be.
Thank you for that . I thought so as another niece had the same symptoms and managed now and again with meds when needed until everything settled down. I think she has been giv en propranolol in the meantime and has been referred to an endocrinologist. Will get her to ask the endo to do an antibody test. Thank you.
Also needs Vitamin D, folate, ferritin and B12 tested too
Hashimoto’s frequently starts with transient hyperthyroid results and symptoms before becoming increasingly hypothyroid
As Greygoose says, Hashimoto’s frequently starts after pregnancy
Common for medics to assume these results above are Graves’ disease
Important/essential to test all thyroid antibodies for Hashimoto’s and Graves’ disease
For full Thyroid evaluation she needs TSH, FT4 and FT3 plus both TPO and TG thyroid antibodies tested for Hashimoto’s (and can be high with Graves’ disease)
And test TSI air Trab antibodies for Graves’ disease
Also EXTREMELY important to test vitamin D, folate, ferritin and B12.
Low vitamin levels are extremely common, with BOTH Graves and Hashimoto’s
Ask GP to test thyroid antibodies and vitamin levels NOW or 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)
Private tests are available as NHS currently rarely tests Ft3 or thyroid antibodies or all relevant vitamins
I'd say give it time, when I first had my blood test results my T4 was similar and T3 higher and people said on here a lot with graves are far higher!
To be fair I was diagnosed Dec 2020 and now June 2021 all of my stats are now in range, next check up tomorrow fingers crossed still fine, and on 5mg Carbimazole, so I am not sure why they are mentioning RAI already?! Once she starts meds it may get under control with meds PLUS a lot will be down to giving birth as this can affect the thyroid afterwards
I'd be more concerned about the liver marker, have they said what could be causing this?
The thyroid enlarges slightly during pregnancy, and oestrogen & hCG cause higher levels of thyroid hormone. hCG is the hormone that can make us feel very sick. Did she have a difficult pregnancy?
Sometimes the thyroid gland continues to be inflamed after pregnancy, known as postpartum thyroiditis - when thyroid hormones become elevated & symptoms of hyperthyroidism are felt, which may transgress into symptoms of hypothyroidism.
Either way your niece’s endo/doctor should know that postpartum thyroiditis often resolves itself after 12-18 months after when baby was born.
To decipher if her thyroids exaggerated response is due to thyroid antibodies, ask that she be tested for TPOAb & TGAb (Hashi) or Trabs & TSI (Graves). Your niece certainly does not need to consider surgery at this moment in time. Print off a copy of the NICE guidelines & offer her endo/doctor a copy .
Gestational diabetes develops during pregnancy & usually disappears after giving birth but may be hanging around due to postpartum thyroiditis. Elevated liver enzymes are common in both high & low thyroid hormone levels & usually return to normal level once a euthyroid status is achieved. Remember no hormone works in isolation.
Hi, I'd be encouraging her to get her diet on an even keel to help liver and blood sugar. You could get a glucose monitor to keep an eye on it while things settle. Also her B12 - did she have nitrous oxide, in which case getting an active B12 test not just a serum would be a good idea. (Nitrous can inactivate a % of your B12 but serum shows both so you won't know if it is low.)
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Help please with test results
Help please with blood test results
Help with blood results 
Help with thyroid blood results 
Help interpreting thyroid results
