Advice please on results

[spikeacus]

Hi all,

All new to this and I have all my blood results below and waiting to see the specialist next month and I am wondering if I am still moderate hyper or severe? On no thyroid meds yet only betas so advice appreciated

[PurpleNails Administrator]

Welcome to forum.

Your FT4 isn’t severely over range, but you may be symptomatic if your FT3 is unbalanced. It could be low or high.

Your Thyroid-Stimulating Immunoglobulin is high. This is the marker used to diagnosed Graves disease.

Graves typically causes very high FT4 & FT3 levels, but any continuous elevation requires treatment.

Why was there a 6 month gap after over range FT4 & positive TSI?

I should think doctors will suggest you start a low dose carbimazole.

Have tests been similar time of day? It’s usually recommended tests are early around 09.00 fast overnight. Stop supplements containing biotin as can interfere with test.

[spikeacus in reply to PurpleNails]

T3 never been tested.

Graves not yet been confirmed by anyone.

6 month gap cause GP is useless I had to throw a hissy fit to get this lot done 🙈 and having a telephone consultation a week today about the results which is pretty useless to be fair as seeing the specialist on the 1st Oct.

I have never been asked for fast for the tests and they have all been done around the same time of day early morning as work in a hospital so the phelbs kindly do it for me first thing.

I am only taking propanol at the moment and not taking any supplements.

[PurpleNails Administrator in reply to spikeacus]

That’s quite unusual. Drs usually freak at low TSH & introduce carbimazole at 1st sign. & even specialists will “over do” carbimazole to see the TSH rise even when FT4 & FT3 become very low.

First step you need FT3 tested. Likely to be higher or over range. Then you can start a low dose. 5mg to start with, to see what impact it has on level, or higher if FT3 disproportionately high.

There are private options if doctor / lab refuses FT3. Can be done by post & fingerprick sample. Or you may be able to sweet talk your colleague to do a venous draw.

Retest after 6 weeks when medication started / adjusted.

You’ve had consistently low TSH so that’s why I’m surprised you’ve not been monitored. I shouldn’t be, mine was missed for 4 and a half years.

Propranolol can lower FT4 : FT3 conversion, so likely helping you prior to antithyroid. Do not stop propranolol abruptly. The specialise did so with me & I became very unwell with migraines.

Drs don’t account for time or day / fasting ect. They are factors which can affect results so best to carry out test in consistent manner. Drs only look for if levels in range or not.

You might like to try over the counter supplements - selenium & l cartinine supplements which can be helpful. I take 100mcg selenium & increase to 200mcg for maximum of 6 months if eyes are causing issues. I switched between acetyl & cartinine supplements. Can help lower FT3, I felt it effect stopped working as well and it’s a pricier supplements stopped using.

Ideally test to folate, ferritin, B12 & vitamin D as may become low when thyroid abnormal. Also gluten issue common with thyroid autoimmune so ask for this to be tested too.

Do you have troublesome symptoms?

[spikeacus in reply to PurpleNails]

Thank you that’s really useful information and I will be asking for the T3 test, along with folate, ferritin, B12 & vitamin D, my GP surgery isn’t the best and literally has to lose my temper and quote the nice guidelines to get this blood test done, do not know why it’s such a problem to be monitored, but I know I am not the only one!

I have been tested for some stomach issues including a FIT test and all that has come back okay as far as I am aware.

I take it daily currently prescribed 20mg x 3 day I must admit I normally forget in the mornings 🙈 so normally twice a day.

There has been no conversation about putting me in thyroid meds from the gp at all just basically to see the specialist and they didn’t even chase up when they put me on the Propranolol. I have had to wait 10 months for the appt and my blood tests 18 months and only cause I kept going back feeling generally unwell another gp listened and put me through all the tests think they was worried to start with it may have been cancer due to very irregular and changing bowel movements and a sharp weight loss (one positive of all this) to get this far!

I am still trying to get my head around it all and believe it may have been a loss that kicked it all off, it was totally sudden and unexpected. That’s the only thing that I can think it was.

The main symptoms are irregular and changing bowel movements, tiredness big time and now aching and painful joints mainly knees (I do have osteoarthritis but this is a different pain the last few weeks), and heartbeat is irregular, palpitations and fast and anxiety that can literally floor me as it rises from my feet all the way to my head and can take away my breath at times. As for heat total intolerance to any!

[pennyannie in reply to spikeacus]

Graves is an Auto Immune disease for which there is no cure and this phase of ill health maybe just a ' blip ' and your thyroid reset itself once the immune system calms back down again.

There is likely a genetic pre-disposition with a family member maybe a generation away from you with a thyroid health issue and Graves can be triggered by a sudden shock to the system like a car accident or the unexpected death of a loved one -

though for others seems to occur ' simply out of the blue '.

No two peoples journey with Graves is the same and why it is so poorly understood though stress and anxiety are known common triggers.

[pennyannie]

Hello Spikeacus and welcome to the forum :

As you can see from the results you have posted over the past 18 months your T4 readings have been rising and to probably likely to go over the top of the range with your TSH having dropped out the bottom of its range.

I see you have been prescribed a beta blocker - is this Propranolol as this tends to slow the conversion of T4 into T3 and helps reduce the symptoms tolerated when with an overactive thyroid which looks like what you are dealing with.

The antibody reading - the over range TSI - Thyroid Stimulating Immunoglobulin is positive and over range and would suggest a diagnosis of Graves Disease - is this what you have been told and what symptoms are you dealing with ?

It's difficult to answer your question as to if you are moderate or mild hyper - everyone is different but I would think the next step is to have an Anti Thyroid drug - such as Carbimazole or Propylthiouracil ( PTU ) prescribed as this will semi block any new daily thyroid production and slowly your thyroid hormone production will reduce back down into range with hopefully any symptoms relieved.

Is this consultant you are seeing in October an endocrinologist ?

The NHS generally allocate a treatment window with an AT drug of around 15-18 months -

basically all this does is ' buy you time ' while we wait for your immune system response to calm back down again - with the hope being your thyroid reverts to normal function without the need for any drugs.

Something has triggered your immune system to go on the attack and currently antibodies are attacking your thyroid causing an increase in your thyroid hormone production which in turn can cause symptoms of hyperthyroidism and over stimulation throughout your whole body with your metabolism running faster than normal.

We do now have some research that you may like to keep :-

pubmed.ncbi.nlm.nih.gov/338...

ncbi.nlm.nih.gov/pubmed/306...

I found the most well researched of all I researched when diagnosed Graves that of Elaine Moore- books and website - elaine-moore.com

[SlowDragon Administrator]

Ideally test to folate, ferritin, B12 & vitamin D as may become low when thyroid abnormal.

Also gluten issue common with thyroid autoimmune so ask for this to be tested too.

Definitely get these tested