My Thyroid Function Results (Please Help)

[ThankfulJoe]

Hi there,

I was diagnosed with Hyperthyroidism (Graves Disease) exactly a year ago and was put on meds to get my thyroid back into the normal range. I was given NeoMercazole and after a 8 month treatment my results came back in the normal range. Every two months I go for tests since then and this is now the second test after I stopped the meds which is 5 months after having the last Neomercazole pill.

The problem I have is for the last two weeks I have felt terrible, high anxiety, adrenaline pumping through my veins and just not willing to face usual activities that I faced before. My eyes are also constantly burning and dry. I was thinking perhaps my hyperthyroidism returned and went for blood tests. These are the results I got.

TSH : 0.56              
Free T4 : 12.8
Free T3 : 5.7

From what I can gather all fall within the normal range so wondering why I am feeling this way, perhaps a placebo effect or am I developing an anxiety disorder? Or are the results infact high showing that the condition has returned?

Thanks to anyone who can shed some light.

[Brandi_Thelen]

I don't know if you are interested in holistic type choice to compliment medical treatment but when my results look like yours and I am feeling symptoms I tend to reach for my Lemon balm. Comes in tea and droplet forms. Helps me a lot.

[ThankfulJoe]

Thank you for the feedback Goolarra, I will give it two months and then go for another blood test and will ask for the TSI. Really appreciate your input on this matter. Makes me feel alot better :-)

[goolarra]

For what it's worth, your TSH is now in normal range.  It's on the low side.  It's moved down considerably since January, which probably reflects the higher FT4 level currently.  It could be a trend, but with only two readings, it's too early to really call that.

Would you consider asking your doctor to include TSI?  TSI antibodies do the work of TSH for it.  The TSI antibodies attach to the TSH receptors in the thyroid and stimulate it to produce more T4.  So, when antibodies are up, TSH is very, very low.  If you're monitoring TSI, it will give you a better idea of if you are going into or coming out of remission.  

Typically, when antibodies are active, TSH is close to undetectable.  Considering that you were quite hyper, I think a TSH of 0.56 is quite respectable.

[ThankfulJoe]

Thanks for the feedback Goolarra, I have to admit though that I feel anxious etc and edgy but then I take a anxiety pill and feel normal and the sweats etc go away, so to be honest I do think that my mind might be playing tricks on me.

I do however would like to note what you think of my TSH being 0.56. Is this  considered low or in the context of what it was when I was diagnosed how would you rate it right now.

Thanks :-)

[goolarra]

So, it the past few months, your FT4 has gone from 10.6 to 12.8 (same range on both 7.6-16.1).  But it's still only 61% of range, which is a little high of the 50% target for FT4.  FT3 has actually gone down, but it's still above range.  Both of these latest results re far below the results on diagnosis.

FT3 is the test that correlates best with symptoms.  Ordinarily, I'd tell you that, with FT3 above range, you might be having some hyper symptoms.  However, when we look back to January, when you felt really good, and compare, that doesn't hold water.

Have you thought about a small dose of methimazole to see if it helps?  

[ThankfulJoe]

Think someone posted in the wrong thread.

I received my results for interest sake and I can't make sense from the numbers. Would appreciate it if you could help me here.

So when I was feeling terrible and didn't know what was wrong with me I went for a blood test and the scan on the thyroid and this is what the blood tests showed:

My Test Results:

20/09/13 : TSH : 0.06 |  Free T4 : 35.6 |  Free T3 : 12.6

The reference guideline for this test was:

TSH : 0.20 - 3.5 mIU/l | Free T4 : 7.7 - 16.9 pmol/l | Free T3 : 3.4 - 5.9 pmol/l

This is where I was diagnosed with Hyperthyroidism. I started taking neomercazole and blood tests continued until it showed I was normal again. Treatment for about a year and 4 months. I then went for my first blood test after stopping the pills for 2 months and the following is what my tests showed:

19/01/15 : TSH : 2.82 | Free T4 : 10.6 | Free T3 : 6.2

The reference guideline for this test was:

TSH : 0.35 - 3.5 mIU/l | Free T4 : 7.6 - 16.1 pmol/l | Free T3 : 3.5 - 5.4 pmol/l

I then waited another two months and went for my blood test which happened yesterday. Now please note for the last two weeks I have been feeling highly anxious again and in need of anxiety pills not to get panic attacks.

