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Thyroid lab help from a newbie.

Hi Everyone. Really hoping someone can help out a very confused thyroid newbie:

I went to the doc experiencing extreme Left side pain and they ran a load of bloods as you'd expect. I've had weight related problems for about 8 years. Never terribly overweight but not able to lose no matter what I do, also suffered terribly with ridiculously heavy periods (sorry guys) so when the doc called me in saying I had Thyroid issues I thought 'that explains a lot'

But then he hit me with these labs, taken march 26th:

Serum Free T4 32.9 pmol/L (9.0-23.0)
Serum TSH level <0.01 mu/L (0.20 - 4.50)
Serum Total T3 2.2 nmol/L (1.1 - 2.6)

And said I was hyPERthyroid not Hypo like I was expecting.

He then ran a Thyroid Peroxidase Antibody level test which came back as <10 kiu/L (0 - 35)

BUT all of my symptoms point to Hypothyroid. Weight gain, heavy periods, feeling freezing all the time, depression, joint aches.

While I was waiting to see the Endo, I actually felt better than I had for years and my pain went away..

By the time I got to see him (May 18th), I was still feeling pretty well. They took bloods that day and the results were:
FT4 11.1 pmol/L  9.0 - 23.0
TSH 1.97 mu/L 0.20 - 4.50

They didn't do T3.

So the Endo basically put me to the bottom of the appointment pile and said I couldn't see him until mid August.

A few weeks after that, everything tanked again. The muscle fatigue came back, couldn't climb stairs without stopping, joints ache, can't lift my arms over my head for longer than a second.. feel like someone has inflated a balloon in my head, ankles look like the Michelin man (very puffy) and voice got hoarse (this is scary as I'm a singer for a living!) so I went to my GP and requested another blood test to see if anything had changed, thinking maybe i've swung the other way. Those results:

Serum free T4 11.7 pmol/L 9.00 - 23.00
Serum TSH 2.52 mu/L  0.20 - 4.50mu/L

So very little change. I requested a Free T3 test as well, but they didn't do it.

I am absolutely gutted, to say the least. I know it sounds weird to wish you had bad blood results, but I just hoped this would be the answer as to why I was feeling so awful. Now it feels like all the doctors will just write me off. Genuinely don't know what to do.

I have an ultrasound scan on Thursday, but given those blood results, I'm guessing they won't spot anything.

Can anyone see any reason why I might be feeling so rotten from those bloods?

The other weird thing is that my heart has been doing odd things. Lots of palpitations and resting heart rate exceeded 127 the other day. It wasn't even doing that when my T4 was 32.9.

I'm so confused and fed up. Don't know where to turn.

Sorry for the moan.

Wow. That was a long post!
2 Responses
Avatar universal
You have to consider the possibility of lab error on the 3/26 blood work.  Your TPOab was negative, indicating you probably don't have Hashi's, but in order to rule it out, TGab (thyroglobulin antibodies) have to be tested, too.  The U/S may reveal more than you think.

In the last two labs, your FT4 was at 15% and 19% of range, which is way too low.  Many of us had hypo symptoms until FT4 was about 50% of range.  Thyroid test ranges are very flawed, and the whole bottom half of the range should probably be considered hypo.

I think you have found an explanation.  The tough part, now, will be to get someone to treat you based on low, but in-range FT4, and symptoms.
Avatar universal
If you lookup Hashimoto's Thyroiditis you will see that transient periods of thyrotoxicosis (over-activity of the thyroid) can occur. This might explain the March labs. Even tho your recent labs look somewhat similar to the May 18 results, the TSH is climbing (moving more hypo). TSH is the slowest to change (like 1 - 2 months) and new tests again might be higher yet.
As to what to do - you have to learn everything you can about thyroid stuff and actively participate in decisions with your doctor. I would suggest that you really need to find a doctor that you can be really confident knows about thyroid stuff. It appears that the endo will not help.
I hate to be a wet blanket, but it is possible that your palpitations and high heart rate might be atrial fibrillation, (which I am dealing with) which is also related to hypothyroidism.

If you live in the USA, there are labs where you can get all the tests you want, and of course pay for them. I have resorted to this recently.
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