Blood test results- Possible Hashimoto’s flare instead of rheumatoid arthritis?

[sunshineisbetter]

Please refer to previous post- last week I was experiencing tingling/numb/ swollen fingers and lost my sense of touch along with a few other symptoms. I was prescribed steroids for suspected rheumatoid arthritis by my GP (without being seen.) I decided to not start taking the steroids and to get a blood test instead. Here are the results below…..

I guess they are the results of a flare up??

I still haven’t started the steroids and am waiting to speak to my GP again over the phone on Friday this week. Symptoms have now calmed a little.

Endocrinology appointment rescheduled for September.

(Not yet diagnosed or on any medication)

[greygoose]

I don't know that there is such a thing as a Hashi's 'flare-up'. But, a Hashi's flare is when the immune system attacks the thyroid, and the dying cells dump their stock of hormone into the blood, causing levels of FT4/3 to shoot up suddenly, and the TSH to drop.

Those results are not saying Hashi's flare - aka Hashi's 'hyper' swing. They are showing hypothyroidism due to Hashi's. Which would, of course, cause all sorts of bad symptoms. Your TSH is over-range, your FT4 only 32.5% through the range (euthyroid is at least 50%) and your antibodies are very high, so your doctor should now start treating you with thyroid hormone replacement.

[sunshineisbetter in reply to greygoose]

Ah thank you for educating me….I’m quite new to all of this!

[greygoose in reply to sunshineisbetter]

You're welcome.

[sunshineisbetter in reply to greygoose]

Can I ask what FT4 only 32.5% through the range indicates?

I don’t fully understand what euthyroid being at least 50% means?

[greygoose in reply to sunshineisbetter]

A euthyroid person is a person that has no thyroid problems - in other words: normal. However, when a doctor says 'normal', all s/he means is 'in-range', which isn't always good. As you can see, yours is in-range, but too low. A truly 'normal' FT4 would be about 50% through the range. Yours is only 32.5%, so that indicates that your thyroid is struggling and can only manage to make that small amount of hormone when the TSH is over-range.

I don't know how much you know about this, and don't want to tell you things you already know, but TSH - Thyroid Stimulating Hormone - is a pituitary hormone that stimulates the thyroid to make more thyroid hormone. In a euthyroid person, it would be around 1 - never over 2 - so you can see that yours is quite high. The problem is that doctors know very little about thyroid and believe that the TSH has to be over 10 before they can diagnose. That is not true if there are high antibodies. Because the antibodies indicate that things are going to get worse, not better.

[sunshineisbetter in reply to greygoose]

I don’t really know much about T4.

I have researched into TSH and antibody levels so have a better understanding of those and yes I assumed things were not going to improve without some help!

[greygoose in reply to sunshineisbetter]

T4 is a thyroid hormone which is basically a storage hormone. It has to be converted to T3, the active thyroid hormone, before it does very much.

When you're diagnosed as hypo, the doctor puts you onto levo, which is T4. You should start on 50 mcg unless you're very young, very old, or have a heart condition. But not all doctors understand that, and some of them think you should start on 25 mcg, which is wrong. So, watch out for that.

[Buddy195 Administrator]

I’m so glad you tested privately and didn’t go on your GPs telephone diagnosis. I hope you receive prompt treatment for your Hashimotos & you start to feel better soon.

[sunshineisbetter in reply to Buddy195]

I actually had a spare incorrect blood test form from my GP lying around that I used! But thank you for your supportive words x

[sunshineisbetter]

Update: Spoke to a different GP today who has recommended that I take the steroids and wait to see an endo before trialling any thyroxine as it might make me feel worse. She openly admitted that they don’t know enough about it all as it’s a specialist area so would prefer to wait for advice from the endocrinologist! Frustrating 😬

[vocalEK in reply to sunshineisbetter]

Don't understand how Thyroxine might make you feel worse, if your body isn't producing enough of it. Worsening hypo symptoms from untreated disease will definitely make you feel worse. This site says that patients with R.A. are more likely to develop hypothyroidism. creakyjoints.org/comorbid-c...

[sunshineisbetter in reply to vocalEK]

I really hope the endocrinologist in September actually listens to me!

[SlowDragon Administrator in reply to sunshineisbetter]

She openly admitted that they don’t know enough about it all as it’s a specialist area

Unbelievable

Hypothyroidism is almost always managed by GP’s in all but the rarest of cases

Levothyroxine is 2nd most prescribed medication in U.K.

Over 90% of primary hypothyroidism is autoimmune thyroid disease also called Hashimoto’s diagnosed by high thyroid antibodies

There’s around 2 million people in U.K. on levothyroxine

You have high TSH, low Ft4 and sky high thyroid antibodies….

As clear a case as likely to see

[sunshineisbetter in reply to SlowDragon]

My TSH was back from to 3.5 on Friday so ‘normal’ again…..

[SlowDragon Administrator in reply to sunshineisbetter]

Was test done as early as possible in morning before eating or drinking anything other than water

[sunshineisbetter in reply to SlowDragon]

No because the test was for something else and I added it on 😆

[SlowDragon Administrator in reply to sunshineisbetter]

What time was test

Always test thyroid early morning before eating or drinking anything other than water to get highest TSH

[sunshineisbetter in reply to SlowDragon]

Yes I usually do this when specifically testing my thyroid. Thank you

[SlowDragon Administrator in reply to sunshineisbetter]

You’re not on any levothyroxine yet are you?

[sunshineisbetter in reply to SlowDragon]

No not yet x