Am I euthyroid?

[kvmj]

07/11/2023

TSH 2.38 range: (.465-4.68)

FT3 3.9 (2.8-5.3)

Ft4 .9 ( .79-2.18)

Vit D 70.4 (32.0-100.00)

I was diagnosed in 2017 with a toxic multinodal goiter. I chose to forego RAI and surgery. I was well controlled by Methimazole. Because you have to stay 6 feet away from other living things and undergo treatment at your own home, I didn't want to try RAI until my cat received the exact same diagnosis. He underwent RAI on 08/30/2021 and I did it the following day. Kitty is normal, but I have lingering symptoms, I have a pronounced tremor still, my hair started falling out a year ago although I still have about half left, but I have gained about 50 pounds which I cannot seem to lose. I think I may need a tweak. I have a CMP and CBC from the same date which are unremarkable.

This forum has been invaluable and I would appreciate your advice.

[SlowDragon Administrator]

Are you on any replacement thyroid hormones

If yes, what exactly

For full Thyroid evaluation you need TSH, FT4 and FT3 tested

Also both TPO and TG thyroid antibodies tested at least once

Very important to test vitamin D, folate, ferritin and B12 at least once year minimum

Recommended that all thyroid blood tests early morning, ideally just before 9am, only drink water between waking and test and last dose levothyroxine 24 hours before test

This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip)

Hair loss suggests you’re anaemic

Get full iron panel test including ferritin

[kvmj in reply to SlowDragon]

I posted TSH, T3 & T4 also Vit D. Antibodies were tested 10/2017. Both were negative. I was hyperthyroid and now within normal ranges.

I'm in the US and we do not routinely test folate, ferritin or B12,

I'm not taking anything thyroid related now.

[SlowDragon Administrator in reply to kvmj]

So next step get full iron panel test for anaemia

And get B12 and folate levels tested

Did you do this test early morning

[kvmj in reply to SlowDragon]

All my tests are before 9 am. I really don't think that I could possibly be anemic. I made endocrinology test years ago and I was nowhere near anemic.

I think if I'm not euthyroid, it's with the data that I've posted.

[SlowDragon Administrator in reply to kvmj]

Most medics won’t consider you might be hypothyroid unless TSH is high

But after Graves’ disease TSH can be stuck low

Low vitamin levels also lower TSH

Obviously your TSH is too low for conventional diagnosis

Looking at central hypothyroidism and/or vitamin deficiencies

Central hypothyroidism

bestpractice.bmj.com/topics...

ncbi.nlm.nih.gov/pmc/articl...

endocrinologyadvisor.com/ho...

academic.oup.com/jcem/artic...

ec.bioscientifica.com/view/...

FT4: 0.9 pmol/l (Range 0.79 - 2.18)

Ft4 is only 7.91% through range

FT3: 3.9 pmol/l (Range 2.8 - 5.3)

Ft3 44.00% through range

[pennyannie]

Hello Kvmj :

Can I suggest that that you also register with the Elaine Moore forum - if you haven't already.

elaine-moore.com

It is Stateside and Elaine Moore went through the same procedure for her Graves and finding little help or understanding post RAI started researching Graves herself and now with a world wide following and an acknowledged leading researcher in this specialist field

With a bit of luck you may find people in the same area code as you and be recommended a doctor who understands the complexities of medicating Graves after RAI thyroid ablation.

I was immediately started onT4 medication after RAI in 2005 but became very unwell around 10 years later when i found Elaine Moore's books and then purchased a laptop for myself and found this forum as well.

I now self medicate with Natural Desiccated Thyroid which I understand can be more easily prescribed in the States than here in the UK .