Very confused and worried

[Niamhwill]

Hi all

I have had a goitre for many years and never really thought anything of it.  Have always been a 'tired soul' as my granny says and had issues with weight gain and anxiety/depression.  I thought well this is just the way I am, my doc just liked to prescribe me anti anxiety meds and let me get on with it.  Well I have finally had enough and my symptoms are getting worse.  I have a low ferritin level of 4 and have been prescribed ferrous fumerate, I an constantly exhausted, down, gaining weight, irregular periods and have severe headaches, goitre is swelling, I have ONLY ever had my TSH levels checked which cane back at 0.9 two weeks ago, also TBO which was 'normal', please help as I am so worried right now that it is something serious thank you.

[goolarra]

There are two different T4 tests.  T4 (also called total T4 or TT4) is a measure of the total T4 in your blood.  However, much of that T4 is chemically bound by protein and unavailable for use by your body.  FT4 is the unbound or free portion.  It's what's actually available to your body.  T3 test also come in total and free.  If "free" is not specified, the test is total.  TT3 and TT4 are considered obsolete and not nearly as useful as FT3 and FT4.

[Niamhwill]

Also, would really appreciate any advice from all as to what bloods I should be asking (begging in my case) my doc to test, I need to be armed with as much info as I possibly can.

Many thanks

[Niamhwill]

Hi, I had my bloods done today and doc has asked for t3 & t4 tests, but not FREE T3 & T4, are these different ? Sorry if this may seem a daft question but I really don't have a clue?
Thanks

[goolarra]

ESR is a measure of inflammation.  So, your thyroid is swollen (inflamed)...why are we (as in your doctors) surprised ESR is elevated?  That was a rhetorical question...

Good luck.  Post your labs with reference ranges when you get them if you'd like.  Ranges vary lab to lab, so they have to come from your own lab report.  We can help you interpret them.  Keep in mind that just being "in range" is often not enough to relieve symptoms.  

[Niamhwill]

Hi
I am having it taken tomorrow afternoon, also esr levels ( again not quite sure of exact initials? ) as this was raised after full blood work.  I think because my first initial encounter with this issue was over 13 years ago and no investigatory work was done I trusted in all my doctor had to say, now I am older and have the confidence to question I am literally kicking myself that I didn't pursue all them years ago (I was only 17) but we live and learn, and it is very interesting and insightful talking to you, I can learn a lot.

[goolarra]

I had a blocked salivary gland many years ago.  EXTREMELY painful, especially when eating anything vinegary, but my thyroid didn't swell.  I had it for months until a little "stone" popped out of the duct under my tongue, and it went away never to return.  Are you having pain?

Are you waiting on the results of your FT3 and FT4 or has the blood yet to be drawn?

[Niamhwill]

Hi, no, she has never really questioned me about it, I was sent to the ENT department as they thought it was a blocked saliva gland??? I am going to start writing everything down when I go, no doubt will receive some curious glances but I couldn't care less.  I know deep down I am a happy and ambitious woman who is being prevented from achieving by her own body!!

[goolarra]

Well, if we don't find anything, great!  That's information, too...we'll know to look elsewhere to explain symptoms.  I don't know about U.K., but in the States, I think it's easier to ask for and get a $2,000 MRI than a $50 blood test for thyroid.

Has she explained why your thyroid is swelling?  Inflammation is a sign that something is wrong.    

[Niamhwill]

Hi, sorry, yes I did mean TPO, couldnt quite remember the exact initials.  My doctor is very hard to encourage to investigate things further as she seems to think it's all something and nothing.  I'm in the UK and unless you have private healthcare it can take a while to be referred for specialist care and treatment.  I should have mentioned my grandad had thyroid toxicosis, aunt has diabetes, dad is under investigation for thyroid.  I had to insist last week that my T3 and T4 levels were tested, doctor kept saying and I quote ' I find it highly unlikely that we will find anything'. How frustrating !!

[goolarra]

TSH is, at best, a screening tool.  If you have symptoms, FREE T3 and FREE T4 should also be tested.  T3 and T4 are the actual thyroid hormones and give a much more complete thyroid profile.  

I'm not familiar with TBO.  Did you mean TPOab (thyroid peroxidase antibodies)?  That's one antibody that's a marker for Hashi's.  The other is TGab (thyroglobulin antibodies).  Both have to be tested as some of us with Hashi's are TPOab positive, some TGab positive and some both.

Don't get too worried yet...most thyroid conditions are extremely treatable.