overactive thyroid : my tag is 1.85 but my T4 is... - Thyroid UK

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overactive thyroid

Prudypruds profile image
37 Replies

my tag is 1.85 but my T4 is 25.4 is that really high? As 22 is the max for normal? Waiting for the gp to call me on Monday.

Getting worried as my symptoms are, slight weight loss even though I feel hungrier, nervous, anxiety cold clammy hands my heart rate use to go down to 50-60 when resting now it’s 60-70.

Can’t seem to relax is that normal? Head feels right with a headache too.

Eyes are sore as well.

surely 25.4 isn’t too high?

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Prudypruds
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37 Replies
Jaydee1507 profile image
Jaydee1507Administrator

The range for each test differs from lab to lab so you need to quote the mimimum and maximum for each test.

I'm assuming your TSH is 1.85?

Are you on levothyroxine? Tell us some more about your situation.

Prudypruds profile image
Prudypruds in reply toJaydee1507

TSH is 0.27-4.2 and T4 is 11.1-22

Prudypruds profile image
Prudypruds in reply toJaydee1507

yes sorry 1.85 it’s the T4 which is higher been given nothing yet, call today and they said doctor will call me Monday

Jaydee1507 profile image
Jaydee1507Administrator in reply toPrudypruds

So you're not diagnosed with a thyroid condition as yet, I think. Your TSH is very 'normal' at the moment but for some reason your T4 has gone slightly over. No it's not a huge amount over at all but might signify that something is going on.

There's 2 types of autoimmune thyroid condition. Hashimoto's can start with a hyper or overactive phase before it makes you go hypothyroid. Then there's Graves disease which makes you hyper. To find out which you might have you need to get your GP to do antibody blood tests. Hopefully he/she will do that when they've spoken to you on Monday.

Prudypruds profile image
Prudypruds in reply toJaydee1507

thank you! Is there anything I can do minimise my symptoms? My parent recommend me to take multi vitamins.

Buddy195 profile image
Buddy195Administrator in reply toPrudypruds

Prudypruds, multivitamins are not recommended here. We recommend testing key vitamins folate. Ferritin, B12 and Vitamin D and then post results for further advice re supplementation as needed.

Prudypruds profile image
Prudypruds in reply toBuddy195

b12 is 251 value of 197-771

Jaydee1507 profile image
Jaydee1507Administrator in reply toPrudypruds

Multivits aren't recommended around here for a number of reasons. They tend to contain the cheapest form of vitamin, they contain iron or magnesium that stops you absorbing the rest of the contents, they contain too small an amount of anything to make a difference if you are deficient. Here, we test key vitamins and then supplement whats needed. Ferritin, folate, B12 & D3.

When you speak to your GP I hope he will be running further investigative tests. Make a few notes to keep by you when he's on the phone. You need thyroid antibodies tested but also the following vitamins: ferritin, folate, B12 and D3. When you get the results post them here with their ranges - usually in brackets beside the number.

Prudypruds profile image
Prudypruds in reply toJaydee1507

B12 Range:197 - 771 ng/L mine was 25

Serum folate Range:1.9 - 25 ug/L mine was 5.2

Serum ferritin Range:30 - 400 ug/L mine was

200

Jaydee1507 profile image
Jaydee1507Administrator in reply toPrudypruds

Ferritin is fine.

Folate is too low. Should be 50%+ of the range. Will need supplementing.

B12 is really not good enough at all. I will tag a couple of people in who are good at advising on these results. SlowDragon SeasideSusie

See if GP will add D3 test to the tests he might order on Monday.

Prudypruds profile image
Prudypruds in reply toJaydee1507

cheers b12 is 251 not 25 🤣

Jaydee1507 profile image
Jaydee1507Administrator in reply toPrudypruds

Yes I saw that. Although it's within the range it's pretty low. The B12 test the GP does is a serum B12. There's a slightly different one 'active' B12. TBH I'm pretty brain fogged myself and wouldn't want to lead you astray so tagged the other people. It does warrant further investigation though.

