I had an overactive thyroid about 3 years ago which was apparently caused by an infection of some description. I had carbimazole at the time but I was soon feeling better after a few months and my treatment stopped.
fast forward to present day and my symptoms of mental issues have returned . I had bloods done last week with results..
tsh 5.8
t4 17
t3 was not my checked. My gp has sent me for another blood test however I'm worried about having thyroid issues again because I'm all too aware of how it made me feel last time
should I be concerned by these results ?
34 year old male.
Thank you for your time and feedback.
Written by
craigleese123
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Please add range for FT4 . ranges vary between labs.
TSH above range? If two TSH above range 3 month apart GP may consider treatment if symptomatic (which you are)
Have you ever had any thyroid antibodies tested?
Transient hyper as you describe for a few months is often the initial stages of autoimmune thyroiditis.
The immune system attacks you thyroid the damaged cells release there hormone stores causing a rise. As more of the thyroid is gradually destroyed the ability to maintain function lowers.
Edit to say - high TSH occurs when thyroid levels are low the pituitary is signalling the thyroid to make more. If FT4 Is high it might be that the FT3 is low. Usually the body does priorities FT3. But higher the TSH harder the thyroid is working to maintain levels.
Oh really, thank you for taking the time to read my previous post purple nails. I felt pretty dreadful to be honest for a period of time. It toke a further 10 months from bring hypothyroid to actually feeling normal again.
I'm just waiting results of my latest blood test to see what, If anything is the next step.
I thought I recognised your name and looking back see I too replied to you,
Ideally your antibodies should have been run before you were prescribed anything as not all hyperthyroid health issues are managed with Anti Thyroid drugs like Carbimazole.
Do you have a copy of your original blood test result detailing the diagnosis and medical evidence and the justification of prescribing the AT drug ?
We are looking for antibodies which will likely be expressed as either a TPO : TgAB: TRab and or a TSI :
Does the NHS complete an antibodies test under endo or that only privately through medichecks like purple nails has highlighted above?
I'm no longer under my endo because I was discharged 3 years ago so having to go through my gp which is proving to be difficult to say the least. Struggling to get an appointment to discuss my blood results from last week.
My concern is that tsh was only 5.8 which I know is not high in terms of an underactive state however is it high enough experience underactive symptoms?
The only reason I agreed to a blood test was my mental state over the past 6 weeks has deteriorated in terms of high anxiety and low patience threshold.
Most of the feedback we seem to get is that GPs can request TPO antibodies to be tested if hypothyroidism is suspected but only a hospital specialist can order a TSI or TRAb is Graves if suspected with high FT4 & FT3.
I suspect its a case of GPs not wanting to get involved in more complicated (& expensive) tests & interpreting them.
What tends to happen is - at the first sign of low TSH medics treat as Graves and give carbimazole, if the hyper turns out to be transient, as it was with you. Then the medication is stopped early.
This is rather careless & risky approach and in cases where the hyper is transient giving the medication which hastened hypothyroid levels could be prevented by testing antibodies at diagnosis then it would be established early on if Graves can be confirmed and treatment necessary - Or if you have hashis and need to be vigilant for levels dropping.
Or in other cases there is no autoimmune and something else is going on. Like in my case with a hyper nodule.
You mention you were Ill for nearly a year after stopping carbimazole, were your levels monitored? they may have been low or fluctuating.
You may have adjusted to low levels without realising. I missed symptoms with elevated levels which rose gradually over years. You & your body automatically find ways to compensate to being less well.
Symptoms mostly come from low FT3 (most experience this). FT3 is the active powerful hormone. Some aren’t so affected by low FT4 - when other feel they are. TSH however doesn’t cause symptoms directly. So even a slight rise to TSH doesn’t tell you how severe your symptoms might be.
The TSH should reflect what the FT4 & FT3 are doing but it doesn’t always behave correctly. Which is why you need the FT4 & FT3 tested.
TSH is also often delayed in responding to levels.
FT4 currently isn’t low by (most ranges) so why would you TSH be high? Your FT3 might be low. There’s also the possibility your FT4 & FT3 have been low until recently & TSH much higher & levels are altering. ie FT4 & FT3 rising and TSH dropping from being higher.
Sudden symptoms as you describing could be explained by fluctuating levels.
My gp agreed to have an ft3 test. He also looked in my discharge notes from the consultant 3 years ago and my antibodies where tested then which came back as normal.
Would the be a requirement to check the antibodies again 3 years on ?
My bloods in the last 3 weeks have been..
Ft3 5.6
Ft4 17
Tsh 5.8
I have requested the gp to refer me back to specialist however with my current mood (although I do feel better), I'm wondering if it is my thyroid making me feel this way or if I should seek further medical help (ref anxiety/sleeping)
The TSH is high which is why lab likely tested FT4 & FT3. Often if TSH in range the lab drop FT4 & FT3 test. Even if requested.
If you have 2x high TSH within 3 months you can be given levo replacement. Even if FT4 & FT3 in range. It shows thyroid is struggling in maintain levels.
TPO ab are usually tested on 2nd test to see if positive for autoimmune. You may already had these tested previously.
Which antibodies were previously tested. There are several types. You need results & range of those antibodies.
Thank you again for replying. Apologises also if you are having to repeat yourself.
I was not issued the ranges for the blood results even when I asked. I'm not sure how long I will be waiting for endo again however I'll get my bloods done privately in the next couple of weeks to help you and endo to understand the full picture without delay.
Lots of practices offer online access. Ask if practice can set up full access to records including historical records. If you are in England practices are contractually mandated to provide online access.
If they don't have facility then they must provide copies and you can not be charged.
Before I had online access I would phone reception in advance request recent test results or give date of test and say can I collect (give 2 days to organise & print) on Thursday.
They often like time to arrange to print & make sure they are available to you (doctor has to view & file first) then you can have a copy.
Oh wow thank you. Didn't know about the gp portal. I've registered for that, just need to confirm with gp tomorrow. If I get full blood detail I'll post back. Thank you again
Thank you Purple Nails. I'm in the process of sorting online access.
Whilst I was with the gp I got print outs of my bloods..
Tsh 5.76 (0.1 - 5.0)
Ft3 5.6 (3.5 - 6.5)
Ft4 17 (12-23)
GP has spoken to endo who have refused to see me stating thyroid function is good and to have bloods done in 2 months time. GP referred me to mental health for anxiety/sleeping etc.
Not really happy with the outcome but I'm not a Dr so I don't really know.
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