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Hyperthyroid symptoms but normal results?

Hi,
I've been rapidly decling for several months. When I first got sick it felt like hormone / thyroid related but after bring told my thyroid was normal I let it go.

However many people keep telling me you can still have thyroid issues with normal results? Is this true?

I paid for a comprehensive blood screen in March which included thyroid. My results then were:

Free T4: 16.1
TSH: 2.29

People keep saying my symptoms are classic hyperthyroidism or maybe something wrong with my adrenals. Also that I should get T3 tested as hasn't been done?

It bagan last summer with odd hip and foot pains, then really kicked of in Sept. I sudfenly became easily startled, hot flushes, dizzy / fainting spells, periods weird & all over tge place, slurred speech, neck and head pain,itching over my thyroid and pressure sometimes pain, hoarse voice, rapit weight loss, extreme thirst, hearing loss, facial & eye pain, extreme muscle weakness, increasing numbness in throat, arms, feet, tons of new moles & freckles & spots, itching burning type pains, severely impaired mental function, low mood. Its got so bad I've ended up being rushed to hospital by ambulance recentlty. They just ran basic bloods & found nothing. I keep being handed to neurology who have been useless in taking it seriously. I've had brain and spine MRI and lumbar puncture (but even had to fight to get those tests done) which were normal.

People tell me untreated hyper thyroid can lead to neurological symptoms so I'm wondering if I should follow that path. It sounds silly but no Dr has followed my decline and taken control to do a diagnostic work up. So I'm having to try and help myself. The sicker I get the harder it is tho. Its destroyed my life ad I'm hardly able to do anything.

I'm 37 and don't think it's menopause.

If anyone has any suggestions please help. It seems you just can t rely on doctors anymore which is scary.

Best wishes,


Mandy

12 Responses
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649848 tn?1534633700
COMMUNITY LEADER
No I would not avoid Synthroid until vitamin/mineral deficiencies are brought back to normal.  While vitamin D and iron help with metabolism of thyroid hormones, they are not going to be all that instrumental in decreasing hormone levels that much.  It should be noted that deficiency in any of these vitamins/minerals can/will cause hypo-like symptoms, so it's likely the symptoms won't all go away with Synthroid, and the deficiencies will have to be dealt with anyway.  They should all be dealt with simultaneously...
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Avatar universal
if someone has deficient iron, or b12 or d3....and a tsh of 6, would you avoid synthroid until deficiency is back to normal and retest?
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1756321 tn?1547095325
My fasting glucose was normal when I had impaired glucose tolerance (showed up on a 2 hour oral glucose test at 10.7 mmol/L).  I felt so bad with extreme thirst, severe sudden fatigue after meals, numbness/tingling, burning tongue. In my case hyperthyroidism caused my impaired glucose intolerance and worsened my existing insulin resistance.

Excerpt from Patient UK - Impaired Glucose Tolerance...

"The World Health Organization (WHO) has said that someone may have diabetes if they have:

a fasting blood glucose of 7 mmol/L or more, OR
a blood glucose 11.1 mmol/L or more after a two-hour oral glucose tolerance test (GTT)

The World Health Organization (WHO) has said that someone has impaired glucose tolerance if they have:

a fasting blood glucose of less than 7 mmol/L, AND
a blood glucose of 7.8 mmol/L or more but less than 11.1mmol/L after a two-hour oral GTT"

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649848 tn?1534633700
COMMUNITY LEADER
The T3 needs to be FREE T3 (should always be specified "Free" or "FT3, since T3 is, typically considered to be Total T3) and the Free T3 and Free T4 should be done at the same time in order to make sure you have a proper ratio.  I'm not even sure you can get Free T3 done by itself... doing a Total T3 and/or Total T4 is a complete waste of money and I don't think you can get Total T3 done by itself either.

No - urine samples aren't more accurate for checking thyroid than blood tests; if they were, those would be preferred method and I've only heard of them being done when someone could not get their doctor to do blood work and they needed an alternative method of testing.

