Opinion on these TSH, T3 and T4 values

[Tomchr]

The past years, I have noticed the following symptoms: Tinnitus lasting days, headaches when stressed, hair strands have become very fine, teeth clenching, high irritability, facial redness, warm/moist cheeks and forehead, light sensitivity, frequent bowel movements, constant pain in the lower right abdomen (four inches right from the belly button)

Symptoms worsen while sleeping at night or just taking a short nap, especially tinnitus, headaches and facial oiliness.

Does these values look unusual?

TSH (range 0,4 - 4.8 IU/L)

15. dec. 2022: 1,32

23. jun. 2022: 2,9

16. dec. 2021: 6,94

26. apr. 2021: 2,83

16. nov. 2020: 1,62

4. nov. 2020: 5,09

T4 free (range 11,5 - 22,7 pmol/L)

23. jun. 2022: 15,9

16. dec. 2021: 17,0

4. nov. 2020: 18,1

T3 total (range 1 - 2,6 nmol/L)

23. jun. 2022: 2,3

16. dec. 2021: 2,6

4. nov. 2020: 3,6

Folate: 49,4 nmol/L (range: normal >8,6 nmol/L)

Vitamin D3: 174 nmol/L (range: normal >50 nmol/L)

Vitamin B12: 638 pmol/L (range: normal >200 pmol/L)

Ferritin: 142 µg/L (range: 12-300 µg/L)

TRAb <0.8 IU/L (range: normal <1,0 IU/L)

Anti-TG <12 kIU/L (range: normal < 40 kIU/L)

Anti-TPO <28,0 kIU/L (range: normal <60 kIU/L)

[pennyannie]

Hello Tomchr and welcome to the forum :

Working from these graphs is not ideal - do they also have printed the actual blood readings in number form please ?

A euthyroid ( normal functioning ) - TSH would be around 1.20-1.50 - with a T4 at around mid point in the range - say 50% with the T3 tracking just behind at around 45% through its range.

Your thyroid is struggling -

Your TSH jumped significantly in 2022 and has then tended to fall back to around 3 ??

and this is suggesting you are now likely dealing with symptoms of hypothyroidism.

In the UK we need to wait until the TSH s over 10 before getting a diagnosis and being prescribed T4 - thyroid hormone replacement -

I don't know how things are - where you are -- but years ago a TSH over 3 was all that was needed to diagnose and start treatment - with the first line option being T4 - thyroid hormone replacement.

Your T4 looks to be ' holding on at around 16 - with your T3 having now slid down and now being under the range.

The active hormone that runs the body is T3 - which is converted by the body from T4 when needed for power to function - the more you do - the more T3 you will need - like fuel in a car -

and without enough 3 - you will start dealing with hypothyroid symptoms which are multi organ and from your head to your toes - all need to beat and metabolise and repair , restore and replenish your body overnight so you have the energy and brain power to get through the next day all over again.

Please also ask your doctor to tun your ferritin ,folate, B12 and vitamin D as with a slowed metabolism which is what you are now dealing with - the body struggles to extract key nutrients from food no matter how well and clean you eat - and all thyroid hormone replacement options - work best when these core strength vitamins and minerals are up and maintained at optimal levels -

Just being in a range somewhere is not optimal and can compound your health issues further than necessary - and we can advise - as we have all been there - as this is a patient to patient forum -

supported by Thyroid UK - where you can find a comprehensive list of hypothyroid symptoms that you might like to tick box - and present to your doctor - and tick off from - once you are optimally medicated on thyroid hormone replacement,

thyroiduk.org

[SlowDragon Administrator in reply to pennyannie]

In the UK we need to wait until the TSH s over 10 before getting a diagnosis and being prescribed T4 - thyroid hormone replacement -

Actually many U.K. medics do now diagnose when TSH is over 5, especially if high thyroid antibodies

Starting levothyroxine - flow chart

gps.northcentrallondonccg.n...

Graph showing median TSH in healthy population is 1-1.5

web.archive.org/web/2004060...

