# Thyroid blood test results indicating hypothyroidism :(



## MrHypo (Dec 30, 2015)

I've suffered with lots of weird symptoms for a long time. My pulse is slow, my body temperature is low, usually around 96 farenheit (~35.5 C) measured under the tongue. Myriad of other things... But I think temperature and pulse are probably the biggest indicators where it's harder to blame other possible causes.

I have had two blood tests done for thyroid function. The first came back normal (in range, anyway):

TSH - 2.45 mu/L

FT4 - 11 pmol/L (hmm, quite borderline)

On the second blood test the result shows good levels of FT4 but out of wack TSH:

*! TSH - 5.42 mu/L*

FT4 - 15.4 pmol/L

Lab ranges they give are 0.35 - 4.94 mu/L for TSH and 9 - 19 pmol/L for FT4.

I don't get what's happening because my vital signs are constantly fluctuating. My temperature can rise to normal (97.7 farenheit / 36.5 C) at times, but other times it will dip extremely low to even 95 farenheit. I also experience heart effects such as palpitations now and again. My blood pressure rises and falls all the time, sometimes I'm in the prehypertension range and other times my blood pressure drops and I experience near-fainting, pins and needles and head rushes when I stand up. I'm on a rollercoaster ride here.

I am supposed to repeat the test in 6 weeks. I'm worried that it will come back normal due to the ever fluctuating state of my body and they will refuse to treat me, even though I have had a lot of horrible symptoms for a few years now. By the way the lymph nodes on the side of my neck and on the underside of my jaw have been raised for about 2 months now. Well that's when I first noticed anyway.


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## Lovlkn (Dec 20, 2009)

Welcome to the board!

11 is on the low side for FT-4 and TSH can lag us to 6 weeks so it makes sense that your TSH and FT-4 do not necessarily follow together.

On your second test your FT-4 looks to be in good range while your TSH is completely hypo.

Do you take supplements of any sort?

Did you have the labs drawn approximately the same time of day?

A Free T-4 along with a Free T-3 would give the clearest picture of thyroid function at time of lab draw. Antibodies, TPO and thyroglobulin.

You might also ask for an ultrasound of your thyroid to see why you are having fluxuations and to see if there are nodules causing this as well as to check out the lymph nodes.


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## MrHypo (Dec 30, 2015)

Lovlkn said:


> Welcome to the board!
> 
> 11 is on the low side for FT-4 and TSH can lag us to 6 weeks so it makes sense that your TSH and FT-4 do not necessarily follow together.
> 
> ...


No I don't take any supplements. First "normal" test was at the start of the day while the second test was a bit later on in the day.

I've been ill for quite some time and it'd be great if I could take thyroid meds and make it all go away. I don't trust my results to come back out of range again even though I'm symptomatic with low temp and pulse etc, I expect a borderline result and refusal of treatment. I want the doc to just prescribe me T3 or something to see if I feel better after taking it then I know one way or the other whether it's the problem or not.


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## joplin1975 (Jul 21, 2011)

I think you might also want to have thyroid antibodies tested.

Is this your GP running these tests?


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## MrHypo (Dec 30, 2015)

joplin1975 said:


> I think you might also want to have thyroid antibodies tested.
> 
> Is this your GP running these tests?


Yes. I'll ask for these things to be tested:

TSH

FT4

FT3

RT3

Antibodies

That's everything right? I heard antibody tests are unreliable though, because there has to be an active attack on the thyroid for the levels to register high enough to class as having Hashi's. I also heard TSH can be unreliable too lol, because the range is wider than it should be. Some places use 3.0 as the upper limit, well here in the UK it's 4.94 as the upper limit. If I was in some parts of America I'd have one result with borderline-high TSH / borderline-low T4, and another result with perfect T4 but raised TSH.

Not sure how the T4 manages to be perfect, maybe the extra TSH being produced has been effective? But I feel like sh*t almost every day.


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## joplin1975 (Jul 21, 2011)

Yup. Get TPO, TSI and Tg/TgAB for antibodies.

A lot of doctors use TPO to diagnose Hashi's. That's not really correct as a biopsy is the gold standard. Still most of us with Hashi's will have abnormally high levels of antibodies regardless of whether or not we are in the midst of an attack. It's just that in an attack, they spike higher.

