Is Serum Free T4 reading extraordinarily high! Why would it change so much in 1 year?
Why am I so heat intolerant? (Was same when hypo - and now with hyperthyroidism?
Why won’t GPs refer me to an endocrinologist? Have asked my previous GPs and current one. Would an endocrinologist be able to help?
Do I need an urgent T3 B/T. Years ago the head of B/Testing at my local hospital said I should always have based on the results she’d seen. But GPs refuse and aren’t interested
HISTORY
My TSH has been at the lower end for years, and Serum Free T4 at higher end of spectrum.
Diagnosed in 2010. Over the years the dose of Levothyroxine has been adjusted to as high as 175mcg, now reducing, and last year down to alternating 75/100mcg daily.
Just had blood test results. Called by GP next morning. Told to change to 50mcg daily, and even better not to take a tablet for a day or two. He’ll organise a follow up in 8 weeks.
Symptoms:
HEAT INTOLERANCE: For years I’ve been heat intolerant. Gets worse every year. Try not make arrangements between April and October. Won’t go to weddings, on the beach, outdoor cafés etc. In temperatures over 17c and especially if humid, I am useless. No energy, panic and could pass out. Friends don’t always understand and think I’m creating a fuss. Just been invited to an important family event in June 2023 a couple of hours away, and am already panicking. Have had to say won’t know if I can go until last minute, re weather. They are quite upset and assume I don’t want to go
I don’t know anyone who is as heat intolerant as I am. Not helped by getting heavy puffy feet (take Furosemide for that).
FLUID RETENTION
See above
EYES
Had cataracts and vision correction done 9 months ago. Immediately after had red eyes/aching/ sensitivity to light. Gets worse reading/writing on mobile. Wear photochromatic and blue light filter glasses. Doesn’t look as if will improve now. Surgeon says caused by dry eyes.
Others: RIDGED NAILS/HARD SKIN ON HEELS
Medication: THYROXINE, STATINS, FUROSEMIDE, VIT D,
Written by
Beachbird
To view profiles and participate in discussions please or .
Only had FT3 done when first diagnosed . All the GPs I’ve asked over the years refuse to and do ‘t want to know
May look at the private testing available as another reply lists them
Should a GP do thyroid antibodies?
Maybe I have to wait for this 8week follow-up and insist on an appointment with GP to discuss. Perhaps he will ask for more tests?
I didn’t do anything five years ago because everything seemed under control (Vit D probably helped) Except for thisconstant heat intolerance is it totally affects my life for the best part of ½ the year, and fluid retention (improved since on Furosemide)
Sometimes a GP will test Thyroid Peroxidase (can't do Thyroglobulin antibodies at primary level) if they think it is warranted, by no means is it routine. I've been diagnosed hypothyroid since 1975 and never had an antibody test on the NHS.
The Vit D Council, the Vit D Society and Grassroots Health all recommend a level of 100-150nmol/L (40-60ng/ml), with a recent blog post on Grassroots Health mentioning a study which recommends over 125nmol/L (50ng/ml). Doctors are taught very little, if anything, about nutrients so have no concept of "optimal" levels, all they want to see is that it comes somewhere within the range then they are happy.
“Is Serum free T4 level 38 pmol/L just ‘high’ or an unusually high results? Can’t find any comment on this online”
FT4: 38 pmol/l (Range 10 - 22) 233.33%
So nearly 2 and a half times normal range & is high. It not unusually to see those with autoimmune Graves for levels to reach over 3x norm and I’ve see results on here reaching 5 nearly 6x but that is the exception.
Any elevation needs to be addressed and reducing your levo would be first step.
Antibodies are useful for diagnosis and although all causes of hypothyroidism are treated same way If you have autoimmune thyroiditis it explains why fluctuations can occur.
Do you usually test this time of year? Some find they need more hormone in warmer months and less in summer. So if previous tests were winter time the rise could be different by end of summer.
As other mention GP are expected to treat deficiencies but are not taught a great deal about nutrition. They prefer not test all then they are no obligation to offer treatment. Such as the comment that everyone in UK is deficient - then why isn’t everyone treated?
Dr will likely say something like if you eat a balanced diet you shouldn’t need supplements but if you want to don’t exceed the recommended dose.
Have you been given advice & help to deal with dry eyes?
Re is result unusual. Thanks that was something I really wanted an answer to. Scoured the web for a couple of hours unable to find out.
Timing of tests:
My routine tests are done every year (at my request). Recently have been in August/September. Serum Free 24 has always been ca. 20-22 from memory. In 2018 it was 27 and repeat test required.
