Jodypody

Hi Elsa they aren’t alarming results and accepted within range. The antibody test maybe worth retaking? Assuming you’re female can I ask how old you are?

Elsa1509 in reply to Jodypody

Thanks so much for your reply Jodypody. I am 54 and have been trying low dose HRT patches for some months so I wonder if that has changed things ? Normally my FT4 is mid range or higher although my FT3 is always near the bottom! There could be many reasons for my fatigue and other symptoms but I was just a bit surprised by my results this time round given that both Free Ts were low in range. Thank you!

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pennyannie

Hello Elsa :

I have read on here that people are advised that they may well need to increase their Thyroid hormone replacement when they introduce HRT :

Your levels are very low and likely impacting on your overall health.

Sadly in primary care the usual thyroid blood test, a TSH and possibly a T4 will not be enough, not to rule out auto immune issues, or inflammation, or low vitamins and minerals, especially ferritin, folate, B12 and vitamin D, which can also compromise one's health.

Seeing as you have been diagnosed with a multinodular thyroid gland is this being monitored as this again will likely have a bearing on your thyroid hormone production ?

If you go into the Thyroid UK website, this is the charity who support this forum, you will find private companies who will undertake a full thyroid blood test ( usually around 10 separate results ) and then start a new post with these results and ranges and forum members can talk your through your next steps back to better health.

Elsa1509 in reply to pennyannie

Thanks so much Pennyannie for your reply. I am thinking of spending out on a more comprehensive panel of thyroid tests including antibodies but I think this may be better with a blood draw rather than a finger prick which does add to the cost. I think/hope it will be worth it. I’m sure I should be on some kind of levo regime but I realise it is highly unlikely I will be considered eligible by any doctor. I have heard/read that oestrogen therapy can ‘block’ thyroid hormone but it’s too complicated to understand ! I’m pretty sure my vitamins are very good in range.I was anaemia again earlier this year (ferritin was 4 and haemoglobin below range) but have got this back up (probably far from perfect but despite trying 3 times I didn’t get my ferritin figure in August from a repeat blood test!) just told it was “normal”.

Thank you 🙏

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pennyannie in reply to Elsa1509

Well, normal is but an opinion, and definitely not optimal and in all honesty we need to see facts and figures to advise you properly.

Since you had a ferritin at 4 " sometime in the past " I would have thought this needed to be kept under permanent review.

Yes, I get a venous blood draw yearly now, as I self medicate with full spectrum thyroid hormones and supplement ferritin, folate, B12 and vitamin D on a daily basis.

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Elsa1509 in reply to pennyannie

Thanks Pennyannie. My ferritin has been as low as 3 in the past so 4 wasn’t my worst figure ! As my periods have pretty much stopped I reckon I might not be so prone to anaemia and I’ve had every test under the sun to check for internal bleeding. I just can’t store iron ! I will do a private test soon as i don’t think the GP will do more than 2 in a year 😕. I’m going to see if I can also get my thyroid gland checked out as well given the pain on the right side (nodule was 1.5cm there many years ago).

I feel spurred on to continue with more tests and thank you so much for your very helpful input 🙏!

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humanbean

3 Nov

TSH: 1.33 (0.27 to 4.2) 27% of the way through the range

FT4: 12.8 (12 to 22) 8% of the way through the range

FT3: 3.91 (3.1 to 6.8) 22% of the way through the range

11 Nov (same ranges)

TSH: 2.02 45% of the way through the range

FT4: 13.6 16% of the way through the range

FT3: 4.2 30% of the way through the range

Personally, I wouldn't be happy with Free T4 and Free T3 levels as low as yours. This is just a generalisation, and there are many exceptions, but for anyone who is hypothyroid from any cause the preferred levels of Free T4 are often around 60% - 80% of the way through the range, and for Free T3 are 50% - 70% of the way through the range.

"Normal" or "healthy" people will most likely have Free T4 and Free T3 about mid-range (ish). TSH levels in healthy people with healthy thyroids are discussed in this thread :

healthunlocked.com/thyroidu...

...

TSH is not a thyroid hormone, it is produced by the pituitary in response to instructions from the hypothalamus. Both the pituitary and the hypothalamus are in the brain and both control the output of many hormones in the body, not just TSH.

You might have a degree of Central Hypothyroidism. This is a condition in which the pituitary produces too little TSH in response to low levels of Free T4 and Free T3. But it might do this because the pituitary itself is not working very well (which is referred to as secondary hypothyroidism) or because the hypothalamus is not working very well (which is referred to as tertiary hypothyroidism).

...

On the other hand your low TSH might be caused by the effects of your thyroid antibodies TPO and Tg in some way. If your thyroid is being attacked by your immune system then your T4 and T3 might rise as a result, which then reduces your TSH. But TSH changes quite slowly in comparison to changes in T4 and T3. When the immune system attack subsides your TSH may be slow in rising again while T4 and T3 reduce quite quickly. So if the pattern of your results is caused by an immune system attack it would depend on which stage of the attack you were at at the time of the testing.

...

Another possible issue is the levels of your nutrients.

I am on no drugs or vitamins whatsoever that could impact my results (only Vit D and C). My Vit D is always over 100 and folate and B12 are always good (in the past).

It would be interesting to see your levels of Vitamin B12, folate, vitamin D and ferritin (iron stores), if you have recent results for them.

This thread :

healthunlocked.com/thyroidu...

shows the effect of better nutrient levels on my own T4 and T3.

Low iron must be avoided in hypothyroidism :

Title : Why Hypothyroidism is Worse with Iron Deficiency

Link : restartmed.com/hypothyroidi...

Other important nutrients are magnesium, selenium and zinc for best health with hypothyroidism.

...

Another possible issue is your cortisol levels. Low levels of cortisol and high levels of cortisol both have undesirable impacts on TSH and both problems regularly appear in thyroid disease. I would suspect you might have high cortisol since your TSH looks too low for your thyroid hormone levels.

paulrobinsonthyroid.com/hig...

Elsa1509 in reply to humanbean

Thanks for all this amazing information Humanbean! I’m so sure there is something wrong with me and last year I did a cortisol test and it was quite above normal (first thing fasting). I think ongoing stress with the pandemic and life stressors have left me a bit deplete and simultaneously I started the menopause so it’s been hard. I will get my iron checked again as well and B12. I do eat red meat and full fat dairy and I believe I’m ok with all this. I am gluten free and have been for years. I will definitely do some more tests and report back - I really appreciate all the help here so much 🙏 thank you!

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humanbean in reply to Elsa1509

For full info on your iron the best test is an iron panel. Doctors rarely do them, but they can be done with a finger-prick test from Medichecks:

medichecks.com/iron-tests/i...

And you can get a discount off the price with the code from this link :

thyroiduk.org/help-and-supp...

SeasideSusie 's advice on how to get the best results from a finger-prick test are given on this link :

healthunlocked.com/thyroidu...

Note that test samples should be sent back as soon as possible after they are are produced on a Monday or Tuesday. To be sure your sample arrives in good time you could spend extra money on posting using "Guaranteed Next Day Delivery by 1pm".

royalmail.com/sending/uk/sp...

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Elsa1509 in reply to humanbean

Thank you so much Humanbean. I will pay for guaranteed delivery next time and will send any future tests off at the start of the week so they don’t potentially sit in a lab all weekend. I will get a full iron test done as that will be interesting to see. Thanks for all the great links as well !

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