test results

[Lollipop93]

hello everybody, I have been having debilitating epigastric pain and on and off sickness and diarrhoea for 6 months and a new doctor referred me for blood tests which included my thyroid my results have come back and the doctor has said he is going to urgently refer me and also test me for Graves’ disease as my cousin and Nan both have it. I wondered what people’s thoughts were on my results really as he didn’t really say the severity of it just that he will give me an urgent referral and look out for symptoms of ‘thyroid storm’ I’m a bit shaken up really as I never thought my bad stomach etc would lead to this result

Please see below, they were happy with T4;

Serum TSH level:

0.11 mu/L

Normal range:

0.4 to 4.9

Serum free T3 level:

6.4 pmol/L

Normal range:

2.4 to 6.0

Serum free T4 level:

14.7 pmol/L

Normal range:

9.0 to 19.0

thank you

[greygoose]

Well, I think you can shake down, now. We absolutely need the ranges for those results, but if they are typical of what we usually see here, your results aren't that bad. I think your doctor is just looking at the TSH, which is a tad low, and panicking. But I don't think those results look anything like Graves'.

What time of day was the blood draw for these tests? Because TSH fluctuates throughout the day, being highest before 9 am, and at its lowest around midday.

But, to say any more, we need the ranges.

[Lollipop93 in reply to greygoose]

Ok thank you I had them at 10:30 so actually probably a really good time! I think because my symptoms have been so debilitating especially with my stomach and I’ve lost 7lb this month and then he just mentioned an urgent referral I was just worried really.

Please see below, they were happy with T4;

Serum TSH level:

0.11 mu/L

Normal range:

0.4 to 4.9

Serum free T3 level:

6.4 pmol/L

Normal range:

2.4 to 6.0

Serum free T4 level:

14.7 pmol/L

Normal range:

9.0 to 19.0

Thank you x

[greygoose in reply to Lollipop93]

Before 9 am would be better because the TSH starts to drop sharply after that. And a low TSH scares the living daylights out of doctors!

So, your FT4 is 57.00% through the range, which is slightly high, but not drastic. However, your FT3 is very much higher in-range. And that is abnormal. Although it doesn't have anything to do with Graves', I don't think.

But, what they didn't do is antibodies. And for a doctor that suspects Graves', that is a pretty serious omission. The only way to find out for sure if you have an autoimmune disease like Graves' is to test the antibodies:

TRAB or TSI for Graves'

TPOab and TgAB for Hashi's - because the problem is more likely to be Hashi's than Graves'.

[Lollipop93 in reply to greygoose]

he has referred me for the test for graves next week so hopefully we will know then

[greygoose in reply to Lollipop93]

I strongly suggest you also get tested for Hashi's. Because if the test for Graves' antibodies is negative, that will leave you non the wiser. While they're taking the blood for one test, there's no reason for them not to do the other - except cost, of course, but well worth it.

[Lollipop93 in reply to greygoose]

I have requested that and will get it done next week, thanks!

[greygoose in reply to Lollipop93]

You're welcome.

[Lollipop93 in reply to greygoose]

also can I ask, my symptoms have been pretty deliberating but from what I can see my numbers don’t seem too far out out of the ranges really, do they class it as hyperthyroidism as soon as they’re out of range etc? Thank you

[greygoose in reply to Lollipop93]

Your numbers aren't that far out of range. Your FT4 is well within range. Your numbers do not suggest Graves'/hyper at all. It's just your GP obviously knows nothing about thyroid and had a fit of panic because of the low TSH - I bet he doesn't even know what T3 is! But your TSH isn't low enough to be Graves'. It would be zero if you had that. It's low because your FT3 is high, but not high enough for Graves'. But doctors do not understand blood tests well enough to think about it logically.

[RedApple Administrator]

Lollipop93, You are not taking any thyroid medication, correct?

[Lollipop93 in reply to RedApple]

No I’m on no medication whatsoever

[RedApple Administrator in reply to Lollipop93]

In which case, your doctor might be concerned about what looks to be over range FT3, which in turn gives under range TSH. That may be the cause of your stomach issues. Further testing for Graves/hyperthyroidism will help to indicate whether you need anti-thyroid medication or not. Nothing to panic about at this stage 😊

[Lollipop93 in reply to RedApple]

Thank you, I think because my cousin has suffered so badly with graves and has had to have a pacemaker etc I just thought of worst case scenario. I really hope we can get to the bottom of it and my symptoms can be helped.

[RedApple Administrator in reply to Lollipop93]

Even if it does test positive for Graves, it's not looking to be bad at this point. So chances are it can be effectively controlled over the long term.

[Lollipop93 in reply to RedApple]

What other tests do they typically do now after this? He’s referred me to endocrinology but don’t know what the next stage involves

[SlowDragon Administrator]

Autoimmune HYPOthyroid disease frequently starts with transient hyperthyroid results and symptoms before becoming increasingly hypothyroid

Hashimoto’s can initially be misdiagnosed as Graves’ disease is all thyroid antibodies not tested

Request GP test thyroid antibodies

TSI or Trab antibodies for Graves’ disease. If these antibodies are negative it’s not Graves’ disease

TPO and TG antibodies for Hashimoto’s

Also you need vitamin D, folate, B12 and full iron panel including ferritin

[Lollipop93 in reply to SlowDragon]

Thank you I have done and doing it next week

[McPammy]

your T3 result is over range meaning you’re taking too much. I’d reduce the T3, wait a week and see if that improves your situation.

[Lollipop93 in reply to McPammy]

Thank you, I’m not taking anything I’ve just found out about hyperthyroidism yesterday when the doctors called with my blood results

[McPammy in reply to Lollipop93]

Oh my apologies I didn’t read your post close enough. I was looking at the blood results and just thought t3 was too high.