Hi, is anyone able to take a look at my daughter's blood test results as we're wondering whether she has hypothyroidism. She has a number of different symptoms and we've seen several different doctors but no one is prepared to prepared to look at the whole picture and join all the dots together. Her symptoms currently include low energy, frequent debilitating fatigue, chronic (slow transit?) constipation and other IBS type issues, hormonal issues (very irregular periods and acne, possible PCOs?) and a very low immune system. She never gets severely ill but whenever she feels exhausted which is pretty often at the moment, her fatigue is usually accompanied by sore throats, colds and headaches. We saw a functional doctor this time last year who commented that her thyroid looked a bit sluggish and she gave us some natural supplements to boost her thyroid, however I was a bit dubious about these supplements, and in fact all the advise she gave us, so my daughter never took them. These are her blood results from the functional doctor:
Total Thyroxine - 78 (59-154)
TSH - 2.17 (0.27-4.2)
Free Thyroxine - 13.7 (12-22)
FT3 - 3.4 (3.5 - 7.7)
Thyroidglobulin Antibodies - <10 (0-115)
Thyroid Peroxidase Antibodies <9 (0-34)
Vitamin D - 37 (30-100)
Vitamin B12 - 640 (211-911)
Ferritin - 20 (10-291)
Folate - 17.6 >5.38
She also had raised fasting cholesterol of 5.3 (should have been<5.0), raised HDL Cholesterol of 2.1 (1.2-1.7), and top of the range LDL cholesterol of 2.9 (<3). We were really surprised about this as she eats a very healthy pescatarian diet low in saturated fats, however I understand that this might be indicative of issues with her thyroid.
We're aware that her Vitamin D levels were pretty low, so she's been taking 2000iu of Vitamin D throughout this winter, however it doesn't seem to have made any difference and she's actually been more ill this winter than last winter.
I've arranged to have all her bloods redone next week via Medichecks and we also have an appointment with a private endocrinologist in four weeks' time, however, if anyone has any comments/ideas on her results from last year, I would love to know - there seems to be a huge amount of knowledge and expertise on this board, and I'm currently feeling very lost with what I can do to help her.
Many thanks for your help!
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Cookerybookaddict86
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Yes she is most likely hypothyroid. Her TSH is too low given she has low / low normal fT3 AND fT4 (both). It's difficult to get a diagnosis in these cases but I'd push hard for hormone therapy. She is likely to need some liothyronine as well as levothyroxine since TSH also stimulates T4 to T3 conversion and an abnormally low TSH (for her fT3, fT4 levels) will lead to impaired conversion.
Supplements 'to boost a thyroid' are in my view a load of tosh. In any event her problem is primarily too little stimulation from TSH although there may be some failure of the thyroid also. Abnormal TSH response could be due to pituitary damage or perhaps more likely concurrent illness, strict dieting or depression.
Central Hypo is when the problem lies with the pituitary (Secondary Hypo) or the hypothalamus (Tertiary Hypo), rather than the thyroid itself (Primary Hypo). So, I would suggest you do some research into that before talking to an endo. Most doctors only look at the TSH, and they would say your daughter's is 'normal' because it's in-range. But there's absolutely nothing 'normal' about a below range FT3. And it's low T3 that makes you hypo, not high TSH, that is just an indicator. It's low T3 that causes symptoms such as your daughter is suffering - in fact, I cannot imagine how she manages to get out of bed every morning!
The treatment for Central Hypo is exactly the same as for any other form of hypothyroidism: thyroid hormone replacement. But, if the pituitary is at fault causing low TSH, other pituitary hormones could also be low, causing all sorts of other problems. So, they need tesing, too, such as ATCH, which stimulates the adrenals to make cortisol.
High cholesterol has nothing to do with diet. Cholesterol is made in the liver, and the liver does its best to keep levels steady. So, the more you ingest with food, the less it makes. The less you ingest, the more it makes. But, when T3 is low, the body cannot process and excrete cholesterol correctly, and it tends to mount up in the blood. This is nothing to worry about, it's a symptom, not a disease.
This is such useful information, thank you so much for taking the time to reply! We're now wondering whether an issue with her adrenals might be why she feels exhausted and permanently under the weather - she's had a cold which she can't shake off for the last 4 weeks. We will definitely ask the endo we're seeing in April about possible problems with her adrenals/cortisol as she certainly seems to tick a number of boxes for potential issues.
Yes, but just the low T3 alone would cause all those issues. She might have low cortisol on top, but she definitely needs a higher FT3. I would concentrate on that, for starters.
As well as the above, something too low Is her ferritin. Has gp done iron studies for anaemia. Others will pick up on it and have info to hand to link for you. Xx
Her symptoms currently include low energy, frequent debilitating fatigue, chronic (slow transit?) constipation and other IBS type issues, hormonal issues (very irregular periods and acne, possible PCOs?)
In all people, a serum ferritin level of less than 30 micrograms/L confirms the diagnosis of iron deficiency
Low ferritin likely causing fatigue
Look at increasing iron rich foods in diet
Eating iron rich foods like liver or liver pate once a week plus other red meat, pumpkin seeds and dark chocolate, plus daily orange juice or other vitamin C rich drink can help improve iron absorption
This is interesting because I have noticed that many patients with Hashimoto’s disease and hypothyroidism, start to feel worse when their ferritin drops below 80 and usually there is hair loss when it drops below 50.
Thyroid disease is as much about optimising vitamins as thyroid hormones
Many thanks for the reply and all the useful info, its very much appreciated.
I didn't flag this up with our GP as we assumed it was normal - it was within range and didn't show up as red on the results form. I'm really kicking myself now that I didn't pick up on the fact that it was right at the bottom of the range! My daughter is having her ferritin redone next week as part of her Medicheck blood tests, so we will certainly look into how we can raise her levels once these tests have been done.
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