Advice, please?

[BuenoReeses]

Hello, Looking for some advice, please? I've had the following blood results-

28/10

TSH 0.72 (within range 0.2 - 4.00)

22/11

Free T4 22.1 ( within range 11.0 - 22.6 )

Free T3 6.8 ( outside range 3.5 - 6.5 )

04/12

Free T4 23.5 ( outside range 12 - 22)

Free T3 6.3 ( within range 3.1 - 6.8)

TSH 1.15 ( within range 0.27 - 4.2)

Antibodies- both in range.

My GP says no further action.

My symptoms are anxiety, difficulty sleeping, tired, heart racing, muscle spasms, restless legs, upset stomach, shakey & dramatic unintentional weight loss.

Could I have your thoughts, please?

Should I consider a private endocrinologist?

[TiggerMe Ambassador]

Are you taking medication? These results are quite high and would give you all of the symptoms you describe

[BuenoReeses in reply to TiggerMe]

Thank you for your reply.My GP says as TSH is in range to test again in a few months, just dont know if i hould wait that long? Im not on any medication

[TiggerMe Ambassador in reply to BuenoReeses]

I'm not familiar with when they start treatment for hyper... yes your TSH is bang on but your GP needs to look beyond that at your high free's and if he doesn't know how to interpret he needs to ask an Endo for advice, your symptoms suggest it's an issue

[BuenoReeses in reply to TiggerMe]

Thank you, i think ill go down the private option.

[TiggerMe Ambassador in reply to BuenoReeses]

Probably the best idea, borderline readings are hard to get the NHS to act upon 🤗

[PurpleNails Administrator]

Your TSH appears normal, but your FT4 & FT3 are high quite high / over range. The high levels would account for hyper symptoms. It’s common for TSH to drop low when thyroid rises even a little so this is why doctors are incorrectly assuming normal TSH means there’s no issue.

By both antibodies I assume TPO & TG antibodies. Might be worth testing TRab or TSI antibodies as these are associated with hyper Graves. TPO & TG are not always present. GP can’t request TRab or TSI, needs to be endocrinologist or done privately.

Fluctuations are seen with thyroiditis, continue to monitor levels & it may show a gradual decline.

Borderline elevations are also seen with hyper nodules. (Which is not autoimmune)

Is appearance & feel of thyroid normal for you? Issues swallowing? Any swelling in lower part of neck, a little above collar bone. It can help If you have a bottle water and gulp water with your chin lifted up, swellings can go unnoticed unless looking.

Reason for high frees should be investigated. Ultrasound Scan of thyroid would be the ideal way to find out & can be arranged privately.

Waiting months when unwell very unfair. 6 weekly testing sufficient time to compare levels.

[BuenoReeses in reply to PurpleNails]

Thank you for your reply.My swallowing feels ok, im not sure what im looking for swelling wise. It does seem I would be best getting a private endocrinology appointment. Its just so damm expensive!

[BuenoReeses in reply to BuenoReeses]

Also to mention my sister has hypothyroyism.

[PurpleNails Administrator]

Perhaps monitor using private blood test and push case with GP. Private endo may not treat any quicker than NHS doctors, but might test further which you can organise yourself with less expense.

If you do arrange visit to private endo having a complete thyroid & nutrient test will help ensure you have best information to get as much from appointment.

Here’s a list of companies offering different options, some packages include thyroid function, key nutrients and thyroid Antibodies. Others a basic function only. Some also have discount codes available.

Test with nutrients (folate, ferritin, B12 & vitamin D) might help. Nutrients can be affected by abnormal thyroid & mimic symptoms.

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

You order 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.

If GP testing thyroid funtion every 3 months, arrange a complete test in between.

Test close to 9.00 fast overnight,

I suspect results won’t stay same, it’s more likely TSH drops in response to continued high Free T4 & Free T3 or Frees lower and TSH rises at slower rate behind.

[BuenoReeses in reply to PurpleNails]

Hi, the most recent blood tests i had were with medichecks. The antibody tests were thyroglobulin 16.9 ( within range 0 - 115) & thyroid peroxidase <9 (within range 0-34).GP has completed a lot of blood tests, which found b12 was low 195ng/l, i have since had a b12 injection. Iron low but within range. Vit d within range & folate 17.2ug/l ( outside of range 3.0 -14.4)

FSH 15.5u/l, im 46yrs so started hrt 5 weeks ago and felt no benefit other than a horrendous reaction to the progestrone.

My symptoms started about 4 months ago, following redundancies being announced at work. Its been a stressful period but i have never experienced anxiety so severe and have been desparatley trying a reason. The weight loss in particular is really concerning me as im already petite. Im eating regular meals.

