Can anyone help with this thyroid result?

[Appervine]

An elderly relative has been having some word finding difficulties in the last few weeks. He was referred for various tests by the doctor and most of the results have been fine. He's being referred to a memory clinic and neurologist which is all good.

Something that concerns me though is his thyroid result. Doc says it's borderline and in fact better than it was last time it was tested. She said he could have a trial of thyroxine for a couple of months but that there might be side effects such as palpitations so he has declined it.

Results are: TSH - 6.89 mu/l (0.35-3.50)
T4 10 pmol/l (8-21)

Given that he is 80 years old and being referred for further investigations for a potential stroke I can understand his reticence but I know that a long-standing underactive thyroid can cause memory problems.

Do you think this result would be worth pushing for a referral to a thyroid specialist or is this result in the normal range for someone of his age?

I would say the word finding thing could def be thyroid related when my tsh was that high I was terrible with words. It's not borderline the range is around .2-4.5 so he's quite abit over plus the t4 is very low too.
The older you are the more side effects but I doubt he would get palpitations on a trial dose.

My thoughts too ELR. Given that these are supposedly better results than a year ago I think we can assume that the TSH levels have been high for a while.

His problems have really only been apparent for a few weeks though so I wonder if this is unlikely to be the cause - I would imagine it would be a more gradual deterioration and his has become quite severe over a matter of weeks. Still, I feel that he/we would be justified in pursuing this avenue even if we rule it out as a cause.

I can't understand why the doctor refers to this as borderline and was wondering whether the normal range was different for an older person or something.

Have you tried seaweed?

I read an article not so long ago commissioned by the World Health Organisation in partnership with UNICEF on Iodine deficiency in Europe.
Click on the link to take you to the document.
www.who.int/nutrition/publications/VMNIS_Iodine_deficiency_in_Europe.pdf

Seaweed is incidentally the richest natural source of this fragile element.

The article makes for interesting reading if only for the fact that you don’t expect to see the word Europe and deficiency in the same sentence.

Iodine is used by the thyroid gland in regulating metabolism and growth and up until around 15 years ago the accepted strategy for ensuring the population got enough in their diets was through iodized salt.
As we’ve abandoned salt this condition seems to have crept back.
I live in Derbyshire which has a history of goitre a condition caused by a lack of iodine, in fact it was so prevalent here at one time that the condition also became known as Derbyshire Neck.

Seaweed has a normalising effect on the thyroid gland having a positive effect on both hyper and hypothyroidism it’s also natural so no scary side effects to be worried about.
I’d certainly be inclined to try this for a few weeks before going down the thyroxin road.

Apart from iodine seaweed has an incredibly broad nutritional spectrum and also contains glutamic acid which is a natural flavour enhancer.
It’s a great health strategy not just for dealing with people on compromised diets but for everyday wellbeing, we use it in our cooking every day.

The ancient Ayurvedics had a great saying:
When diet is wrong medicine is of no use.
When diet is correct medicine is of no need

I hope things sort themselves out for your elderly relative.

I don't know if ranges change as you get older, but with a TSH over range and an FT4 result only 15% into the range, most people would very definitely be hypothyroid and symptomatic.

When my TSH went over 2.5, I could not complete a sentence, I forgot how to drive and I got lost in places I knew well. Terrifying!

Thanks Raymman and MrsTweedie.

Having done a bit if reading it seems that TSH does increase with age and treatment at his TSH level is a bit of a grey area.

MrsTweedie - did your symptoms come on suddenly or was it more gradual? His problems have only become pronounced in the last couple of weeks. Also he's not forgetful but is having problems finding words and explaining things so I wonder if that's more of a neurological issue.

Thanks for your replies. Will read about the seaweed!

There was a study done regarding Tsh in The elderly and they are cautious due to osteoporosis and heart stuff. At the same time it is out of range but a grey area as often they don't treat till over 10. I know they won't keep my mums Tsh low now, though I think she needs more than she has.

It IS however a common cause of dementia in the elderly. I get word finding issues at over 2.5 too.

He could try ultra low dose of 25 every other day and slowly titrate up to see if it helps/ causes side effects?

Be careful with seaweed, yes it contains iodine and if you are hypothyroid due to iodine deficiency then it's fine but if you are hypothyroid due to autoimmune thyroid disease(hashimotos) then iodine is not a good idea.

Thanks everyone. Actually have moved on very quickly. He's had a brain scan and it turns out that there is a serious physical reason for his problems.

I appreciate all your replies though.

Subclinical hypothyroidism doesn't need treating generally.