[Tomchr in reply to SlowDragon]

Thanks for the flow chart. What about secondary hyperthyroidism due to pituitary adenomas causing high TSH->high T3/T4?

[Tomchr in reply to pennyannie]

Thank you for looking at my numbers. What I find strange is that the times I have had high TSH levels above range, T3 total levels have been above range as well. Metabolism does not seem to have slowed down. Quite the opposite.

[pennyannie in reply to Tomchr]

Do you have Free T3 readings there please -

so we can make a direct correlation with the Free T4 results ?

Rather than these Total T3 readings -

 Tomchr

So you are saying that your metabolism is increasing - do you mean now in 2024 - maybe it is - but unable to comment as we have no thyroid results post 2022 - so I don't understand -

Why are we only looking at historical blood test results and what is your question ?

have you any antibody readings please - probably looking like TPO - TgAB - TSI - TRab - or words - TSH Thyroid Receptor with ranges / numbers and or cut off values ?

Update - so - all the antibodies appear to be negative 2 years ago.

[pennyannie in reply to pennyannie]

Just seen your reply below - do you have any comments or the cut off / ranges there for TRab and anti TPO - and obviously the ranges for the vitamins and minerals - thank you -

If you press the More icon you can then go into Edit and amend / change that already written within that post.

[Tomchr in reply to pennyannie]

Done! Our doctors only measure TSH, Free T4 and Total T3. I find it quite disturbing.

[SlowDragon Administrator in reply to Tomchr]

Early stage Hashimoto’s (autoimmune HYPO) frequently starts with transient hyperthyroid results and symptoms…..this happens as thyroid cells breakdown releasing excess thyroid hormones

After each autoimmune attack thyroid becomes more damaged and more hypo

[SlowDragon Administrator]

Tinnitus can be low B12

Low vitamin levels common as we get older and/or if thyroid is struggling

Get vitamin D, folate, ferritin and B12 levels tested

Plus thyroid antibodies and coeliac blood test

[Tomchr in reply to SlowDragon]

I have amended the blood level tests

[SlowDragon Administrator in reply to Tomchr]

Antibodies all negative

Were you unwell in Nov 2020 or Dec 2021 …..perhaps Covid?

Vitamin levels are good

Do you supplement?

[Tomchr in reply to SlowDragon]

Symptoms have remained the same throughout the years, both before and after Covid. Maybe tenseness is somewhat reduced. I supplement with B, C, D, magnesium and zinc. Another thing, symptoms worsen while sleeping, especially tinnitus, headaches and facial oiliness.

[arTistapple]

Abdominal pain where you are saying- have you checked for appendicitis. A ‘grumbling’ appendix could account for that pain. There are other less problematic reasons for pain in that area too but it would be good to check.

[Tomchr in reply to arTistapple]

This is also something that I think it could be. However, could a problematic appendix cause headaches, tinnitus and hormonal symptoms? I mentioned it to my doctor and he said "Cronic appendicitis? Never heard of it! There is no such thing. There is only acute appendicitis."

[arTistapple in reply to Tomchr]

Your doctor sounds as if he is a prat. Did he examine you? There is a specific examination for the appendix. Basic 101 doctoring. You could have ‘apparently’ unrelated issues going on.

When you are hypothyroid ‘apparently’ unrelated are often queerly related. Inflammation is (like in so many illnesses) extremely common in hypothyroidism and it can pop up anywhere in the body. Gall Bladder. UTIs. Arthritis. Pericarditis. The list just goes on. However it is unlikely that any GP or Endo connects the dots. It could be a lesser problem where chronic constipation creates little pockets in the bowel to pop out, allowing debris to get caught and cause inflammation and pain. This is very common. Mostly it passes but it too can become chronic. Diverticulosis it’s called. When it’s active it’s called diverticulitis. You can improve that by your diet and preventing constipation (big hypothyroid issue). However it is very common even in people without thyroid issues.

Tinnitus unfortunately a hypo symptom.

Headaches same.

Hormonal symptoms? Where to start on that list?