Prudypruds profile image
Prudypruds in reply toJaydee1507

sorry B12 was 251

SlowDragon profile image
SlowDragonAdministrator in reply toPrudypruds

B12 on the low side

Are you vegetarian or vegan?

if NOT vegetarian or vegan and have low B12 symptoms (see list below) ask GP to test for Pernicious Anaemia before starting any B vitamin

Low B12 symptoms 

b12deficiency.info/signs-an...

Also need vitamin D tested

vitamindtest.org.uk/

Important to test thyroid antibodies for autoimmune thyroid disease

Autoimmune HYPOthyroid, also called Hashimoto’s frequently starts with transient hyperthyroid results and symptoms before becoming increasingly hypothyroid

Testing TPO and TG antibodies for Hashimoto’s.

Tpo or TG antibodies can also be mildly raised with Graves’ disease (autoimmune HYPERthyroid)

Need to Test TSI or Trab antibodies for Graves’ disease ….usually only tested via endocrinologist

Link about thyroid blood tests

thyroiduk.org/getting-a-dia...

Link about Hashimoto’s

thyroiduk.org/hypothyroid-b...

Symptoms of hypothyroidism 

thyroiduk.org/wp-content/up...

Link about Graves’ disease

thyroiduk.org/hyperthyroid-...

Graves Disease antibodies test

medichecks.com/products/tsh...

Prudypruds profile image
Prudypruds in reply toSlowDragon

vitamin D should be fine as I take 1000ug daily for the last 2-3 years

SlowDragon profile image
SlowDragonAdministrator in reply toPrudypruds

Test vitamin D twice yearly via NHS private testing service when supplementing 

vitamindtest.org.uk

Prudypruds profile image
Prudypruds in reply toSlowDragon

so the plot Thickend, spoke to the GP today……

And said that my ferium and b12 are within range and to take multivitamins, my tsh and t4 result were the same in 2018 and went down to normal on there own over 9 months period and three different blood test. So he has said he will re-do bloods in three weeks and do an antibodies test. In the meantime he has given me nothing, I told him about the weight loss and said to eat more fatty food if necessary! My question is what vitamins should I take and what dosage?

Jaydee1507 profile image
Jaydee1507Administrator in reply toPrudypruds

Almost forgot, am not the best person to speak to about hyperthyroidism but GP can probably prescribe Propranalol which should help in the mean time.

Verde1 profile image
Verde1 in reply toPrudypruds

Have oranges and green cabadge, also brocoli spinach. as they are associated to help to bring down hyperthyroidism. I

Prudypruds profile image
Prudypruds in reply toJaydee1507

also have a high bilirubin level of 45 and a low level Serum phosphate of 0.75

Jaydee1507 profile image
Jaydee1507Administrator in reply toPrudypruds

I don't really know anything about those blood tests. Oh the other thing it could be is a thyroid nodule that puts out oo much thyroid hormone.

SlowDragon profile image
SlowDragonAdministrator in reply toPrudypruds

High bilirubin is probably Gilbert’s syndrome - very common genetic variation

britishlivertrust.org.uk/in...

SlowDragon profile image
SlowDragonAdministrator in reply toPrudypruds

rarediseases.org/rare-disea...

Some affected individuals have reported vague, unspecific symptoms including fatigue, weakness and gastrointestinal symptoms such as nausea, abdominal discomfort, and diarrhea. Researchers do not believe that these symptoms are related to excess bilirubin in the blood and may occur coincidentally or due to other reasons such as anxiety over the diagnosis.

TeaFree profile image
TeaFree in reply toPrudypruds

This is an interesting discussion, because there are parallels with my experience. Particularly the elevated bilirubin, about which there is widespread misunderstanding. Doctor's primers are apt to write this common finding off as of no clinical significance.

