I am trying to support a friend who has recently been told that the following test results are normal. She is struggling with excessive tiredness, weight gain, hair loss, low mood, dry skin & brittle nails and asked to be tested for hypothyroidism. Although I have Hashis I can't seem to retain what is normal and what is not to be able to help her, so any advice appreciated. I am really worried about her she is just not herself.
TSH 1.80 mU/L. (0.35 - 3.30)
Serum free T4 level 13 pmol/L (10 - 25)
Plasma glucose level 6.2 mmol/L (3.7 - 5.6)
Thanks in advance.
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t3rcam
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Hi, The T4 is low, so she needs a higher dose of treatment. What is she taking? If not, she would benefit from thyroxine but as TSH Ok , modern rulings , she may need to go to an endo for treatment.She may feel worse before improving. Also what is the Free T3? Normally, as a general rule,on treatment T4 should be in top third of range and Free T3 near the top,. However, it also depends a lot how one feels, normal for one may be quite different to another. Normally if Free T3 low ,after some months of treatment ,we need T3 on a script for Hypo ( low thyroid)It takes about a year to get the treatment right, normally. With frequent blood tests and drug rises as needed. When I was first treated, many years ago, only my Free T3 was low and it was below range.
The Glucose is high so she needs another diabetic test, called a Hb1Ac blood test, then she should have treatment with drugs and only have the diabetic diet.Ideally she should also have Ferritin, B12 and Folic acid, and Vit D tested. if D low , then calcium test, if the corrected calcium below range then treatment with vit D ( a hormone ) ,ideally from an endo or GP. Repeat tests for D and calcium and rises in amount of D if OK as needed. It takes 3 months for D to be fully in the blood.Diabetes is autoimmune and hormonal so often goes with thyroid disease.
Hi Jackie, thanks for getting back to me. She hasn't been diagnosed with hypothyroidism yet. Her symptoms rang bells for me and she asked my advice. Her doctor doesn't seem concerned about her test results. I wondered if she should also get an antibody test in addition to the tests you mention. She is the third friend of mine to be struggling and getting nowhere with the NHS this illness is so widespread it is scary! I look forward to hearing from you.
HI Well at this stage I would concentrate on TSH, T4 and Free T3. There are lots of other useful tests . I use Blue Horizon through TUK, quote TUK 10. for a discount The intermediate test for those costs me £61. They are really a well known Lab called TDL, all the private hospitals use them,a great deal more cost, so most doctors know them for , if you show them it should help treatment.All very easy, on line and post.She could just ask for a trial of thyroxine, a lot of docs will do this and it is better than nothing.
I am sure the FT3 will be low and hopefully she will get treatment but it may need to be by a good endo , who is not so wrapped up in numbers. Most good consultants are not afraid to treat the patient with just a consideration to blood results.It would be a good idea, apart from the other useful tests to have a vit D ( hormonal) and often this needs treating in thyroid disease but if low you need a calcium ( corrected) test first as, D effects Ca and Ca must always be in range.I was originally treated on just low FT3. The diabetes is so important as hormonal and autoimmune and can cause serious medical problems without treatment.( Endo!)A good endo will do all the tests she needs. It still takes a long time to be stable, hopefully a year. I hope all your friends get the treatment they need. I am afraid it is a question of fighting for it. I hate doing that but found it was the only way. There is enough sickess that cannot be treated, thyroid can.
I think an antibodies test would be a good idea. Dr Toft has said in his little book "understanding thyroid disorders", that if antibodies are raised then it can be a good idea to "nip things in the bud" with a low dose of thyroxine. xx
Thanks Shaws I will pass on the info to her. Is it 'unwittingly' or is it too much effort & money to change things, sorry to be cynical but battling with Hashimoto's and the NHS for 12 years now brings out the cynic in me!
I like the way this doctor puts it. The difference between normal and optimal:
When’s the last time you went to the doctor and gave a blood sample – that was then sent to a lab? Chances are that lab result came back ‘normal’. Too often, when interpreting lab values, the doctor looks for normal rather than optimal.
A comparison of values relative to each other yields a great deal of information that would be lost if the values were viewed independently of each other. For example, if the normal height for a man is between 5’3” and 6’ and normal weight is between 130 lbs and 200 lbs., scanning the results column of a lab or other report (for flagged abnormal values) would declare a man who is 5’3” tall weighing 200 lbs to be just as normal as a man 6’ tall weighing 135 lbs. Both are in the ‘normal’ range and therefore would be considered normal. In reality, however, simply looking at a short/obese man next to a tall/thin and a possibly undernourished man would suggest that the two are more than likely not in the same state of health.
More tests as Jackie recommended would tell a more complete story as to what is "normal" for your friend.
Thank you. I have just discovered that her 75 year old mun has been hypo for 9 years and feels fobbed off by the docs because she still has many symptoms. It is soooooo frustrating. Thank you all again.
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