My Latest Results:

29/04/15 : TSH : 0.56 |  Free T4 : 12.8 |  Free T3 : 5.7

The reference guideline for this test was:

TSH : 0.35 - 3.5 mIU/l | Free T4 : 7.6 - 16.1 pmol/l | Free T3 : 3.5 - 5.4 pmol/l

So as you can see I have given you my very first test that showed I was hyper, then another test done showing I became normal again and then the last one which is what I am currently. It's important to note that I felt fantastic at the time of the test from 19/01/15 but since then till the last test which was done 2 days ago I have developed a very high anxiety problem where I need an anxiety pill just to function normally where in the past I wouldn't need any anxiety medication. I also sweat alot in my palms and feet and get adrenaline warm buzzing in my body every now and then.

The big question is... am I actually going Hyper again based on the numbers or am I merely having a psychological problem that is giving me anxiety due to the fear of having another panic attack?

Would appreciate the feedback :-)

[goolarra]

Your TPOab is elevated.  So, there's a very good chance you will be diagnosed with Hashi's.  

TSH has risen, probably because the TPO antibodies have compromised more and more of your thyroid function.

Were the December labs done at the same lab?  Reference ranges may not be the same.  Also, are those FREE T3 and FREE T4 in December?

Are you taking thyroid meds?

How do you feel?  

[Stewarts]

Blood test  2015/04/07                 Reference Range
    Thyroid Peroxidase AB 593.        <35 kIU/L
                             TSH 13.53        0.35 - 5.00 mIU/L
                             T4 FREE 9.      12 - 22     pmol/L
                             T3 FREE 4.1     2.6 - 5.7  pmol/L
  
(Blood test ) 2014/12/09
                             TSH/ 4.95  T4/ 4.95  T3/ 4.2

Do you know why the levels are so different between test results?
                                

[goolarra]

Tachycardia and hand tremors are both symptoms of hyper.  While most hyper is Graves', there are other causes.  

As you said, once you see previous labs, you will have a lot more information to work with.

Always rule out the physical first...

[ThankfulJoe]

My Dr and the Specialist told me that it's all within the normal range considering how high I was previously. I have asked for the previous blood test results to compare. Once I have that I will be able to assess the situation more clearly. I know that when I was diagnosed it was because of my fast heart beat and shaking in my hands.

Since then I have been put on a Beta Blocker and have slowed my heart rate down and have stayed on it even after I was cleared of having hyperthyroidism. But now it seems I am edgy and very anxious for things I never had a problem with before, like meetings and meeting friends. Think it might be psychological but don't want to rule out the test results first. :-)

[goolarra]

Your FT4 is a bit high of the 50% of range target; it's 61%.  

FT3 is above range, which certainly could be giving you some hyper symptoms.

I'm surprised that given those FT3 and FT4 numbers your TSH is as high as it is.  I'd expect it to be considerably lower, especially if you do have Graves'.  TSI (thyroid stimulating immunoglobulin) is the antibody marker for Graves'.  It's part of a definitive diagnosis of Graves', and it's useful in predicting remission if it starts going down.  So, it should be monitored regularly.  

It will be interesting to compare to previous labs.  

[ThankfulJoe]

Apologies for not including it

The Reference (normal range) is:

TSH : 0.35 - 3.5 (units is mIU/L)
FT4 : 7.6 - 16.1 (units is pmol/L)
FT3 : 3.5 - 5.4 (units is pmol/L)

They have not tested my TSI at all if I am honest, also requesting the last blood test in which I felt good to compare. That is a good suggestion in order to see if it's simply my mind or actually the thyroid changing.

[goolarra]

What are the reference ranges on your FT3 and FT4?  Ranges vary lab to lab and have to come from your own lab report.

How do these labs compare to your previous ones, when you were feeling good?

Have they regularly been testing TSI?