Hi my test results are TSH 1.46MU/L (Normal range 0.27 - 4.2 mu/l)
ft3 13.1 pmol/L (normal range 12-22 pmol/L)
FT4 4.1 (RAGE 3.1 - 6.8 PMOL/L)
My tsh dropped down to near 0.08 mu/l in 2020 and my t4 was 16.8 pmol/l T3 was 5pmol/L
As my T3 and T4 hormones have fell over the last 3 years and my TSH has increased I was wondering if this is something to be concerned about? I've heard of subclinical thyroid but I'm confused about hypo and hyperthyroid?
My symptoms are extreme dizziness/off balance, don't feel right, terrible brain fog can't think straight, tired and weak but feel a little bit wired as well. I cannot do much exercise as my heart doesn't feel right and I can be quite ill some days. I have been having b12 injections as somebody told me it sounded like I was suffering with pernicious anaemia but sometimes I still have these symptoms despite the injections
Thankyou
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Rach77788
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Pretty sure you've got your T4 and T3 mixed up. Should be:
ft4 13.1 pmol/L (normal range 12-22 pmol/L)
FT3 4.1 (RAGE 3.1 - 6.8 PMOL/L)
OK, so your TSH is 'normal' (euthyroid). But, your FT4 is pretty low, only 11.00% through the range - euthyroid is around 50%.
Your FT3 is 27.03%, which is also very low. But it's unusual to have the FT3 higher in range than the FT4, which could suggest a failing thyroid.
So, why would that be? Well, given that your TSH is not reflecting your thyroid hormone levels, as it should (when thyroid hormones levels are that low, the TSH should rise accordingly to stimulate the thyroid to make more hormone), you could have a pituitary/hypothalamus problem, rather than a thyroid problem. (Don't know how much you know about thyroid so don't want to go into too much detail at this point.)
Or, could be that you have Autoimmune Thyroiditis - aka Hashi's - and due to immune system attacks on the thyroid, the TSH is having trouble keeping up with thyroid hormone levels, because it moves more slowly. Did you have TPO and Tg antibodies tested?
Or, it could just be that this is normal for you. I take it this is your first thyroid function test? So, we have nothing to compare it to.
And, I'm afraid that if you go to the doctor and suggest you might have a thyroid problem, he's going to look at that TSH and opt for the third theory. They know so little about thyroid.
So, what can you do? Not a lot right now, but keep on testing to see how things evolve. And, I would also suggest your get nutrients tested - vit D, folate and ferritin (usually I would say B12 but as you're having injections, there's no point). Are you also taking a B complex with your B12 injections? If so, not much point in testing folate, either. If you aren't, then you should be.
Then, if you have any other deficiencies, you should supplement them along with their cofactors. When one is hypo, one often has low stomach acid, and that leads to nutritional deficiencies, which doesn't help your thyroid.
No haven't been tested for TPO and TG and Yes it is all as a result of my stomach - I know this but the doctors don't listen. I have low stomach acid and found taking HCL helps as I did have nutritional deficiencies, I was low in zinc and had very low ferritin as I fear I haven't been absorbing nutrients from food for the last 20 years. Been fobbed off as IBS although I've just had an endoscopy and have gastritis. Don't know the cause yet or even if they are going to look for one. I have had terrible stomach issues since age 15 along with hair loss, extreme fatigue and now all the enamel is wearing off my teeth despite not drinking fizzy drinks, alcohol or smoking. I am taking vit d , b vits and iron and folate and a multi vit. I also have endometriosis and I suspect PA although doctors would not entertain this as my serum levels were normal but I was falling into things and was extremely ill back in October and b12 injections have helped a lot
I have had previous thyroid tests please see below but not for t3;
OK, so the reason doctors fob you off is because of your euthyroid TSH. Your FT4 is mainly on the low-side - I assume the ranges are always the same as above? - but doctors wouldn't understnd that. So, it does rather look like Central Hypo (i.e. a problem with the pituitary or hypothalamus, rather than the thyroid itself). But, you prove it, you would need other pituitary hormones tested, and I don't think you can do that privately.
But, what you could do is do a 24 hours saliva cortisol test. If that is low enough throughout the day, you'd have justification in asking for an synacthen test which would show if the problem stems from the adrenals themselves or the pituitary. It it's the pituitary, then that would affect TSH production and therefore the thyroid. That's the best way forward that I can suggest.
By the way, we never recommend multi-vits, for a multitude of reasons. But, if it contains iodine, that could be negatively affecting your thyroid, because iodine is anti-thyroid. Multi-vits a one huge waste of money!
Hi just an update, I've had antibodies tested which indicates I haven't got Hashimotos. Do you think I am justified in asking to see an endocrinologist with the t4 being so low but the t3 being higher?
I doubt an endo would see the significance of that. They tend to be diabetest specialist who know little to nothing about thyroid. Besides, I doubt an endo would agree to see you as your results are all in range. So for them you are 'normal'.
You cannot rule out Hashi's on the basis of one negative antibody test because antibodies fluctuate all the time. And some Hashi's people never even have over-range antibodies. So, it's the old thing about not being able to prove a negative.
Yes ranges are all the same although I've noticed they have raised the ranges over the years. Oh really, I thought with not absorbing nurtients properly I would play it safe and get a multi vit. I've just started taking a new one and it does have iodine in it!I will stop taking that then, I have heard that people with thyroid deficiency have an iodine deficiency? Or is that mis info?
Thankyou for all the advice where would I get a saliva cortisol test? It might be worth to note I have had an unusually high stress life, which I know would affect adrenals. I've heard stomach function also impacts thyroid, as my stomach is so terrible is there anything I can do to help my thyroid and adrenal health that works in your experience?
I have heard that people with thyroid deficiency have an iodine deficiency? Or is that mis info?
That is mis-info. Iodine deficiency is pretty rare in most places. And there are so very many other possible causes of hypo. But, even if you got tested and were deficient, it's not just a case of taking a multi-vit with iodine in it. There's a whole protocol to be set up.
I've heard stomach function also impacts thyroid, as my stomach is so terrible
More like low thyroid function impacts the stomach. With low T3 stomach acid production is compromised meaning that you have difficulty digesting food and absorbing nutrients.
is there anything I can do to help my thyroid and adrenal health that works in your experience?
Well, you could start by raising your stomach acid so that you digest and absorb better. Even if it's just taking a dose of vit C before meals. Have you had your nutrients tested: vit D, vit B12, folate and ferritin? If they are sub-optimal they would need optimising.
But, if it is your pituitary that is not functioning correctly, there's nothing you can do about that. It can't be cured or healed. The only possible way of raising FT4/3 levels is to take thyroid hormone replacement.
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