Eyes:
Surgeon who did the cataracts/vision is following me up. Prior to op was on dry eye drops for occasional achey eyes (on mobile too long!). But irritation, red eyes, fatigue, achey - all far worse post op. Took a few courses of steroid drops as eyes were inflamed for several weeks. And now using Thealoz (dry eye drops) a few times a day, and wear photochromatic glasses/sunglasses most of time as still sensitive to bright/sun light
I read one of the symptoms of hyperthyroidism is eye probs, including light sensitivity. But who knows if connected. as wasnt hypo same time last year
Well Most medics say Thyroid Eye disease TED is only associated with Graves, although there is more acknowledgment that those with Hashis also suffer with TED.
Care for TED can be poorly recognised and treated.
I’m hyper from a nodule and have neither autoimmune and half specialist I see say I have TED - in fact they assume I’m aware I do. The other half say it not possible.
TPO & TG are associated with Hashi also present with Graves
TSI & Trab with Graves & TED
There a strange overlap with antibodies. Your ophthalmologist specialist may be able to test TRab but GP -say- they can’t.
Many report dry eye with thyroid issues.
I “self treat” with the recommended remedies- inexpensive selenium supplement- 200mcg at first but this should dose should only be taken for 6 months. Then reduce to 100mcg . Bear in mind selenium rich food can take you over the maximum requirement.
*Preservative* free eye drops & wipes. Rotating different brands seem to help. Liquid versions for daytime & gel versions at nighttime.
I was prescribed a eye gel last weekend when my local walk in centre sent me to A&E. ocufresh carbomer lubricating eye gel, it’s not too gloopy and useable for day. I think it contains a mild preservative.
For when eyes are dry I use warm compresses (eg wheat bags, microwaveable gel masks) helped. Very gentle massage toward lash line. Both these “unclogs” the blocked Meibomian Gland & lipid oil layer protects eye and retains the water.
If swollen, inflamed and more painful, I switch to cold compresses.
If you like to moisturise near your eye area use water based clear gels not oil / cream. I did this as developed milia white spots round eye. I found the puffiness & swelling reduced when I switched.
Serious complications are rare + changes in appearance often improve greatly within months. Do not Google and panic over worst case scenarios.
Keep a photo record of eyes eg take a photo every 2 or 3 weeks.
Many report TED triggered or worsened when thyroid levels are low / high or fluctuating.TED charitable trust.
Lot to consider here. One doctor at the eyeclinic advised massaging the Meibomian Gland. Got a microwaveable warm compress *mask.
Both felt uncomfortable/*heavy Seemed to make eye sore. Maybe can tolerate now as a few months later.
Friend recommended Blephasol for cleaning eyes. Used for a month. Very good but expensive as needs replacing after 2 months.
Maybe coincidence, but after 2 days of not taking thyroxine was able to go to sleep on left side. Before disturbed by heart beat. Starting Thyroxine 50mcg lower dose this morning.
What water based clear gel do you use? I have a milia white spot in lower eyelid.
Thanks - I am quite calm, not a panicker! Just it’s difficult to talk things through with the GP nowadays. And over the years have encountered mistakes, eg given husband’s blood test results, and he mine etc.
NB I’m not losing weight, which seems to be a symptom of Graves
Boots do a couple. A Cucumber eye gel & a vitamin C eye gel.
I’d use the Vit c one in morning as it’s orange scent is invigorating.
Bodyshop does elder flower un perfumed mini pot.
My current favourite is Avon adapt hydra rescue on the go facial serum. It marketed for menopausal woman but I won in a raffle and now wouldn’t be without out. It’s a pump bottle which I prefer over fiddly lids.
I have some tool like a wand with metal end. To dip in serum and help message in gel. Have you seen the facial stone smoothers called gua sha this also helps with massaging round eye.
You can also get roller ball version but I disliked an inbuilt cream rollerball that vibrated.
Symptoms can be very deceiving I was hyper many years and gained weight entire time. Didn’t lose any until lower in normal range and had energy to exercise and a normal appetite.
Too late 🥰. Just bought “Cetaphil Hydrating Eye Gel-Cream With Hyaluronic Acid - Designed to Deeply Hydrate, Brighten & Smooth Under-Eye Area - For All Skin Types - Hypoallergenic & Suitable for Sensitive Skin - 0.5 Fl. Oz”
Had the best reviews and suitable for sensitive skin. Lets see how it goes. Not cheap. But expect lasts a while. Worth a try. Thanks for suggesting moisturing gel anyway. Will deffo look at Avon’s. Use their body lotions all the time. The cucumber one too. Not keen on sweet/scenty.
So maybe I’ll lost some weight now??!! Walk a lot but too slowly in recent weather.
Content on HealthUnlocked does not replace the relationship between you and doctors or other healthcare professionals nor the advice you receive from them.
Never delay seeking advice or dialling emergency services because of something that you have read on HealthUnlocked.
severe hyperthyroid symptoms, high tsh, high end t4, low end t3
12 year old with low T4, normal TSH, I am desperate for any advice/ input on blood test results
Possible to be hypothyroid with low TSH and high Free Thyroxine? 
Low TSH, high T4...with symptoms
Very low TSH and High T4
