Thyroid help needed please. Consistent low T4 with normal TSH...

[LacksDaisies]

Brief history
41 yo female with depression. Was on 20mg but getting worse so increased to 40mg which hasn't helped. As had other niggling symtoms which could be thyroid related (chronic fatigue, weight gain, painful joints esp hands and feet, hair problems, the worsening depression) doc ordered FTT which showed possible thyroid problems and asked me to have further blood tests

Repeat test has come back, and although I don't know the exact numbers, the summary is "consistently low T4 with normal TSH"

Am booked in to discuss with the GP on Monday, and have tried to find out information but it would appear that thyroid results are a bit of a minefield and have left me more than a little confused. From what I understand the normal TSH could be a red herring as the brain overcompensates for an underactive thyroid by producing more TSH and that "normal" is a pretty broad brush anyway. I also found one snippet of info that said that fluoxetine may cause abnormal levels, and am worried that this will be dismissed due to the ADs even though there are lots of other symptoms.

any advice from those in the know would be greatly appreciated, especially things I should be asking my GP.

Poorly DS2 so have to post and run but will be back later.

TIA

indeed Leonie! My weight has just crept up gradually, but I haven't changed the way I est or what I eat, but it is much harder to lose anything. I stopped drinking over a month ago and that has made absolutely no difference which I am a bit peeved with as I was drinking rather a lot

Thanks for that 4plus1, it's one of the websites I found, but didn't realise it had a forum. I've been looking at pituitary problems but there is much less layman's information out there than for the thyroid and lots of it is a bit too scary to contemplate.

Feeling completely washed out today, but DS2 had a really disturbed night so that isn't helping. We were meant to be having a family outing, but I've sent DH out with the kids as I just don't have the energy.

thank for all your help

I have a mine of info to discuss with my GP!

Is anyone else having vision problems?

hi phipps, I get blurring sometimes, but that comes and goes. I have short sight in one eye and long sight in the other though so I just put it down to my wonky eyes as it does seem worse if I'm stressed or tired.

I am trying not to worry but secretly I am very scared. .

My left eye is blurry and I am fed up of rubbing it to try and clear it as it doesn't work and then it stings as it feels like when you get moisturiser in your eye.

might be worth getting checked over by an optician phipps; that way they can tell you if anything is physically wrong with the eye rather than as a result of something else?

I have under active thyroid and am on 200 mg thyroxine a day it has taken me years to get thyroid level right (i still dont really understand test results) but i was still feeling tired depressed ect had more blood tests done and turns out i have b12 anemia which can cause pain/tingling in hands and feet.I now have to have b12 injections every three months which has helped greatly,just wondered if your gp has check your b12?

aaargh joeyjog, not something else to think about!

I'm glad you are feeling better though!¬ I'm settling in for this to be a long haul, even though the letter from the doc says it's "relatively simple" to put right!

I have malapbsorption issues as a result of the coeliac disease, maybe I need to get various other things tested.

sorry to add to the brain overload i know how you feel have had a long haul myself,but all of your symptons rang a bell for thyroid and b12 aniemia,and if you have malabsorbtion issues definatly worth asking for a test. hope you get it all sorted soon and start feeling well again.

yes i agree too much thyroxine isnt good i was on 250mg at one point,it can be dangerous,i was getting auful palpitations ect but have found i have settled well on 200mg anything less and i start feeling tired ect again.

You might find these people helpful. My Dad has suffered from thyroid problems for years and he's found them really helpful. Is tricky because as you know is so personal and what is right level for one person can be very different for another. Hope you get some answers

The body converts T4 to T3 which is what your cells need to function correctly. The mechanism by which T4 is converted to T3 isn't well understood and from what I understand it isn't very easy to measure T3 reliably. Likewise giving T3 directly doesn't always reflect in raised T3 levels in the body. Also you may need to take T3 many times per day as it's not available in a slow release format.

TSH should rise if T4/T3 levels are low, and normally one would suspect a pituitary fault if this was happening, but I believe that not everyone's TSH levels respond to a lack of T3/T4 in the body in the same way and that the accepted normal TSH ranges may not be valid.

The way thyroid problems are dealt with in this country are appalling. GP's seem completely uninterested in finding the causes of problems - they just hand out the medication. I've just been for my third blood test having had a request for TSH T3 & T4 measurements - on the form. The results came back as just a TSH measurement - they might as well tell you how windy it is - it would be just as useful!!.

I'm on 200mg of Thyroxine and am still feeling cold, lacking in energy and have broken nails. Hopefully I'll get to see an endicrinologist after 5 years of asking.

Has anyone been privately for help with this? I have posted in chat about how I couldn't get an appointment for weeks with my original doctor so saw another one and he pretty much told me to go away.

LacksDaisies - I saw an optician only about 2 months ago for a routine eye test. Do you think I need another check?

If there was anything untoward I would have thought that it would probably have shown up during your eye test. Did they look at the back of your eyes?

the site that Leonie linked has information about when you aren't happy with the service you've received from your GP and how to go about getting a second opinion.

Am really worried about my appointment now as there seems to be a lot of difficulty in getting the right treatment

I'll update later!

Yes, I paid £10 extra to have the back of my eye photographed. I just feel so fed up with it all. I have no energy, weight gain, vision problems and apparently there is nothing wrong with me. [bangs head against wall]