But you will find that this is very far from the case and may explain an awful lot on its own. Not least because it betokens a likely snp (UGT1A1) that impedes Phase II detox in the liver, affecting glucuronidation, and restricting production of the master antioxidant glutathione (GSH) gilbertssyndrome.com/hypoth... . Without enough of it you will be prone to (particularly alcohol, heavy metal and e.g. mould) toxins. If you think this is so then down the road you may look at NAC supplementation.

However, you still have a couple of outstanding elementary bases to cover yet, in terms of definitive testing for antibodies (thyroid and stomach - PA will depress B12 absorption), but also Free T3 (and possibly reverse T3). And, independently, hypochlorhydria (low stomach acid) not only has innumerable consequences but a sort of chicken and egg relationship with impaired thyroid function.

The thyroid hormone that matters is T3. And your slightly elevated TSH and elevated T4 may betoken poor conversion from T4 to T3. In fact, as you clearly have Gilbert's, like me, this is more than likely, because a great deal of T3 is ordinarily converted in the liver. So, your elevated TSH and T4 may be your body's way of trying to crank up inadequate T3.

Incidentally, propranolol (Inderal) a beta-blocker is also known to depress T3 conversion healthunlocked.com/thyroidu.... So, you should bear this in mind.

It is not all bad news though. Bilirubin (a breakdown product of heme) is a formidable antioxidant all on its own, and probably the body's way of compensating for depressed GSH, it's clever like that! And people with moderately elevated bilirubin demonstrate a significantly reduced (like by around two-thirds) risk of coronary artery disease (CAD) in later life.

Of course, you do not mention cholesterol, but in the old days before doctors relied overly on (misinterpreting) a couple of thyroid markers and undertreating much latent thyroid disease as a result, elevated cholesterol would have been taken as indicative of possible thyroid issues, and is not unrelated to Gilbert's too.

In fact, you will find that there is a frustrating cluster of ailments that may arise from your detox and other systems going a bit slow (mild mitochondrial dysfunction is likely). The key thing is to get some feel of your own based on tangible testing of what the route of causation is. Many of the symptoms and supplement recommendations are common. However, almost all of this will fall below the GP radar or be misunderstood at best.

Much can be achieved by understanding the impact of helpful nutrition, avoidance of adverse foods and identification of real allergies and clinical findings e.g. coeliac, gluten, lactose sensitivity (as opposed to all the ones you might be led to suppose. I wonder if you have lost the outer third of your eyebrows (Hertoghe's or Queen Anne's sign)?

Really, the only least remarkable things about my routine bloods, before I went on to greater things, were consistently elevated bilirubin, elevated cholesterol, elevated creatinine, and increased RDW. In researching the cause of problems that have cropped up since I have found I have had very low B12 (which elevates homocysteine - very bad!) and my T3 is borderline low, despite my TSH and T4 not being a million miles from yours.

redhead41 profile image
redhead41 in reply toJaydee1507

you need T3 as well to make sense of these values.

Buddy195 profile image
Buddy195Administrator

Please post your blood test ranges, as these vary between laboratories.

I had very similar ‘hyper’ symptoms when first diagnosed as hyperthyroid/ Graves, but later antibody testing showed I’m actually under active with Hashimotos (and TED). Do ask your GP for antibodies to be tested.

Regarding sore eyes, I would ask your optician to check for symptoms of Thyroid Eye Disease and refer you to a specialist ophthalmologist if needed. If TED is suspected I would take 200ug selenium daily, as studies show it is beneficial to mild/ moderate TED if taken for 6 months. If your eyes are dry, use preservative free drops regularly (eg HycoSan or Hyloforte).

Prudypruds profile image
Prudypruds in reply toBuddy195

I will mention it to them on Monday although it would make sense for it to be overactive as weight loss and get hungry (feel sick) is a symptom?