Even at 2.45, I'd argue the TSH is too high. Mix in the antibodies that skew the results & the fact that it lags behind actual thyroid hormones (recall TSH is produced by the pituitary), and yeah, it's not always considered reliable or important.

Don't forget that ultrasound, especially is you are male!


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## MrHypo (Dec 30, 2015)

joplin1975 said:


> Yup. Get TPO, TSI and Tg/TgAB for antibodies.
> 
> A lot of doctors use TPO to diagnose Hashi's. That's not really correct as a biopsy is the gold standard. Still most of us with Hashi's will have abnormally high levels of antibodies regardless of whether or not we are in the midst of an attack. It's just that in an attack, they spike higher.
> 
> ...


Thanks for the info. Yeah I'm a guy. By the way not sure if it's important but my Vitamin D levels are also low. 33 nmol/L, pathologist says to use OTC supplements. Also my GFR is low (below range quite a bit at 66 mL/min). I had a kidney ultrasound and the results of that test were that my kidneys are okay.


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## Lovlkn (Dec 20, 2009)

Yes - your D is low low low. I started there and now take 5K IU daily to maintain 55-75, it seems to fluxuate despite taking the same amount.

The prescription to raise d is 50K IU weekly for 12 weeks and re-test. Then you have to try different daily doses and re-test until you find one that works.



> the lymph nodes on the side of my neck and on the underside of my jaw have been raised for about 2 months now.


I would be concerned - an ENT could perform a ultrasound of your thyroid if you went in to have your lymph nodes checked out.


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## MrHypo (Dec 30, 2015)

I went back to the doctor today to discuss the poor results. They said there's no way my underactive thyroid would be causing me any symptoms at 5.42 TSH and would also not be causing the low Vit D or low GFR. I feel that I'm symptomatic though... But they say treatment would not be right now and my TSH needs to be much higher before I get meds.

Will not test Free T3 they said they don't do it, I tried to get that and RT3, they just won't do it.


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## joplin1975 (Jul 21, 2011)

Well, all I can say is that I've had my TSH at just about every number between 121 and 0.3 and a TSH of 5.42 would ABSOLUTELY cause your symptoms (not saying there aren't other issues in the mix -- who knows!). I will also say that my eGFR was pretty low after my extreme hypo spell and it has very much normalized now. So, to say I disagree is putting it mildly.

Are you able to get a second opinion?


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## MrHypo (Dec 30, 2015)

joplin1975 said:


> Well, all I can say is that I've had my TSH at just about every number between 121 and 0.3 and a TSH of 5.42 would ABSOLUTELY cause your symptoms (not saying there aren't other issues in the mix -- who knows!). I will also say that my eGFR was pretty low after my extreme hypo spell and it has very much normalized now. So, to say I disagree is putting it mildly.
> 
> Are you able to get a second opinion?


I can get a second opinion but every single GP here says the same thing. I've tried e-mailing specialists but I don't get a response one way or the other. In the UK they make 4.95 or something the upper limit of the TSH range.

The doc even said that the TSH level means I don't have an underactive thyroid it's just "at risk". Every single time I mention my low body temperature which I would think is one of the most obvious no-brainer signs they don't even acknowledge it.


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## blablabirdie (Feb 4, 2015)

Definitely can be symptomatic at 5.42. That is around what my TSH was when I was first tested (also based in Europe, but north of you). The doctor requested further tests and then ran a free t3, free t4 and TPO test. My TSH three days after the first test jumped to almost 8. The doctor thought that was weird, but still felt I did not have full-fledged thyroid disease yet (despite almost 500 TPO count).

Thankfully, as he had been treating me for a year for depression and anxiety, he agreed to let me try a low dose of levothyroxine to 'humor' me. That was a year ago. He just upped my dose to 125 mcg and admitted in our last appointment that he had made a mistake. I made sure to let him know that my depression and anxiety disappeared after about 1 month on thyroid meds, as they had been symptoms.

Please, keep pushing to get this jump started. I still feel like I lost a year of my life being treated for the wrong thing. As soon as I started on this med I felt like myself again.


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