Worried over newly diagnosed with over active thyroid.

[Barb6374]

Hello. Im new here.

Background info.

Type 1 diabetic for 45 years.

On lansoprazole, furosemide,ramipril,atorvastatin, vitamin d.

Dec 2020 had a mild heart attack, was put on aspirin, bisoprolol and amiodarone.

Amiodarone was stopped in jan2022.

Double bypass sept 2021.

2 weeks ago had booster and flu jab. 3 days later was violently shaking as cold , then hot. Drs took bloods.

As i felt worse the next day drs sent me to hospital. They said i had a urine infection.

Dr at hospital looked at my blood results and said my thyroid had come back high.

He said to re test bloods in a month incase it was the urine infection that had caused the high result.

My own gp got in touch with an endocrinologist and they said it was highly unlikely caused by a urine infection and didnt want to wait another 2 weeks to test and have given me carbimazole 10mg once aday.

I havent started them yet as dr was saying about to look out for sore throat, high temp etc, and it worried me.

Also bloods showed low folate , so am taking 5mg aday for 4 months.

My blood results are

Vit b12 =265

Ferritin =98

Folate=3

TSH=0.01

FREE T4=34.3

FREE T3=4.1

Sorry for the long post but i dont know anything about over active thyroid. I feel fine except i do get tired and breathless but i have been like that since the open heart surgery.

Im scared.

Thanks in advance for any replies.

Barbara x

[PurpleNails Administrator]

welcome to forum,

Can you add ranges they vary between labs.

The FT4 looks very high but FT3 very low. (By most ranges)

10mg carbimazole is a low starting dose for carbimazole.

Have doctors tested for thyroid antibodies?

Doctors should ideal be confirming cause of hyper before suggesting an anti thyroid. Hyper levels can be transient.  

Unless there’s evidence it’s continuous eg Graves. 

Carbimazole can very rarely cause a drop in white cells which is why doctors warn about sore throat.  

The patient information leaflet will detail all the issues to look for, there are other symtoms to be vigilant for too.

The risk is very low and outweighs risk of continuously hyper levels.  

[Barb6374 in reply to PurpleNails]

Hello purplenails , thank you so much for replying .

The TSH range is 0.27-4.2 mine is 0.01

T4 range is 12-22 mine is 34.3

T3 range is 3.1-6.8 mine is 4.1

I dont think i have been tested for thyroid antibodies , on my test results would it say thyroid antibodies or something else ?.

On my health record it says thyrotoxicosis.

I did say to my gp wouldnt it be better to wait another 2 weeks to repeat the test but he said that the endocrinologist said its highly unlikely the urine infection caused the high t4 and to start the carbimazole straight away.

When i picked up the tablets yesterday they didnt have enough and had to give me two brands. They were put into a bottle with no patient info leaflet !!.

[PurpleNails Administrator in reply to Barb6374]

You have T4 Thyrotoxicosis as your FT4 is high but FT3 is quite low in range. 

Free thyroxine- FT4: 34.3 pmol/l (Range 12 - 22) 223.00%

Free triiodothyronine FT3: 4.1 pmol/l (Range 3.1 - 6.8) 27.03%

So while your FT4 is just over double normal range your FT3 is 27% of range and some would report feel ping hypothyroid (under active) at that level. 

When is your next test?  Contact doctor & ask is they will test.

TSH

FT4

FT3 

Thyroid antibodies: 

TPOab (Thyroid Peroxidase antibodies)

 TGab (Thyroglobulin antibodies) 

TPO & TG are “autoimmune markers” - & appears with BOTH Hashimoto’s & Graves.  Hashis causes transient hyper prior to under active.  Graves continuous Hyper.  

If hyper Graves Suspected 

TRab (TSH receptor antibodies - measures stimulating, neural & blocking antibodies)

And / or 

TSI (Thyroid-Stimulating Immunoglobulin) MUST be tested. 

GP can arrange TPO specialist likely needs to request TRab / TSI.  

A form can be sent you or your practice.  

If thyroid is abnormal, nutrients can be affected ask if they will test:

Folate

Ferritin 

B12

Vitamin D 

If Doctor won’t / can’t test everything necessary there are private options we can advise on.

List of companies offering different options, some discount codes available.

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

You order a test online - the kits arrives via post sample taken by finger prick (extra fee for private venous draw). Post back and results available online quite quickly.  

There’s lots of options, some packages include thyroid function, key nutrients and thyroid Antibodies.  Others basic function only.  

Is that something you think you could manage?

“When i picked up the tablets yesterday they didnt have enough and had to give me two brands. They were put into a bottle with no patient info leaflet !!.”

pharmacist obligated to supply Patient Information Leaflet (PIL) for both brands at time of dispensing.  Even if it were a subsequent prescription.  some patients need to know specific manufacturers ingredients due to allergies. 

Contact chemist, say this is a new medication & you require the manufacturer patient information leaflet for all the brands you have been given.

[Barb6374 in reply to PurpleNails]

They want me to start on the tablets and re test bloods in 4 weeks time.

I could look into private tests as i see there is monitor my health which is my local hospital, Rde exeter.