Don't worry about picking my brain... that's what we're here for...
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Avatar universal
Thanks for your help!

I'm going to get the t3 and antibodies done at least. I read somewhere that urine samples can be more accurate for checking thyroid, do you know much about that?
Sorry to keep picking your brain!
Helpful - 0
649848 tn?1534633700
COMMUNITY LEADER
Ah - you just shed some light on the issue... if you were gaining weight, then started losing weight rapidly, but now you've stopped, you could very well have Hashimoto's and you started out hypo, with the weight gain, then you "could" have been hyper at the time you were losing... While Hashimoto's ultimately ends up with the patient hypo, it's quite common to have periods of hyper in the beginning stages.  Those periods can last for a few weeks or a few months.  They can alternate with periods of hypo or normal...

You should also be aware that quite a few symptoms that many people think are exclusive to hyper can also apply to hypo, so we have to be careful when going by symptoms, alone.  That's why we rely quite heavily on blood work, when certain symptoms are present.

Be sure to get the 2 antibody tests I mentioned above... those will be the most telling as far as thyroid tests, but you also need the Free T3 and Free T4.  

It's good that you're supplementing with iron; that will help with, both, the energy issue, as well as the thyroid issue.

I'm sorry, I don't trust any lab report for a B-12 that simply says "no action required"... it's not up to the lab to decide that.  The range for B-12 is quite wide - usually from about 200-1100 and anything less than 500 is suspect, even though it's within the range.  My lab even puts a note on the report saying that anything under 500 may present symptoms of deficiency.  Some countries have 500 as the bottom of their range... I'd insist on a number result, if I were you.

As far as home tests - I don't have much confidence in the finger prick tests you're referring to, but there are online sites from which you can purchase your own tests, without a doctor's order, depending on where you live.  You order the tests from the online site, pay for them with a credit card, the online site e-mails you a lab order and tells you what lab to go to in your area for the blood draw (from what I've seen, it's almost always LabCorp).  You go get the blood draw, then in a couple of days, the online site e-mails you the results, which you can then take to your doctor for action - be sure to take only a copy and retain the original for your files in case you have to find a different doctor...

There are several sites from which you can order labs on this basis... one I've used, myself is healthcheckusa and I've had real good luck with it.  I think there may some less expensive ones, but I can't vouch for those as far as quality and service.

I just took a look at healthcheckusa and for $80 you can get TSH, Free T3 and Free T4 and for another $90 you can get TgAb and TPOab.  These are very reasonable and easy to get, if you have a LabCorp within easy driving distance.

A Vitamin Panel that includes Vitamin D, B-12 with folate and magnesium is $150, which I think is a bit much - vitamin B-12 and D might be better gotten from your doctor.
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Avatar universal
PS: I was looking at private home tests for checking some of the things you mentioned. One lab uses finger prick instead of a needle in arm blood sample. Does anyone have experience of these finger prick tests accurate? It was on medicheck.

Cheers,
Helpful - 0
Avatar universal
Hi there, thanks so much for your time ☺

I had a fasting diabetes blood test - normal. Dont think ive had any other diabetes blood tests though. They checked sugar in my urine and have had lots of the finger prick tests. Normal, although With the latter my sugar myhas been low a few times.On one occasion when I collapsed the ambulance guy said if my glucose had been just one digit lower, he would be giving me glucose. And I had just had a meal. Its usually between 5 and 7 though. On my fasting blood test it was around 5.1. My mum is diabetic so we keep checking mine using her machine and its normally OK. I'm surprused its normal with the symptoms I have and the strong family history of diabetes.

I think people assumed I would be hyperthyroid due to the weight loss, altho prior to becoming unwell I had been gaining weight & struggling to lose it even if I didn't eat. So to suddenly drop two clothes sizes was a shock especially as this was over Christmas when I was stuffing my face! I crave sugar a lot. My weight seems to have stopped declining now though but I should be the size of a house with what I eat.