Buddy195 profile image
Buddy195Administrator in reply toPrudypruds

I lost weight, had fast pulse, palpitations, tremor, gastritis and had TED, yet antibodies show I have an under active thyroid. Other members with an under active thyroid also report that they first started with a ‘hyper’ phase. That’s why antibody testing is so important.

Graves Disease (hyperthyroidism) needs to be confirmed via positive TRab or TSI antibody testing.

Prudypruds profile image
Prudypruds in reply toBuddy195

and the range is in the comment above sorry

Jaydee1507 profile image
Jaydee1507Administrator

Your name is on that, also cannot see what test it is?

Prudypruds profile image
Prudypruds in reply toJaydee1507

not my name but the doctors so I’ll delete it

SlowDragon profile image
SlowDragonAdministrator

Looking at your other posts

Your GP prescribed Lansoprazole (PPI)

This is likely cause of low B12 and folate

Lansoprazole will lower vitamin levels

Especially magnesium and B12  

gov.uk/drug-safety-update/p...

webmd.com/heartburn-gerd/ne...

pharmacytimes.com/publicati...

Anxiety and low heart rate are common hypothyroid/Hashimoto’s symptoms

Is there autoimmune disease in your family

Request coeliac blood test too

Prudypruds profile image
Prudypruds in reply toSlowDragon

yes I was on those tablets for a while and it was 30mg then 60mg for a few months! Makes sense, what tablets are recommend to take to increase both?

Prudypruds profile image
Prudypruds in reply toSlowDragon

looking at 2018 my thyroid results are almost exactly the same

T4 and tsh results
SlowDragon profile image
SlowDragonAdministrator in reply toPrudypruds

possibly your thyroid levels just run higher than average ?

But might account for feeling a bit anxious

Vitamin D was low

silverbelle51 profile image
silverbelle51

Might want to check soy consumption it comes in a variety of forms in almost everything. Suggest Dianne Greggs book "Hidden Danger of Soy"

SlowDragon profile image
SlowDragonAdministrator

Most people with Gilbert’s syndrome can ‘t easily process many medications or supplements

Are you currently taking any medications?

Suggest you test vitamin D now

Test twice yearly via NHS private testing service when supplementing 

vitamindtest.org.uk

Start supplementing B12 to improve low levels

After 2-3 weeks add in a daily vitamin B complex

Low B12 symptoms 

b12deficiency.info/signs-an...

With serum B12 result below 500, (Or active B12 below 70) recommended to be taking a B12 supplement as well as a B Complex (to balance all the B vitamins) initially for first 2-4 months.

once your serum B12 is over 500 (or Active B12 level has reached 70), stop the B12 and just carry on with the B Complex.

B12 drops 

healthunlocked.com/thyroidu...

B12 sublingual lozenges 

amazon.co.uk/Jarrow-Methylc...

cytoplan.co.uk/shop-by-prod...

B12 range in U.K. is too wide

Interesting that in this research B12 below 400 is considered inadequate 

healthunlocked.com/thyroidu...

Vitamin B complex

supplementing a good quality daily vitamin B complex, one with folate in (not folic acid) 

This can help keep all B vitamins in balance and will help improve B12 levels too

Difference between folate and folic acid 

chriskresser.com/folate-vs-...

Many Hashimoto’s patients have MTHFR gene variation and can have trouble processing folic acid.

thyroidpharmacist.com/artic...

B vitamins best taken after breakfast

Thorne Basic B recommended vitamin B complex that contains folate, but they are large capsules. (You can tip powder out if can’t swallow capsule) 

IMPORTANT......If you are taking vitamin B complex, or any supplements containing biotin, remember to stop these 7 days before ALL BLOOD TESTS , as biotin can falsely affect test results

endo.confex.com/endo/2016en...

endocrinenews.endocrine.org...

In week before blood test, when you stop vitamin B complex, you might want to consider taking a separate methyl folate supplement and continue separate B12

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