I need help plz

[Lifebxx]

I’m 20yrs old female suffering from HYPER symptoms n I believe there is something wrong with my thyroid since also my mom has it too.

I get a lot of heart palpations, tired, weak , no energy at all, headache, dizzy and I feel something weird in my left lobe of the thyroid and it looks swollen.

My blood tests through out the year

Tsh / 1.60 ulU/ml ( 0.51-4.3) Ft4 / 1.03 ng/dL ( 0.98 - 1.63 )

After this within 4 month I got my tsh level tested again tsh / 1.99

About 2 weeks ago I redid tsh / 0.70 uIU/ml ( 0.35 - 4.94 )

Ft4/ 0.98 ng/dL ( 0.70 - 1.48)

Anti thyroid peroxidase abs (TPO) 0.37

IU/ml ref range ( 0.0- 5.6)

Anti thyroidglobullin abs 0.55 IU/ml ref range ( 0.0 -4.11)

So my question is what shall I do next ????? I’m so confused

My doctor asked me to do ultrasound because my neck looks swollen.

I’m so sick of all of this I can’t do any of my daily tasks I’m just tired my heart doesn’t stop racing n also for headaches /dizziness that will never leave me

[greygoose]

Hi Lifebxx, welcome to the forum.

Well, certainly your TSH is not suggesting hypo - nor hyper, come to that. It's 'normal' - i.e. euthyroid. But no-one can comment on your FT4 without a range - numbers in brackets after the results, normally - eg (12-22). Ranges vary from lab to lab so we need the ranges that came with your results.

Can you give the actual numbers for the antibodies, please - results and ranges? Just telling us they were 'within the normal range' tells us nothing.

[Lifebxx in reply to greygoose]

Hello there 😣I added the ranges plz check it

[greygoose in reply to Lifebxx]

OK, well, there's not much I can really add to what PurpleNails has said. No way are your labs showing hyper.

However, your TSH doesn't really correspond to your FT4 level. Especially in the first test:

Tsh / 1.60 ulU/ml ( 0.51-4.3) Ft4 / 1.03 ng/dL ( 0.98 - 1.63 )

With such a low FT4, one would expect your TSH to be higher. So, your next step should be to get your FT3 tested, so as to have the whole picture. Could be you have Central Hypo, where the problem lies with the pituitary (Secondary Hypo) or the hypothalamus (Tertiary Hypo) rather than the thyroid itself (Primary Hypo).

Your antibodies are negative, but that doesn't completely rule out Hashi's because antibodies fluxtuate all the time. And 20% of Hashi's people never even have raised antibodies.

As for symptoms, don't fall into the trap of dividing them rigidly into 'hypo' and 'hyper'. An awful lot of the can be both hypo and hyper symptoms.

[SlowDragon Administrator]

Please add ranges on these results

Are you in the U.K.

Very important to also test vitamin D, folate, ferritin and B12

Low vitamin levels are extremely common, especially with autoimmune thyroid disease (Hashimoto’s or Ord’s thyroiditis)

20% of autoimmune thyroid patients never have high thyroid antibodies

Have you had ultrasound scan of thyroid

Low vitamin levels common as we get older too

Roughly how old are you?

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 all relevant vitamins

List of private testing options

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

Medichecks Thyroid plus antibodies and vitamins

medichecks.com/products/adv...

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/

NHS easy postal kit vitamin D test £29 via

vitamindtest.org.uk

[PurpleNails Administrator]

Looking at your FT4 results your first results was low.

Ft4 / 1.03 ng/dL ( 0.98 - 1.63 ) 7% of range

Your recent result has risen *different lab range used*

Ft4/ 0.98 ng/dL (0.70 - 1.48) 35% of range

If you were hyper your FT4 & FT3 levels would be above range.

Usually the TSH becomes very low often <0.01 Which is undetectable.

I think retesting to check levels and a scan is a good idea especially as one side feels swollen compared to other.

Testing FT3 the more active thyroid will give better picture with key nutrients.

[TiggyN]

Nutritionally I would add that you might find that the worst symptoms disappear or greatly reduce when you completely cut out gluten, dairy and sugar from your diet (they tend to be the usual culprits).Take it one step at a time - 3 months with no gluten, see if there’s an upswing in your mood and energy. If not, 3 months without dairy and so on.

I know this can be a painful process, depriving you of some favourite foods, but I strongly recommend it - it has made a huge difference to thousands of people with Hashimotos (symptoms similar to yours) myself included. I really hope you feel better soon.

[Lazybones_freebird]

Please please have them check Ft3 asap! I have graves disease with only Ft3 affected. My Ft4 never went out of range but wasn’t caught until my TSH was <0.01 (normal 0.4-4.0). My Ft4 was still normal! However when they investigated further ft3 was off the chart and that’s what actually causes all the hyper symptoms. It’s a ‘special’ type of graves called Ft3 thyrotoxicosis. You may be on the same path and until I got meds I was suffering. I also got the ultrasound and had a nodule biopsy so I believe in getting all the info the drs want but they need to test your Ft3 in case you have the less common type of graves. After ultrasound they tested for Trab and sure enough it was elevated signifying graves. Which my grandmother had so runs in the fam for me too and I think is strongly genetic. They should test for the Trab antibodies but not everyone even shows those. I think it is 10% or so that have graves but not antibodies. Best of Luck I hope you can have your dr call in a Ft3 lab order asap if they havent done one for you.

[PurpleNails Administrator in reply to Lazybones_freebird]

FT3 Dominance does occur with Graves but it’s more usual with toxic nodules, it’s said nodules lead with FT3.

My FT3 was considerably higher, I have a large solitary nodule. Graves is confirmed by either positive TRab or TSI. I heard that Hashimotos can occur without having positive antibodies but not Graves patients.

Many can have hyper levels without positive TRab or TSI. This is because autoimmune immune thyroiditis (Hashimotos) causes transient hyper prior to levels becoming under active.

If autoimmune is ruled out (eg TPO & TGab) & the hyper it’s continuous it’s likely to be a hyper functioning nodule. This has to be confirmed with a thyroid uptake scan.

I agree a FT3 reading very important to view full thyroid function but an over range FT3 would likely causes low TSH. Even when my FT4 was mid range my fractionally over-range FT3 was enough to totally suppress TSH.

[Lazybones_freebird in reply to PurpleNails]

Very interesting! Thank you for responding. I would agree similarly that when my FT3 was finally tested and over range my TSH was also totally suppressed. I just wondered if the FT3 had been tested earlier if they would have caught my graves sooner. Likely not based on your response.

[PurpleNails Administrator in reply to Lazybones_freebird]

With Graves, the levels tend to spike very high & suddenly. So FT4 would follow quite quickly although TSH does takes longer to respond. Unless there is a pituitary issue affecting the feedback axis, The TSH will initially detect issues. Its afterwards treatments and fluctuating levels makes the TSH unreliable.

Nodules tend to build gradually at a lower level. For example looking through old hospital records I discovered it took over 4 years for my FT3 being just over range to nearly double, my FT4 was fractionally over by the time it was detected. My TSH had been suppressed all that time. I think because it was so gradually I had missed symptoms, fast pulse, headaches & out of control appetite, zero energy I had gained weight not lost any.

Once the TSH has been suppressed it can take longer to respond. Mine has never recovered and I’ve now been euthyroid nearly 3 years. It’s why accounting for FT4 & FT3 is important but medics are wrongly taught TSH is all they need to look at.