# Do i need a second opinion?



## Dee (Sep 28, 2015)

I had a thyroid test last week. I have various symptoms which made me think that i may have thyroid issues (overweight, dry skin and hair, extreme cold, bad periods). My doctor (GP) says my results are normal. Should i seek a second opinion?

Free T4 8.0 pmol/L (7.2 - 16.4 range)
Free T3 4.2 pmol/L (3.8 - 6.0 range) 
TSH 3.43 mIU/L (0.37 - 3.50 range) 
Ferritin 37 ug/L (10 - 150 range)

Its the TSH which worries me, since its so close to the top of the range.

Any thoughts on this? Thanks in advance.


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## Dee (Sep 28, 2015)

I forgot to add fatigue and migraines to my list!


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## Dee (Sep 28, 2015)

Thanks. Dr said everything was normal, including ferritin. I have very heavy periods, but this test was 3 weeks since my last one.


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## Andros (Aug 26, 2009)

SUGGESTED TESTS
TPO (antimicrosomal antibodies) TBII (thyrotropin-binding inhibitory immunoglobulin), Thyroglobulin and Thyroglobulin Ab, ANA (antinuclear antibodies), (thyroid hormone panel) TSH, Free T3, Free T4.

You can look this stuff up here and more.........
http://www.labtestsonline.org/
(Copy and paste into your browser)

TBII
http://www.ncbi.nlm.nih.gov/pubmed/9364248
http://en.wikipedia.org/wiki/Anti-thyroid_autoantibodies
(Copy and paste into your browser)

Blocking TRAbs (also known as Thyrotropin Binding Inhibitory Immunoglobulins (TBII)) competitively block the activity of TSH on the receptor. This can cause hypothyroidism by reducing the thyrotropic effects of TSH. They are found in Hashimoto's thyroiditis and Graves' disease and may be cause of fluctuation of thyroid function in the latter. During treatment of Graves' disease they may also become the predominant antibody, which can cause hypothyroidism.

You do have something going on. You must feel awful w/TSH that high. Also your FREE T3 is not in the best place. Ideally, it should be above the mid-range of the range given by your lab.

You might benefit from some antibody tests. I think you should insist on it and you truly should be on some thyroxine replacement.

A second opinion most certainly is in order.

Also, your ferritin is very low and that is a "clue" re the thyroid. We find that to be true in almost all cases.

Welcome!


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## mstar1125 (May 6, 2014)

I would seek a second opinion with an endo or someone else who specializes in the thyroid. A GP is only going to look to see if your levels are within the lab ranges, and only take action if they aren't. As PP mentioned, the free T4 and T3 are also at the very low end of the range in addition to TSH being at the very high end. Also, I know TSH (not sure about T4 and T3) have a 24-hr rhythm, meaning that levels can change depending on when the blood was drawn. You could get a lower or higher value with a repeat draw, which could be important if you are having any symptoms - you may be spending most of the day above range and you just happened to have your draw done when you were just below range.


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## Dee (Sep 28, 2015)

Thanks everyone.i have made an appointment with a thyroid specialist, unfortunately only a month from now! Obviously he's busy!

I really hope he listens and takes me seriously. A few years back I saw an endocrinologist and she totally dismissed any thyroid issues and blamed my symptoms on insulin resistance/ PCOS. Well, I have subsequently very successfully treated that on a low carb diet, lost over 20lbs, and had many of my PCOS symptoms disappear, but I'm still tired, cold, and have a bunch of other crappy symptoms.

Thanks for listening, glad to know I'm not overreacting about this.


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## Hayatiggs (Aug 19, 2014)

I'm where you are now regarding doctors. Hoping you get some answers soon!


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