My GP referred me to an endocrinologist due to low T4 and normal TSH levels which can indicate an issue with the pituitary gland causing thyroid disorder.
I had the appointment with the endocrinologist, who said that if there was an issue with the pituitary gland then other hormones such as oestrogen would also be off so I would have issues with menstrual cycles which I don't. Is this correct?
He also said that I would be gaining weight which I'm not. Is this correct?
He also said that my T4 would continuously be decreasing, which it's not it's stayed the same for the last year.
Due to these reasons he said he doesn't think I have subclinical / central / secondary hypothyroidism. Is this correct? What do you think?
I'm thinking of seeing Georgina Conway at The Thyroid Clinic for a second opinion.
Any input, suggestions or advice would be appreciated! thank you!
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tnefeh
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Sub clinical hypothyroidism suggests the thyroid is not functioning correctly and is producing inadequate levels of hormones
Central or secondary hypothyroidism suggests a pituitary issue
With low FT4 and low FT3 your TSH should be higher and therefore signalling the thyroid gland to produce more hormone ....since TSH is a pituitary hormone it may be pituitary issue and possibly central/ secondary hypothyroidism
You need to optimise your thyroid hormone levels FT4 and FT3 - especially your FT3
Also vital to optimise ferritin, folate, B12 and Vit D levels to help other organs in your body convert T4 to T3.
Due to these reasons he said he doesn't think I have subclinical / central / secondary hypothyroidism. Is this correct? What do you think?
I don't agree with this diagnosis, based on the very low Free hormones and normal TSH it is possibly secondary hypothyroidism
I agree, you need a second opinion....I'm not a qualified medic!
If you've read other posts on the forum you'll find that it can be difficult to get a diagnosis of secondary hypothyroidism. There are some members that have managed it so hopefully they'll respond.
My FT4 was bottom and below range for many years and I was continually dismissed by my GP being told I didn't have a thyroid problem.
It took some doing but I eventually got an NHS endo referral. Still no hypothyroidism diagnosis but I was prescribed levo for tiredness after a partial thyroidectomy for a suspicious nodule.
Did the endo say anything about your above range cortisol?
I had the appointment with the endocrinologist, who said that if there was an issue with the pituitary gland then other hormones such as oestrogen would also be off so I would have issues with menstrual cycles which I don't. Is this correct?
Mmmmmmmeuhhhhhhh not necessarily.
He also said that I would be gaining weight which I'm not. Is this correct?
Strange thing to say. Did he explain why having a pituitary problem would make you gain weight?
He also said that my T4 would continuously be decreasing, which it's not it's stayed the same for the last year.
Not necessarily. If the TSH is stable at that level, so would the FT4 be, I think.
Due to these reasons he said he doesn't think I have subclinical / central / secondary hypothyroidism. Is this correct? What do you think?
Ok, so what is his explanation for your low TSH? - and it is low considering your under-range FT4. So, is he saying that you're not hypo with an under-range FT4? He doesn't know much about thyroid, does he. But, then, not many endos do. I think you do need a second opinion!
Couldn’t see any results for vitamin D, folate, B12 or ferritin
Have these been tested
What vitamin supplements are you taking
Saw you had head trauma some years ago
This can cause secondary hypothyroidism
Have you tested
Cholesterol or prolactin levels
suggest you look at seeing an endocrinologist with experience of pituitary complications
Roughly where in U.K. are you
Here’s link for how to request Thyroid U.K.list of private Doctors emailed to you, but within the email a link to download list of recommended thyroid specialist endocrinologists
Ideally choose an endocrinologist to see privately initially and who also does NHS consultations
In my opinion, your post highlights the uncertainty within the medical profession, including GPs and endos, about Secondary/Central Hypo - including diagnosis & treatment.
Partly for that reason, I decided a long time ago not to pursue with medics despite the fact my test results are broadly similar to yours. Instead Im addressing what I believe is the root cause of my thyroid test results (outlined in my profile).
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