T3 looks low to me! I have a goitre....help ple... - Thyroid UK

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T3 looks low to me! I have a goitre....help please.

Applebud profile image
21 Replies

I'm waiting for and Ultrasound scan for goitre.

I had to push for T3/T4 blood test after gp took TSH and was then fixated on high cholesterol levels.

I did some research and found that cholesterol levels were raised with thyroid problems and said I would not take Statins until thyroid sorted out.

GP says all levels' normal' - I question T3 but don't know what to do next. I'm having to wait until 18th April for scan.

Other symptoms too. Been having gastro issues; calmed down a bit now.

I'm 59, female.

Any thoughts/support etc welcome.

Serum TSH level - 2.18 mu/L RANGE 0.27 - 4.20

Serum free T4 level -13.1 pmol/L RANGE 12.0 - 22.0

Serum free T3 level -4.0 pmol/L RANGE 3.9 - 6.7

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Applebud
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21 Replies
greygoose profile image
greygoose

Well, they're all in-range, for what it's worth. And, frankly, it isn't worth very much! Your TSH is too high and your Frees are too low. But because they are in-range, your GP considers them all to be 'normal'. He doesn't know any better.

But, he should wise up to the fact that your cholesterol is high because your T3 is low, not because you have statin-deficiency! But that's all they want to do, these days: prescribe statins and to hell with people's actual health. High cholesterol is a symptom, not a disease.

Applebud profile image
Applebud in reply togreygoose

Thank you for this and taking the time to reply, it's what I thought. It's now how I progress, I guess I have to wait for Ultrasound results first, which apparently go back to GP; I don't see anyone at the time of the appointment. It's been a bit of battle thus far just to get them to do T3 &T4 and to keep telling them that until the cause of my high cholesterol is discovered I won't consider masking it with any statins. I do feel bullied every time I have an NHS encounter and that takes a lot of energy and effort in an already stressful life. Any tips on how I get GP (female) to 'wise up'?!

greygoose profile image
greygoose in reply toApplebud

Not an easy task. Doctors really aren't interested in what you think because they think they know it all. But one thing they know nothing about is nutrition, and cholesterol is a nutrient. For that, they get their information from Big Pharma sales reps, who just want to sell statins at any cost. And I believe there are incentives for doctors to prescribe them. Not many doctors seem to have scruples. So all you can do is keep saying no.

I did that with a doctor who wanted to reduce my dose of T3 due to a TSH of 0.40! Not even out of range. Oh dear, he said, we've gone to far with the dose. No we haven't, I said. So, he gave me a long lecture about TSH, which was all wrong. And after that, every time he opened his mouth I just said 'no'. He lost his temper and shouted at me. I just looked him in the eyes. Alright, then, he said, have it your way. And gave me an increase in dose! 🤣🤣🤣 You just have to brazen it out and wear them down, I'm afraid. They are not open to reason. Just stay calm and determined. They know they cannot physically force you to take statins, so they try to scare you, gaslight you, and finally bully you. I really don't think doctors are very nice people. :(

Applebud profile image
Applebud in reply togreygoose

Thank you again. I'm gathering all the information/evidence that I can to prepare me for the next encounter which will possibly be another battle!

greygoose profile image
greygoose in reply toApplebud

Probably. But, just stay calm. And above all, don't cry! Although I know how hard that can be. Or you'll find your doctor trying to force antidepressants on you, too! The just have no idea how normal people function, and that crying can be due to anger and frustration and not just depression. :)

And, most important, remember that you are right and she is wrong!

Applebud profile image
Applebud in reply togreygoose

I won't cry! I'm working on my 'script', it's so sad so many people have to battle to be heard and treated.

greygoose profile image
greygoose in reply toApplebud

It is indeed. And it seems to be getting worse rather than better.

Good luck with your 'script'! Let us know how you get on. :)

Applebud profile image
Applebud in reply togreygoose

I will and thank you.

greygoose profile image
greygoose in reply toApplebud

You're welcome. :)

Applebud profile image
Applebud in reply togreygoose

Hello again , I had the ultrasound scan today - no thyroid nodules found or anything untoward. Not sure what's next - no doubt the GP trying to get me on satins. Rather than investigation thyroid any further as all NHS blood test say normal. Does anyone know anything about Polygenic Hypercholesterolaemia?

greygoose profile image
greygoose in reply toApplebud

Well, I don't, for sure! But, you don't need further investigation, and your blood tests are not saying normal at all. There's nothing normal about an FT3 only 3.6% through the range. Normal (euthyroid) would be 50%. And that is why your cholesterol is high.

Keep refusing the statins because reducing your cholesterol artificially would not solve the root problem, and would put you at greater risk of a heart attack. The body needs cholesterol, it's not in any way a problems when it's high. But when it's low your body has no way of reparing and regenerating itself. It will also lower your sex hormones and, as you are already hormonally challanged, that would not be a good thing to do. Doctors have no idea what cholesterol is or what it does, their only concern is prescribing statins because it's lucrative, and to hell with the patient's health!

Applebud profile image
Applebud in reply togreygoose

Thanks. I'll keep chipping away as I also believe that thyroid is the thing to focus on - not 'high' cholesterol per se. And that thyroid issues are at the root of the raised cholesterol. It is quite hard to keep your resolve at times as 'they' can induce fear which is so counter ptoductive; instead of anticipating an appointment where you might go in and chat/discuss, you go in preparing for battle!

greygoose profile image
greygoose in reply toApplebud

Cholesterol is certainly not the thing to focus on. It doesn't cause any symptoms whether high, low or in between. T3 does.

