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uptake scan clear low tsh
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uptake scan clear low tsh

Hi
I have had thyroiditis last year but my TSH keeps fluctuating and is low still,  it was tsh 0.2 ft4 23 I was really poorly but the weired thing is i never went hypo??, anyway I had an uptake
scan last month which came back clear as my TSH was 0.9 (the highest its been in over a year) then dropped again to 0.5 then 0.7 then 0.6 again
everytime it seems to get higher it dips again?
my latest labs results are:
TSH 0.6
FT4 14
T3 4.5
my tpo is positive (69)
I asked for the TSI antibodie test done but the endo said it would make no difference.
I was just wondering if my T3 was normal as im not sure what the range should be.
the endo wants to leave me again and restest in 3 months time, I feel pretty rubbish everyday
some days are better than others, I am on beta blockers but I am slowly weaning off them as they are
making me very tierd.
Would you say I have a thyroid problem as the endo says it is lurking in the background but think my tierdness is down to something else??? very confused!
many thanks
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Avatar_f_tn
I would say that, combined with your FT4, which is on the low side, your FT3 would confirm that you are hypo.  Your FT3 is only at 7% of range, and upper half (50%+) to upper third (67%+) is the rule of thumb for FT3.  FT3 is the test that correlates best with symptoms, and yours is very low.

Don't suffer some more.  If this doctor won't help you, you might have to shop for one who will.  

Yes, sorry about the typo.  The FT4 range is 9-23, and those are the numbers I used to caculate your percentage.  It is calculated correctly at 37% of range, which falls below the rule of thumb of 50%.  I do think you're slightly hypo based on your FT4, but I think you may be quite a bit more than "slightly" based on your FT3.  

This doctor is obviously fixated on your TSH, and he will keep you miserable.  Does he pay any attention to your symptoms at all?
7 Comments Post a Comment
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Avatar_f_tn
Please post the reference ranges on your FT3, FT4 and TPOab.  Ranges vary lab to lab, so you have to take them from your own lab report.  You can't use a "generic" range.  Reference ranges should be near results on the lab report, often in parentheses.  

If you don't have a paper copy of your report, you could call your doctor or the lab and request their ranges.

When you say you had thyroiditis last year, do you mean that you had hyper symptoms for a while?

Are you on any kind of thyroid meds at the moment?
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Avatar_f_tn
Hi, thankyou for replying, the ranges  are
tsh: 0.55 - 4.78
FT4: 9-23
T3: have not been able to get, this is the one im confused about?
TPO >30
Im not on any thyroid medication I have been on beta blockers which I am currently weaning off, and yes I was hyper with loads of symptoms I was very ill I know I tested borderline lupus as well but the doc spoke to the immunologist who said what i had flagged up on was common in thyroiditis.
The only thing is I have never gone underactive which i understand is the normal pattern with thyroiditis.
I dont have the symptoms as bad as last year but im not great I get exhausted easily/muscle aches/ the odd palpatation not as bad/ cant stand intense heat etc.
I dont understand why my tsh is still low too the endo said it should be higher but to test me again in 3 months.
Just very confused if I have an ongoing thyroid problem or if it just will correct itself?
many thanks
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Avatar_f_tn
As you said, your TPOab is positive at 69.  I believe the range should be less-than 30.  TPOab is one of the markers for Hashimoto's thyroiditis, which is an autoimmune disease.  Were you postpartum when you were hyper?  69 is a positive result, but it's a weak positive.  Many of us have TPOab counts in the high hundreds or even thousands on diagnosis.  Has your doctor diagnosed Hashi's yet?

Your FT4 is currently 14 (19-23), so that's 36% of range, and many people have hypO symptoms until FT4 is up around 50% of range.  Unfortunately, FT3 ranges vary a lot from lab to lab and country to country, so I really can't comment without seeing your lab's range.  Could you call the lab or the doctor and ask for the range?

I agree with you that a TSI would be worth doing.  It is possible to have both Hashi's and Graves' (even though they sound mutually exclusive since one is hypo and the other hyper).  If your TSI is high, it could be what's keeping your TSH low.  

Fatigue is probably the most common symptom of hypo, and with your low FT4, I think you might be a bit hypo now.  Your doctor is focusing way too much on TSH.  TSH is very unreliable, except as a screening tool.  However, without an FT3 range, I'm really just speculating.

I tend to think you have an ongoing thyroid problem.  Your TPOab is elevated, which means that damage to your thyroid is continuing.  This is probably what your doctor means when he says that your problem is "lurking in the background".  However, if you are having symptoms, you should be being treated regardless of whether your labs are out of range or not.  

Do you suppose you could get that FT3 range?  
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Avatar_f_tn
Hi
thankyou you have been really helpful in me understanding things!, I have managed to get my t3 range which is 4-8.3, my last lab result was 4.3 would you say this is good/bad?
No i wasnt postpartum when i was hyper, I literally couldnt breath it was so fightening, im just hoping i will be ok after weaning of the beta blockers(which the endo said to do no).
I asked him for the tsi test but he wouldnt do it so i guess im just gonna have to sit and wait and see what happens ( suffer some more!!)
can i just check when you said about the ft4 range you had put the range 19-23 but it should be 9-23 do you still think i am slightly hypo?
many thanks for your help
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Avatar_f_tn
I would say that, combined with your FT4, which is on the low side, your FT3 would confirm that you are hypo.  Your FT3 is only at 7% of range, and upper half (50%+) to upper third (67%+) is the rule of thumb for FT3.  FT3 is the test that correlates best with symptoms, and yours is very low.

Don't suffer some more.  If this doctor won't help you, you might have to shop for one who will.  

Yes, sorry about the typo.  The FT4 range is 9-23, and those are the numbers I used to caculate your percentage.  It is calculated correctly at 37% of range, which falls below the rule of thumb of 50%.  I do think you're slightly hypo based on your FT4, but I think you may be quite a bit more than "slightly" based on your FT3.  

This doctor is obviously fixated on your TSH, and he will keep you miserable.  Does he pay any attention to your symptoms at all?
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Avatar_f_tn
its awful because I felt like I couldnt talk to him about my symptoms as when i did he told me to stop focusing on them!!!! I could have cried!
Im moving soon so i might change hospitals and get a second opinion, my next test is due in June.
I just would like to feel normal again, maybe one day!!!
but once again thankyou for helping me understand my results more you have been very helpful. many thanks
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Avatar_f_tn
Oh, that's awful.  You should have told HIM to stop focusing on your TSH, listen to how you feel and do his job...make you feel well again.  They can be so insensitive.

Best of luck with your move.  I hope you can find a doctor who will treat according to your symptoms.  Your FT3 and FT4 will probably continue to go down, which won't make you feel any better.  If you start to feel worse, don't hesitate to see your doctor again.  
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