Odd thyroid results - what does this mean?

[celestialsquirrels]

I have been feeling rotten, exhausted, have gone from 10 stone to 12 stone for no reason in 5 months, racing heart, dry skin and hair. So I went to get my thyroid checked.

TSH is very low at 0.01. Plasma free T4 is 26.3 and free T3 is 8.2.
I am seeing my GP about the results in a couple of days, but the receptionist said I need a thyroid antibodies test. I don't really know why.

I was expecting to be hypothyroid but this seems to suggest I am hyper. So why the weight gain?!

All thoughts gratefully received.

Your TSH dioes suggest hyper, yes. Your T4 also sounds quite high, but I can't remember what my normal T4 was so may be wrong on that. I am not sure why you have gained weight, but a friend was tired all the time when hyper, rather than hypo. I get palpitations when mine is too low, so it there is some symptom overlap. I would see what the GP says, obv, but maybe you need to see an endocrinologist to get a better picture. Sometimes it isn't as simple as hyper or hypo, you can veer between the two, swinging up and down, or you can have a problem converting T4 to T3.
Thyroid stuff is horrible, so i hope you get sorted out properly.

Thanks hellymelly. On googling (I know, I know!!) I get info about Graves' disease... Oh dear. My heart is skipping about very oddly but my metabolism seems to have packed up. It is very odd. I may push for an endocrine referral, good idea.

I had hypo symptoms when I was hyper and vica versa! Hope the GP is helpful

Ooh how odd! It's very disappointing - I'd hoped that if I was hyper I would at least get skinnier, not fatter! Damn

If you stop properly converting T4 to T3, then you can have a low TSH and a normal or high T4 but as no T3 is reaching your cells then you feel tired out and get fat, but your T3 is also too high I think, from what I remember of normal levels. I am hypo so mine are usually the other way round. Your bloods do strongly suggest hyper. Thyroid things are far more complex than they are presented as it is a chain of events that make up a healthy functioning thyroid. Any weakness in the chain can cause problems.

As Hellymelly says, it isn't always down to thyroid function, it can be a whole range of endocrine issues (adrenal function, pituitary etc.) The nurses are used to expecting antibodies tests with your results and symptoms because often, when hashimotos (the other auto-immune thyroid disease) symptoms first present, it is usually with hyper symptoms and by the time the test is done the cycle has shifted from hyper to hypo.

Sorry, long sentence! :D

The nurse isn't necessarily right though! I didn't go to the doctor until the hashimotos was well underway and I was thoroughly hypo. The nurse doing the blood test couldn't get any blood from me so rebooked but she cancelled the auto immune test because I 'wouldn't need it' because she knew I wouldnt have hashimotos. I rebooked it and my auto immune antibodies were sky high!

So yes, see what the GP says and if you are offered an endo referral, grab it!

bestpractice.bmj.com/best-practice/monograph/1121.html

There could be a number of causes of this scenario and yes, antibody testing may help to sort out what is going on.

Follow the link and look at the table. You may need more than one sort of antibody testing to get a true picture.

OP I have hashimotos disease ( body producing thyroid attacking antibodies) and for many years my thyroid veered between being under and over active, which various doctors did notice but never actually put two and two together until afterI had my first baby.

It may be that you have been under active for a period and now have swung into over active.

What is the difference between Hashemites and Graves? I have read that a tsh as low as mine can be a good indicator of graves. I will read that link, thanks v much RockingD.

Hashimotos! Damn auto correct

Hashimotos is an auto immune condition, so the body produces antibodies against the thyroid and attacks it repeatedly, damaging the function. Graves disease is another auto immune disease, but it causes an increase in thyroid hormone release, so you have too much T4 and T3, rather than a thyroid that is unable to produce enough. There is quite a lot of symptom overlap between the two conditions.

Hi everyone - saw GP this am. He has put me on 30mg carbimazole and propranolol beta blockers, ordered antibody blood test, referred me to specialist endocrinologist and I have to go back for repeat full bloods in 4 weeks. Consultant appt probably won't be until end of August.

Let's hope I get on with carbimazole...

It sounds as though you are being well looked after. It can take time to adjust to the various medicines involved and sometimes the dosage needs to be adjusted, as you're probably aware. Glad you are on the road to recovery and have some answers. Hope the endo you see proves helpful too and, as you say, you get on with the carbimazole.

Thank you! Swallowed my first pills. Fingers crossed!

Yep, just keep taking them pills. (And read the leaflet and get to a medic with any serious side effects, obviously.)

Are people with graves likely to have to keep taking them for life (as with Levothyroxine for hashimotos) do you know?

I don't think so, I think either it sorts you out or they move onto either radio-iodine or surgical removal of the thyroid...

Ah, I see. So it has a permanent effect on the thyroid itself.

Graves and Hashimotos are similar, related auto immune diseases. Both can occur in the same family.