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Thyriod results query
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Thyriod results query

Hi,

i have recently been feeling a lot of symptoms of lethergy and hypothyroidism. As i have strong family history of thyriod problems i went to see my doctor. The results of my first test showed elevated both free T4 and TSH so my doctor called for a retest. I got my results again back today which again showed simialr results. Though doing my own research i have seen that results like these are abnormal but my doctor says everything is fine and i should get retested again in 6 months. So now i am kind of confused on what to do because of what information i have found myself. Is their any recommendations?
6 Comments Post a Comment
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Avatar_f_tn
You're right; elevated FT4 should be accompanied by a low TSH and low FT4 by a high TSH.  So, something is obviously amiss.  Sometimes, this can be caused by a pituitary issue.

Please post your actual FT4 result and its range (ranges vary lab to lab so have to come from your own lab report).  Did your doctor also test FT3?  It's also unusual to have hypO symptoms with elevated FT4.  The answer to this contradiction could be in your FT3 level.

Please list your symptoms.

You're not on thyroid meds, correct?
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Avatar_m_tn
On my initial test  FT 4 came back 22.4 pmol/L (range 9.0-21.0) and TSH 6.04 mU/L (range 0.20-5.00). Also the original test should no deficiencies in anything like vitamins, iron, etc.

I do not have the retest results to hand as i only spoke with the doctor on the phone and he never gave the information. I will get a copy of them when i go to my next appointment during the week. He said the retest was a more thorough examination of thyroid function said that my FT4 and TSH levels were slightly higher than original test. Other than that he said everything else was fines, never said anything about T3 levels but said thyroid antibodies were fine. The doctor just wanted me to get a retest dome again in 6 months.

Like i said i have a strong family history of hypothyroidism with my mum, dad, 2 brothers and my grandparents all suffering hypothyroidism. I also have several people in my family with type 1 diabetes so i am quite weary of just having to wait another 6 months, especially when i feel like crap.

Other than feeling fatigued and lathergic most of the time my apetite seems through the roof, and i do feel pretty intollerent to heat- i was on holiday a few months back and felt extremely tired during the whole time i was abroad. I am pretty active, i work out about 5 times a week but sometimes i do feel heart palpitations mildly i think when working out but not a lot. I am on top of my diet, tracking my calories making sure i am getting the right marcos in but i feel as if i haved gained some fat too easy.

Hopefully i havent ranted on about unnecesary information lol, but thanks for helping!

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Avatar_m_tn
^^^
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Avatar_f_tn
With an FT4 of 22.4 (9.0-21.0), you should not be feeling hypo.  Are you fatigued and lethargic despite a lot of sleeping, or is it due to insomnia or poor quality sleep?  Your other symptoms...increased appetite, heat intolerance...are usually hypER symptoms.  Weight gain is more often associated with hypo, but some peole gain weight whenever thyroid hormones are too high or too low and some lose regardless.  Is your HR or BP higher or lower than usual?  Constipation or diarrhea?  

Were B-12 and D among your vitamin tests?  Please post those with reference ranges as well as iron and ferritin, if you had a full iron panel.  Selenium?

Also, which antiboies did your doctor test?  Please post those results and ranges as well.  Do you know if your hypo relatives have Hashi's (Hashimoto's thyroiditis)?

Many doctors don't think FT3 is important.  NHS treats FT3 like it's witchcraft.  However, T3 is the only form of the thyroid hormones your body can use.  T4 is a "storage" hormone that basically floats around in your bloodstream until your cells need thyroid hormone.  At that point, it has to be converted to T3 before it can be used.  Theoretically, and in a perfect world, FT3 would track FT4, i.e. as FT4 rises, so does FT3.  For any number of reasons, that is not always the case.  Monitoring FT3 is the only way to evaluate how well your body is converting T4 to T3.  I think it's especially important for you to know because a low FT3 could explain the inconsistency between your high FT4 and your TSH.  Most of our UK members have to go private to get FT3 tested.

I'm with you.  I wouldn't want to put up with your symptoms for another six months.  I urge you not to.

In addition to high FT4 (which apparently is even higher now), there is a major inconsistency between your FT4 and your TSH.  With your FT4 level, we would typically expect your TSH to be low, perhaps close to zero.  That should be explained.

Have you had an ultrasound?  Has the doctor palpated your thyroid to check for nodules?  Nodules are very common.  Most of us with Hashi's have them.

I think that, at this point, FT3 is key to giving you an idea of a direction to head with this.  If your FT3 is low, which would explain your high TSH, then for some reason, you are not converting T4 to T3 (or, more properly, converting it too slowly).  There can be a number of reasons for low FT3, from vitamin and/or mineral deficiencies to drug interactions to more esoteric causes.

If, on the other hand, your FT3 is high, then for some reason your pituitary (which is what produces TSH) is misreading your thyroid hormone levels and calling for more hormone production when it's not needed, or you could have a resistance syndrome in which very high levels of serum T3 are required (very rare).      

I know this is all pretty new to you, so if I've said anything to only confuse you more, please ask for clarification.
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Avatar_m_tn
Yes no matter how much sleep i get it doesnt really seem to matter, my HR and BP are all fine and the only issue with my bowel movements is the frequency as it seems too be a lot

I am not sure exactly all the other checks that has been carried out as all i got was just FT4 and TSH results on a piece of paper.

I am a 3rd year sports science student so i have a good basic grasp of things and what you are saying, which is another reason i was quite worried on how easily he dismissed it.

I have a follow up appointment during the week so i will be looking to get all info in everything that was checked and push for some possible follow up tests or specialist look. If i manage to get all my results (because they seemed very reluctant last time to give me what i allready have) i will post them up.

You have been a great help, thanks again!
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Avatar_f_tn
Yes, it would be best to get a copy of all the lab work they ran so we can evaluate how thorough they've been.  Your symptoms seem a bit mixed, hypo and hyper.  Increased frequency of bowel movements is also a hyper symptom.  

You have symptoms, so it shouldn't be dismissed.  Furthermore, what bothers me more than anything is the high TSH with high FT4.  That's not the way things are supposed to be, and I think you need an explanation.  In fact, if I were you, I think that's how I might approach my doctor..."Please explain my high TSH and high FT4 to me and tell me what you think is going on."  If he can't, then it might be time to suggest FT3.  (When you have FT3 tested, repeat FT4 and TSH on the same blood draw.)

Be persistent about getting copies of your lab work.  Good luck with your appointment.
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