extra info, pituitary hormones

[Happytiredbunny]

i my GP ordered pituitary hormone blood test after TSH and FT4 both being lower end of normal,

Picture attached of all relevant results I’ve had and symptoms

My main concern is the low normal TSH &FT4, low ish growth hormone, high HDL, and low normal cortisol for time of day and stress levels for that morning in particular. I’ve always had low ferritin, and started ADHD meds in the last year which prompted the thyroid checks as they made ‘hyperthyroid’ symptoms worse. Always had low TSH but still in normal range.

I’m just not sure on next steps, whether I push for further investigation or just up my vits and hope things improve!

[greygoose]

I would have thought your main concern should be your very low ferritin. What did the doctor say about that? Why didn't he do a full iron panel?

Of course, your TSH is low, considering your FT4. And, your thyroid is compensating by making more FT3. But, even that would appear to be too low because your cholesterol is high - high cholesterol is a hypo symptom.

As for the Growth Hormone, that is very low, but could be due to your low FT3. You need good levels of T3 for the pituitary to produce GH. So, if we put the evidence of the low GH and the high cholesterol together, that could add up to hypothyroidism, rather than a pituitary problem. After all, the cortisol is not that low, and is bound to be lowish if you're hypo.

As to the TSH, could be due to a problem with the hypothalamus - it's not always the pituitary at fault. But, whether it's the pituitary or the hypothalamus, the solution is to ignore the TSH, and treat the hypothyroidism according to FT4/3 levels.

Have you had vit D, vit B12 and folate tested?

[Happytiredbunny in reply to greygoose]

ha I’ve always suffered with low ferritin/anaemia off and on and was told that my result was ok because it’s in the normal range.

I’ve not had vit D, folate or B12 checked, I’m with a new GP so I’m trying to figure out the best way to approach them with this information and symptoms without coming across as a self diagnosing hypochondriac so all that info if really helpful thank you!

[greygoose in reply to Happytiredbunny]

You're welcome. But, whoever told you your ferritin was 'OK' was very, very wrong. What is your diet like? Are you vegetarian/vegan?

[Happytiredbunny in reply to greygoose]

no, my ferretin was 5 a long while ago so they prescribed ferrous fumerate for 3 months and since then I’ve taken a multi vitamin with extra iron… and ferritin has always come back ‘normal’ since so nothing extra from the doc! diet is pretty average, no restrictions, too much sugar but try to cut down! I’ve had odd symptoms with no obvious cause for a while, and different tests for caeliac and glandular fever, and ovary scans… everything is always normal! I assumed I was more hyper thyroid with my TSH always being low end of normal and I have a slim build, so was surprised when I paid for my FT3&4 test and they were low but again I was told it’s normal! Trying to peice together all the different bits of info without knowing a whole lot about this all

[greygoose in reply to Happytiredbunny]

Taking a multi-vit is unlikely to raise your ferritin very much, because the iron will bind to other ingredients in the pill. To put it bluntly: multi-vits are all rubbish and you might just as well throw your money down the drain.

However, I can't tell you what you should take because I'm not very good with iron. So, I'll tag two people who know more about it: SeasideSusie and humanbean

I can assure you, you are nowhere near hyper! It's not low TSH that defines hyperthyroidism, it's very high FT4 and FT3. Doctors are so wrong when they say that the TSH tells them 'all they need to know'. But, when knowledge is as scant as theirs is, I guess that's not difficult. And, I can assure you that your FT4 is far from 'normal'. Not all hypos get fat! That is just one symptom out of over 300. And you don't have to have them all to qualify. Everyone has their own personalised symptom list.

If you have any other questions to help you piece it all together, please don't hesitate to ask.

[Happytiredbunny in reply to greygoose]

aw amazing thank you so much, it’s reassuring when you feel like you’re going a little bit crazy!

[greygoose in reply to Happytiredbunny]

I think we all feel like that at some point or another - and doctors encourage that. They just don't want to diagnose and treat thyroid because they know they know nothing about it. It's their education - or lack of it - at fault.

[SeasideSusie Remembering in reply to Happytiredbunny]

Happytiredbunny

As your latest iron results are from May 2020 these really are too old to be considered now. You should get an up to date iron panel done so that more meaningful comments can be made.

[Happytiredbunny in reply to SeasideSusie]

thank you! I’ll start there with the new GP and go from there