I am taking iron supplements for the ferritin. Maybe thats why my weight has now stopped declining.

I'm gonna try & get those tests you suggest. I'm sure my Drs are tired of seeing me but I have no choice but to keep returning until they sort me out. When you have such widespread symptoms its tricky as my docs only seem to want to focus on one area at once.

I have a copy of some blood tests my Dr did and B12 just says 'no action required' no value.

Thanks again hope you are well,

Mandy
Helpful - 0
649848 tn?1534633700
COMMUNITY LEADER
You can't delete the other thread... I posted a comment with a link to this thread, so everyone wants to comment can follow the link and come to this thread, then we just stop posting on the other one, so it will move on down the page...

Your TSH is actually toward the upper end of its range and your Free T4 is only at 34% of its range - both leaning toward hypothyroidism, not hyper.  Rule of thumb (where most of us feel best) for FT4 is 50% of range, so you fall somewhat short.  Many of your symptoms are also hypo, including the problems with your periods, dry, itching skin, neck and head pain, hoarse voice, impaired mental function, etc.  

What bothers me as much as those are the other symptoms that are very much like Type I diabetes - those include the weight loss, dizzy faint spells, becoming easily startled, slurred speech, muscle weakening, extreme thirst.  Most important are the weight loss and extreme thirst...

You need to get checked for diabetes.  If you've had a Metabolic Panel recently, it should have a fasting glucose on it... that should be < 100.  You should also request a hemoglobin A1c test, which tells what your blood sugar levels have averaged over the past 3 months.

For thyroid related tests, you need to insist on Free T4 and Free T3, along with the TSH.  Free T3 is the hormone that's actually used by individual cells, so it's the most important of all.  You should also have thyroid antibody tests to determine if you have Hashimoto's.  The tests you need are Thyroid Peroxidase Antibodies (TPOab) and Thyroglobulin Antibodies (TgAb).  

You said you're low in Ferritin... are you supplementing iron to bring that back up?  Iron is necessary for the metabolism of thyroid hormones, so even if you're producing enough hormones, without adequate iron, your body won't use them correctly.  

You said in the other thread that your B-12 is "normal"... often B-12 is in the normal range, but not high enough to alleviate symptoms... if you have the actual level, please post it.

Have you had vitamin D tested?  Like iron, Vitamin D is necessary for the metabolism of thyroid hormones, so even if you produce adequate amounts, your body won't use them correctly.   If you had vitamin D tested, I'd recommend you do so.

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Avatar universal
God  my brain I've just seen now I'm supposed to keep to this thread. So sorry. This is how bad my head has become lol I will try and delete the other thread.

Thanks for your input.

I am low in ferritin.

The reference ranges were:

Free T4: 11 - 26
TSH: 0.35 - 3.50
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649848 tn?1534633700
COMMUNITY LEADER
I forgot to mention that whenever you have thyroid blood tests, you should always make sure the panel includes Free T3, which is the active thyroid hormone, that's used by every cell in your body, while Free T4 is the storage hormone and must be converted to Free T3, prior to use.
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649848 tn?1534633700
COMMUNITY LEADER
You posted a similar thread yesterday, to which I responded... it's easier for us if you keep all your questions in the same thread, so we don't have to keep asking for the same information...

I did ask for current labs, which you've posted here... now we'll need to have the reference ranges for the Free T4... Your TSH does not indicate that you are hyper; however, your FT4 and many of your symptoms may indicate hypothyroidism.  You also have some symptoms that indicate type I diabetes.  Please post the reference range for the Free T4.  

The other thread from yesterday can be accessed via the following link:
http://www.medhelp.org/posts/Thyroid-Disorders/Thyroid-tests/show/2616995

When you respond, it would be best to come back and respond on this thread vs starting a new thread each time you have a comment or question.  
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