Please can you help with lab test results - hypothyroidism?

Hormones
1

I've not been well for some time and have episodes where I feel really ill.. A couple of weeks ago I had one of these 'episodes' and went to see my GP. My symptoms included extreme fatigue, aching all over, really fuzzy head, feeling cold inside, cold hands and feet, heavy, dry eyes, sensitive to noise, slow movements and reactions, slow speech, total lethargy. In a more general sense I am always tired no matter how much sleep I have, when I wake in the mornings I can't use my hands until I shake them because I don't have any circulation (painful pins and needles!), I keep losing my voice when I talk, total loss of libido, difficulty losing weight despite eating next to nothing.

My sister was diagnosed with an underactive thyroid about 10 years ago, so I mentioned this to the GP who sent me for blood tests. He only tested me for Serum TSH which came back as 0.85 mU/L and stated 'thyriod function test results indicate normal thyriod status'.

He also said that all my other results were normal and there was no 'medical reason' for me to feel like I do. I suggested testing for T4 and T3, but he point blank refused and said they didn't need to be done. He mentioned depression and menopause (I am going through the menopause) and said 'I would have to live with it'.

To cut a long story short (sorry for the length of this post), I had private bloods done and these are the results:-

Free T4 11.83 (range 12-22) pmol/L

Free T3 4.59 (range 3.1 - 6.8) pmol/L

TSH 2.27 (range 0.27 - 4.20) IU/L

T4 Total 80.3 (range 64.5 - 142.0) nmo/L

Ferritin 106.6 (range 20-150) ug/L

CRP 3.5 (range <3.0) mg/L

Anti-thyroidperoxidase abs 6.6 (range <34)

Anti-thyroglobulin abs 18.5 (range <115)

Please can you help me to decipher these results? Any help would be very much appreciated, as I feel at the end of my tether!

2

Hi Linda, it all looks pretty normal to me, all within range. you say that you are going through the menopause? i am also and have underactive thyroid, the symptoms are very much the same. i have recently started a course of HRT and i havent looked back wish id done it 2 years ago when my menopause symptoms started, The symptoms you describe are what i had , but the HRT seems to have sorted that out, may be worth talking to GP about that perhaps?

3

Hi Sdob46. Thanks for the advice. My GP did mention HRT, but my mum died with breast cancer, so it's not an option. Also, I've been having most of these symptoms before the menopause started, so I don't think that's causing them. Thank you very much for replying anyway.

4

Many of your levels look quite normal, except for your thyroglobulin and thyroidperoxidase. I think these should be close to zero, mine always are. I did a bit of research and found:

What does the test result mean?

Negative test results means that thyroid autoantibodies are not present in the blood at the time of testing and may indicate that symptoms are due to a cause other than autoimmune. However, a certain percentage of people who have autoimmune thyroid disease do not have autoantibodies. If it is suspected that the autoantibodies may develop over time, as may happen with some autoimmune disorders, then repeat testing may be done at a later date.

Mild to moderately elevated levels of thyroid antibodies may be found in a variety of thyroid and autoimmune disorders, such as thyroid cancer, type 1 diabetes, rheumatoid arthritis, pernicious anemia, and autoimmune collagen vascular diseases.

Significantly increased concentrations most frequently indicate thyroid autoimmune diseases such as Hashimoto thyroiditisand Graves disease.

In general, the presence of thyroid antibodies suggests the presence of an autoimmune thyroid disorder and the higher the level, the more likely that is. Levels of autoantibody that rise over time may be more significant than stable levels as they may indicate an increase in autoimmune disease activity. All of these antibodies, if present in a pregnant woman, can increase the risk of hypothyroidism or hyperthyroidism in the developing baby or newborn.

If a person with thyroid cancer has thyroglobulin antibodies, they may interfere with tests for thyroglobulin levels. This may mean that the thyroglobulin test cannot be used as a tumor marker or to monitor the individual's thyroid cancer. Some methods of testing, including one called mass spectrometry, are not affected by the presence of thyroglobulin antibodies. When measured these ways, the thyroglobulin test can be used as a tumor marker, regardless of whether or not thyroglobulin antibodies are present. However, if a method is used that is affected by thyroglobulin antibodies, then the levels of the antibodies themselves can be used as a tumor marker to monitor thyroid cancer. If they stay high or drop low initially but increase over time, then it is likely that the treatment has not been effective and the cancer is continuing or recurring. If levels are falling and/or have fallen to low or undetectable levels, then it is more likely that the therapy has been effective in eradicating the cancer.

A certain percentage of people who are healthy may be positive for one or more thyroid antibodies. The prevalence of these antibodies tends to be higher in women, tends to increase with age, and for thyroid peroxidase antibodies, indicates an increased risk of developing thyroid disease in the future. If an individual with no apparent thyroid dysfunction has a thyroid antibody, the healthcare provider will track the person's health over time. While most may never experience thyroid dysfunction, a few may develop it.

Is there anything else I should know?

The sensitivity and specificity of thyroid antibody testing is improving but is still not as good as health practitioners would like it to be. All of the thyroid antibody tests have changed over time. This is part of the reason that the tests have historically acquired many different names. There are also many distinct methodologies and each has different reference (normal) ranges

5

Hello Linda:

My name is Shelly and I am a nurse in the USA and I have Hashimoto's Thyroid disease.  Your lab work is very good and all in normal ranges, I know just what you want to hear...LOL.

I was looking over your symptoms and want to suggest a few things.  I know some people look good on paper but feel awful.

i suggest you ask your GP to run a cortisol test, as some symptoms could be from an elevated cortisol level.  Also another thing to test for is Sjogren's syndrome which is a "collection of symptoms" and can cause dry eyes.  They have certain blood tests for it, and you can ask for a sedimentation rate test.  Some of the symptoms you mention can be part of Sjogren's Syndrome.

I hope this helps,

Shelly

6

hi linda i am having similar problems i went to doc with my arthritis and he decided to check my bloods he asked for them again then said both wr negative and said thyroid problem i have to go back in 3 month but since a month has passed ive put on half a stone in weight even though i have been dieting so i am going back on monday but i got prescribed H.R.T also and then i had the thyroid probs so not sure the H.R.T started it of im not on hrt now

7

Hi, you might also want to look into 'foods to eat for the menopause' as there are certain foods that can help reduce menopausal symptoms. A good search is: eat to ease the menopause - there is a bbc link.

Also: Eat to beat the menopause - Daily Mail

8

Thanks to everyone who has taken the time to reply to me. I have not used my computer for a few days, so have only just seen the latest ones. When I had the private bloods done, there were comments on the bottom to the effect that my FT4 levels were slightly low and I should check these again in 6 months or so. I am feeling a bit better at the moment, so I think I will see how I get on and probably have a re-test in 6 months. I'll also have a look at Barbara's suggestion on the BBC website to see if this helps. Thanks again.

9

You know Linda, it would be interesting to see what your thyroid blood test results show now I.e. 'when you are feeling a bit better'. If the Free T4 (FT4) is in range now, that would indicate that at least some of the poor health is related to your thyroud. If the blood tests results show FT4 is the same then you know that the feeling better is not related to it. If the FT4 is worse it means you've got more than one thing going on and that there may be a underlying problem with your thyroid but it isn't causing most of your symptoms.