SlowDragon profile image
SlowDragonAdministrator

Free T4 (fT4) 13.1 pmol/L (12 - 22) 

Ft4 only 11.0% through range

Free T3 (fT3) 4 pmol/L (3.9 - 6.7) 

Ft3 only 3.6% through range

So both Ft4 and Ft3 are far far too low

Was test done early morning for highest TSH?

You need thyroid antibodies and vitamins tested as next step

For full Thyroid evaluation you need TSH, FT4 and FT3 tested

Also both TPO and TG thyroid antibodies tested at least once to see if your hypothyroidism is autoimmune

Very important to test vitamin D, folate, ferritin and B12 at least once year minimum

Low vitamin levels are extremely common when hypothyroid, especially with autoimmune thyroid disease

Highly likely vitamin levels are low with such low Ft3

About 90% of primary hypothyroidism is autoimmune thyroid disease, usually diagnosed by high TPO and/or high TG thyroid antibodies

Autoimmune thyroid disease with goitre is Hashimoto’s

Autoimmune thyroid disease without goitre is Ord’s thyroiditis.

Both are autoimmune and generally called Hashimoto’s.

Significant minority of Hashimoto’s patients only have high TG antibodies (thyroglobulin)

20% of autoimmune thyroid patients never have high thyroid antibodies and ultrasound scan of thyroid can get diagnosis

In U.K. medics hardly ever refer to autoimmune thyroid disease as Hashimoto’s (or Ord’s thyroiditis)

Recommended that all thyroid blood tests early morning, ideally just before 9am, only drink water between waking and test

This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip)

Private tests are available as NHS currently rarely tests Ft3 or all relevant vitamins

Testing options and includes money off codes for private testing

thyroiduk.org/testing/

Medichecks Thyroid plus BOTH TPO and TG antibodies and vitamins

medichecks.com/products/adv...

Blue Horizon Thyroid Premium Gold includes BOTH TPO and TG antibodies, cortisol and vitamins

bluehorizonbloodtests.co.uk...

Only do private testing early Monday or Tuesday morning.

Link about thyroid blood tests

thyroiduk.org/testing/thyro...

Link about Hashimoto’s

thyroiduk.org/hypothyroid-b...

Symptoms of hypothyroidism

thyroiduk.org/signs-and-sym...

Tips on how to do DIY finger prick test

support.medichecks.com/hc/e...

Medichecks and BH also offer private blood draw at clinic near you, or private nurse to your own home…..for an extra fee

Applebud profile image
Applebud in reply toSlowDragon

Thanks for so much all this information. I've only just had chance to log on again. I've tried to contact GP with an email, as suggested by receptionist, but now told i need to make appointment. So that'll take a while...give me chance to look at all those links and prepare even more.

Applebud profile image
Applebud in reply toSlowDragon

Hello again, Would you mind explaining : 'only 11.0% through range' & 'only 3.6% through range' - I don't quite understand.

And also, when you say '20% of autoimmune thyroid patients never have high thyroid antibodies and ultrasound scan of thyroid can get diagnosis' - does that mean the ultrasound scan will clearly diagnose autoimmune thyroid?

Yes, the test was done early morning and it was a fast blood test.

Would you know if an early/fasting blood test is best for antibodies/vitamins and I'm also going to ask for coeliac? GP may refuse but I'm going to try!

Thanks again.

SlowDragon profile image
SlowDragonAdministrator in reply toApplebud

Ft4 only 11.0% through range' & 'Ft3 only 3.6% through range'

in a person who has a normal working thyroid Ft4 and Ft3 would be around 50% through range

Your results show you have very low Ft4 and extremely low Ft3

With such low thyroid hormone levels your TSH should be high asking thyroid to work harder

TSH is message from pituitary to tell thyroid to work

GP probably only looking at TSH

So your thyroid is struggling

Hence goitre and hypo symptoms

Would you know if an early/fasting blood test is best for antibodies/vitamins and I'm also going to ask for coeliac? GP may refuse but I'm going to try!

these can be done any time

You need to be eating gluten every day for 6 weeks minimum before test for coeliac

does that mean the ultrasound scan will clearly diagnose autoimmune thyroid?

Not always ……..but yes can do

serenfach profile image
serenfach

When faced with this situation with a GP who does not know enough, I do one of two things:-

Channel Mrs Thatcher - speak slowly and calmly as it to a three year old, stand my ground and repeatedly say I am clearly underdosed, feel ill, so am requesting a higher dose.

or

Say "oh, so you have not read the paper by (make up two names before hand) about low TSH? You should read it - very clear!"

Or print this out and give it to her-

thyroidpatients.ca/2019/03/...

Good luck!

Applebud profile image
Applebud in reply toserenfach

Thank you for your reply. Even the name of Mrs T gives me unpleasant flashbacks to the 1980!!! Joking apart, I understand what you're saying about keeping calm and keeping it simple. It takes a lot of energy to gather yourself and stand your ground.

serenfach profile image
serenfach

I agree, and we should not have to! Remember the Spitting Image sketch about the MPs out for lunch with Mrs T - the vegetables will have the same? I keep that in mind when dealing with my GP. We should not have to be sitting in the waiting room trying to gather our strength to argue about what they should know!

The other thing I use is to tell myself "big girls pants on!" - dont know whether that may help you? Sending a hug.

Applebud profile image
Applebud in reply toserenfach

that's uncanny, a conversation about that spitting image sketch came up only yesterday with a friend - I shall keep it in mind. Thank you

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