I will have to look up symptoms over/under active thyroid .

Thanks for reply.

[PurpleNails Administrator in reply to Barb6374]

thyroiduk.org

This site has lots of information regarding meanings and symptoms.

thyroiduk.org/if-you-are-un...

Is a good place to start. 

monitormyhealth.org.uk 

MMH has test for Thyroid function. (TSH FT4 & FT3)  or a pack with  Diabetes, Vitamin D, Cholesterol & Thyroid - TSH, FT3, FT4. Or separate vitamin D - but does not offer thyroid antibodies or folate, ferritin & B12.  

There is discount code available for MMH on the thyroid uk list of companies.

[Barb6374 in reply to PurpleNails]

I will look into the other options as i already have the b12 , ferritin , folic acid results, cholesterol, diabetes etc.

I think i just need the antibodies and repeats of the tsh, t3 and t4 .

It would be interesting to see my vit d as ive been taking a supplement since the beginning of the pandemic.

Thank again for all your information.

[PurpleNails Administrator in reply to Barb6374]

medichecks.com/products/thy...

This one does just funtion & antibodies but for a few extra £s you can have key nutrients incl vitamin D?

medichecks.com/products/adv...

How much vitamin D do you supplement? Are you aware of magnesium & K2 important as co-factors.

[Barb6374 in reply to PurpleNails]

I take 10ug a day . How important is magnesium and k2 please .

[PurpleNails Administrator in reply to Barb6374]

10ug is equivalent to 400 iu which is very low amount & would highly likely be insufficient to treat any sort of deficiency.  

Every adult in UK is recommended to supplement with 400iu Sep - March even if in superb health.  

Many require 3000 \ 5000 iu daily all year round to maintain good levels, but over 4000 iu isn’t recommended unless Doctor treating a deficiency.  

Most over the counter version available do not exceed 3000iu. A deficiency would require loading doses eg 25,000 iu (per fortnight for total 6 weeks) 

Magnesium works with D3 to maintain calcium levels & phosphate.  

There are many different forms of magnesium. See this link 

naturalnews.com/046401_magn...

The other important co factor is K2 MK7 this will direct dietary calcium to teeth and bones where you want it and away from tissues and vessels where you don’t.   Calcium supplements are rarely needed and can harden vessels if taken unnecessarily. 

“Better you” brand do a mouth spray which contains both D3 & K2 (red one) also offer In separate (green) for vitamin D, (purple) for K2 only.  

I’m assuming doctors explained to you at the time amiodarone is known to trigger complex affects on thyroid (both hyper & hypo)

Partly it’s due to high iodine content.   This may be a delayed consequence.

  Type 1 diabetes is autoimmune having any autoimmune conditions predisposes you to others.  Being hyper can have affect on blood glucose, are you finding they are becoming raised with high FT4.  

[greygoose]

On lansoprazole, furosemide,ramipril,atorvastatin, vitamin d.

With that list of drugs you're taking, I'd put my money on you have Hashi's, rather than Graves':

Lamsoprazole: a PPI. Used to treat high stomach acid. Problem is, the symptoms of high stomach acid are the same as the symptoms of low stomach acid, and doctors don't bother to check which you have. If you do have Hashi's, you will have been hypo for a while, which would cause production of stomach acid to drop, causing acid reflux, etc.

Atorvastatin: presumably you have high cholesterol? High cholesterol is usually caused by low T3. Well, we can see your T3 is low, and probably has been for some time to cause the high cholesterol.

Your FT4 is high, yes, but more like Hashi's high than Graves' high. And taking that together with the low FT3 makes me doubt very much that you have Graves'.

Problem is, your TSH is suppressed - with it would be, with that much T4 in your system! But, doctors only tend to look at the TSH and gallop to conclusions without doing the proper testing first. Most unprofessional of them, but there you are. So, if it were me, I would on no account take the carbi until the proper testing has been done. If you do have Hashi's, you will rapidly become hypo, and that's not good, either!

I honestly don't think you're in any immediate danger. T4 is basically a storage hormone that doesn't do much until it's been converted into the active hormone, T3. And, it's obviously not doing that! In fact, most of it is probably being converted to rT3 at the moment, which is inert.

Your decision, of course, but I don't think there's any harm in waiting to get the correct testing done.

[Barb6374 in reply to greygoose]

Hello greygoose.

Lansoprazole i have taken for many years due to acid reflux.

Atorvastatin, ramipril, i have been on for maybe 15 years.

A diabetic dr said to start them to protect me in the future.

My cholesterol is 2.1. It was 5 when i started all those years ago.

I think i will get these private tests done .

Thank you for the reply.

[greygoose in reply to Barb6374]

A diabetic dr said to start them to protect me in the future.$$

I don't know about the rampiril but the atorvastatin won't protect you from anything. Could just make things worse. That is a very unprofessional thing for a doctor to say! Where's the proof? You cholesterol is now too low and putting you in danger of a heart attack. Low cholesterol is far more dangerous than high. I think you ought to do a bit of your own research on these things. Just because a doctor tells you to take something doesn't mean he's right.