I suppose im wondering if the symptoms im experiencing could just be linked to stress i have been going through. I have been feeling so unwell, having lots of time of work & have now given into taking fluoxitine as a last resort. Im a week in & the side effects are awful, just feels like all my symtoms are hightened. Could stress be thr cause of high T3 & T4?

Thank you for taking the time to read.

[PurpleNails Administrator in reply to BuenoReeses]

“Could stress be thr cause of high T3 & T4?”

It’s more likely stress can worsen an existing issues, but many doctors will say yes everything can be entirely caused by stress or put down symptoms down to things like menopause.

Stress affects adrenals which does works in tandem with thyroid but its not common for stressed individuals to have abnormal thyroid.

[BuenoReeses in reply to PurpleNails]

Thank you Purple Nails, do you still think its worth me persusing with an Endocrinologist?

[PurpleNails Administrator in reply to BuenoReeses]

I think I’d arrange full private testing initially. It may become clear how to proceed based on further thyroid results. You may also have nutrients to optimise.

If your instincts say you should consult an endocrinologist & you are worried you should do what you feel.

Assuming GP will say no criteria to refer you as endocrinology will reject, you can go private without GP referral.

Thyroid UK has compiled of private GPs & Endocrinologists which can be obtained by contacting Thyroid U.K. either by emailing [e-mail] or using this online form thyroiduk.org/about-thyroid...

[BuenoReeses in reply to PurpleNails]

Thank you very much for all your advice, it is greatly appreciated. I have managed to get a private Endo appointment for next Wednesday. The consultant also works for the NHS so maybe he can refer me back to the NHS after the initial consultation. Thanks again.

[BuenoReeses in reply to PurpleNails]

Hi Purple Nails,

I have had a private Endo appointment, I was given an examination and told my thyroid & eyes are normal. The Specialist said, in a letter to my GP -

Based on high T3 & T4, I have explained the thyroid function is quite atypical and I do not think she has a thyroid problem. I have explained that even in the early stages the first abnormality is a full suppression of TSH, and the fact that hers is detectable is extremely unusual. (He also suggests my GP do repeat tests to rule out assay issues). She tells me that a thyroid USS has been arranged ( by GP), however, I do not think this is necessary.

So I feel I`m no further along! Although I have had an appointment through for the ultrasound.

Unbelievably, My youngest daughter has just had blood results back with a TSH of 4.9mu/L & T4 12.9pmol/L

[PurpleNails Administrator in reply to BuenoReeses]

Private dr still focusing on TSH. Which is what doctor do.

I think an ultrasound is worth while if being offered. USS don’t show function but will detect any anomalies eg nodules or if it’s swollen, showing signs of damage & if vascularity is normal.

Regular thyroid function retesting might be best option, then you’ll have a real picture going forward. 6 weekly if you can arrange it. TSH, FT4 & FT3.

Testing close to 9.00, fasting overnight, stop any supplements containing biotin, this can interfere with testing process.

Antibodies are negative but they do fluctuate maybe retest in 6 months.

Some of your nutrient were low -, ferritin & B12 Have you started supplements?

Folate was high & vitamin D in range.

Most nutrients need to be over 50% of range to be optimal. Do a separate post with most recent folate, ferritin, B12 & vitamin D. & what supplements your taking, you might need further advice on how to improve them.

Your daughter’s results look towards hypothyroid. Are they within range? Dr should repeat in 3 months if sub clinical. See if they will add thyroid antibodies.

[BuenoReeses in reply to PurpleNails]

Thank you for your reply. I will ask GP to retest TSH, FT4 & FT3 & antibodies. Any ideas why my folate is high? I can`t seem to find much online about it, 17.2ug/L (3.0 - 14.4). Could this cause me any issues? My ferritin is 42ug/L (10.0 -291.0). My B12 was 195ng/L & I have since had a B12 injection. I started some iron tablets but they gave me diarrhea, so I need to look at a liquid formula.

My daughters TSH is 4.9mu/L (0.2 - 4.0), FT4 12.9 pmol/L (11.0 - 22.6), Thyroid Peroxidase Antibody Concentration (XabCy) <28 u/mL (0.0 - 60.0), vitamin d 29.5 nmol/L (Indicates insufficiency ), ferritin 21ug/L & calcium 2.17mmol/L (2.2 - 2.6). GP has prescribed high dose of Vit D to take for 8 weeks, then start OTC iron & retest full blood count & TSH.

Hope that makes sense?

[BuenoReeses]

Hi Purple Nails