Central hypothyroidism ?

[Mellania]

Has anyone been successful in getting a central hypothyroidism diagnosis.

[RedApple Administrator]

Mellania, whilst you're waiting for individual members to comment, you could browse through the many previous forum posts about central hypothyroidism healthunlocked.com/thyroidu...

[Mellania in reply to RedApple]

Thank you so much, I will 🙂

[Evej13]

Melania, I have. I'm on NDT with a completely suppressed TSH at < 0.01 (range 0.27 to 4.2). I did it by switching from NDT to synthroid for 8 weeks. My TSH blipped to 0.04 after 8 weeks. It was enough for my endo to diagnose Central. Was it worth it? I would have to say no because I got very sick from the switch and am still trying to find my sweet spot. However, I've been lucky as I have a standing order for TSH, FT4 and FT3, so the diagnosis wasn't really necessary. Is there a reason why you want the diagnosis?

[Mellania in reply to Evej13]

Thank you for replying. I want a diagnosis so I can start treatment and feel better and all points to central hypothyroidism

[Evej13]

Do you have any thyroid test results you can share?

[Mellania in reply to Evej13]

I have posted them on my first post, I think they are easy to find… sorry i am new here

[Evej13 in reply to Mellania]

I don't see them?

[Mellania in reply to Evej13]

I have two

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[Mellania in reply to Mellania]

This is 6 months later

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[Evej13]

I see just the one. In that one, your TSH of 1.37 (ref. 0.27 - 4.2) is 27.99% of reference range. Your FT4 of 11.2 (ref. 12.0 - 22.0) is -8.0% of reference range. Your FT3 of 4.62 (ref. 3.1 - 6.8) is 41.08% of reference range. To me, that would suggest Central hypothyroidism because your TSH is not rising in response to your very low FT4 and lowish FT3. It also seems to me that your thyroid may be beginning to fail because the FT3 is so much higher in range than your FT4. What time of day did you get your blood drawn? I do hope someone more knowledgeable than me will respond to you soon.

[Mellania in reply to Evej13]

Thank you so much, I have had lots of responses to my previous post with lots of info given. I feel like I have had so much support in this group and I am much more educated than I was a couple of days ago!My question was more from a medical point of view, getting a good endocrinologist who will diagnose as I believe it’s somewhat difficult to get this!

[Evej13]

You're welcome. So in the second one, your TSH of 1.54 (ref. 0.27 - 4.2) is 32.32% of reference range. Your FT4 of 11.8 (ref. 12.0 - 22.0) is -2% of reference range. Your FT3 of 3.81 (ref. 3.1 - 6.8) is 19.19% of reference range. Your frees are lower, but still not much of a TSH increase. Perhaps you could get a meds trial if you show your doctor a comparison?

[Mellania in reply to Evej13]

I don’t understand the percentages! Ideally what % should they sit at to be healthy?

[Evej13]

Most people not on medication are around mid-range FT4 and a little higher than mid-range FT3. So both your FT3 and FT4 are below average.

[tattybogle in reply to Evej13]

it's rather too generalised to say 'most' people not taking thyroid hormone have mid range T4 and slightly higher than mid range T3.....

Below are results from 10 healthy people. They show quite a large variation between what is normal for healthy individuals .

5 have T4 below mid range .

3 have T4 below 25%

2 have T4 that goes as low as about 5%

1 has T4 that looks like it goes even lower than 5% (subject 6)

4 have their T3 lower than their T4

Only 3 out of those 10 healthy people have ' Mid-range T4 and slightly higher than Mid range T3'.

Mellania . 'The % thing '...... we can turn fT4 results (or fT3 results/ or even TSH results) into a "% through the range"..... (so we can compare fT4 results done with machines that use different lab ranges ... some fT4 test ranges are [12-22] and some are [7-14] and there are several others , which makes it hard to compare results when looking for any changes in level )

If your fT4 result is eg. 17 [12 -22] then :

12 is right at the bottom of that range (0%)

14.5 is a quarter of the way through that range (25%)

17 is halfway through that range (50%)

19.5 is three quarters of the way through that range (75%)

22 is right at the top of that range (100%)

....if you then sent that same blood sample to another lab and got 10.5 [7-`14] you might think "its lower" because 10.5 is lower than 17 , but with "% through range" its easy to see they are really the same ie, both are "50% through the range"

Here is a calculator we use to do it easily thyroid.dopiaza.org/

..

[Evej13 in reply to tattybogle]

Thanks taggyboggle. I have actually seen that before on thyroidpatients.ca. I was just making a generalization. I think it's that same article that states that on average, FT4 and FT3 levels hover around mid-range.

Gullo TSH and FT3 distribution

[Mellania in reply to tattybogle]

Thank you that makes sense now