oestrogen <18 at 29 years, Dr. says T4 free is normal?

[Faez]

Hello, would really appreciate someone more knowledgeable to take a look at my test results. Have been having very occasional light periods, skin has lost elasticity and feel I've aged 20 years in 1. The Dr. reckons my thyroid is normal and can't figure out why my hormones are so low, suggests I'm underweight because I fall just below the bmi range for my height. I've always been slight and eat a healthy, varied diet so am very sceptical that this is the cause.
She's referred me to an endocrinologist but the wait is many months so am in limbo, looking and feeling awful. I'm obviously very concerned about my long term fertility too. I've tried to lay it out clearly, thank you in advance.

OESTRADIOL, 17B (SERUM) - 10th May, day 3/4 of cycle
Serum oestradiol level < 18 pmol/L [45.0 - 854.0]
Oestradiol ranges shown for follicular phase

LH AND FSH (SERUM) - 10th May, day 3/4 of cycle
Serum LH level 0.6 iu/L [2.4 - 12.6]
Serum follicle stimulating hormone level 2.1 iu/L [3.5 - 12.5]
LH/FSH ref ranges shown apply to follicular phase

Thyroid function test - 25th Sept 17
Serum free T4 level 12.2 pmol/L [12.0 - 22.0]
Serum TSH level 2.21 mu/L [0.27 - 4.2]

Thyroid function test - 10th May 18
Serum free T4 level 13.6 pmol/L [12.0 - 22.0]
Serum TSH level 2.28 mu/L [0.27 - 4.2]

PROLACTIN, SERUM -26th March 18
Serum prolactin level 171 miu/L [102.0 - 496.0]

PROLACTIN, SERUM - 10th May 18
Serum prolactin level 133 miu/L [102.0 - 496.0]

CORTISOL (SERUM) -26th March 18 11.20am
Cortisol level 313 nmol/L
CORTISOL (SERUM) - 10th May 18 11.20am
Cortisol level 249 nmol/L

SERUM FREE TESTOSTERONE - 26th March 18
Serum albumin level 50 g/L [35.0 - 52.0]

SERUM FREE TESTOSTERONE - 10th May 18
Serum albumin level 47 g/L [35.0 - 52.0]
Serum testosterone level 0.4 nmol/L [0.29 - 1.67]
Serum sex hormone binding globulin level 111 nmol/L [24.6 - 122.0]
Serum free testosterone level 3 pmol/L [3.0 - 33.0]

You need an FT3 test. Your TSH is a tad higher than it should be, but your FT4 is only just in range and much lower than I would expect given your TSH, so you may have a thyroid problem.

I can't comment on the other hormone levels, but when you do see the consultant. Don't let him dismiss thyroid as a partial cause of your issues.

Thank you for your response, I am worried that I'll allow myself to be fobbed off again and be back at square one. There's an overwhelming amount of information out there, I'm thinking pituitary tumour now! Also I do know what bmi means, don't know why I added "for my height"..

I’ve had very similar issues since my mid 20s. I’m now 35 and still haven’t had a hypothyroidism diagnosis or treatment despite textbook symptoms as my blood tests have been all over the place.

I started doing private thyroid tests in september last year. The first one my levels were very close to yours (Tsh 2.03, FT4 12.5 and various other levels were all quite low). Repeated it in February this year but the levels appeared to have improved. Just did a test last week and my TSH has shot up to 5.95 and FT4 is 15.7 which is still not ideal.

You really need a broader spectrum of tests and especially antibodies. I would recommend doing a private test every 3-4 months and see what’s going on. I use Medichecks now, and it’s done via a finger prick at home. Unfortaunrely until your levels are actually out of range its impossible to get any help which is why so many order meds from abroad and self medicate.

I too thought a pituitary problem / central hypothyroidism when I got the results that were like yours but it seems my levels go up and down so I now suspect Hashimotos even though my antibodies are only mid range.

Thank you sink, that's really helpful. I've had a look at their tests and am debating which to get. The thyroid check plus rt3 is on offer but thyroid check plus might provide enough information and is much cheaper with the £10 discount applied. What would you recommend?

I don’t get RT3 as my conversion level seems good - I tend to get Thyroid Ultravit, it’s a good idea to get your vit levels checked at least once to make sure there’s nothing obvious there

I had my vitamins checked in Sept 17 and they looked ok.. I think:

B12/folate level
Serum vitamin B12 level 721 ng/L [197.0 - 771.0]
Serum folate level 8.5 ug/L [3.9 - 25.0]
Please note, new method in use as of 15/11/2016.

Bone profile
Serum calcium level 2.39 mmol/L [2.15 - 2.5]
Serum adjusted calcium concentration 2.19 mmol/L [2.15 - 2.5]
Serum inorganic phosphate level 1.05 mmol/L [0.81 - 1.45]
Serum alkaline phosphatase level 77 iu/L [35.0 - 104.0]
Serum total protein level 68 g/L [66.0 - 87.0]
Serum albumin level 50 g/L [35.0 - 52.0]
Serum globulin level 19 g/L [18.0 - 36.0]
Serum urea level 3.0 mmol/L [2.8 - 8.1]

Urea and electrolytes
Serum sodium level 142 mmol/L [136.0 - 145.0]
Serum potassium level 4.3 mmol/L [3.5 - 5.1]
Serum creatinine level 73 umol/L [44.0 - 80.0]
GFR calculated abbreviated MDRD > 60 mL/min [60.0 - 90.0]
EGFR COMMENT 1 eGFR should not be used in patients with acute
renal impairment.
EGFR COMMENT 2 If patient is of African-Caribbean origin the eGFR
result should be multiplied by a factor of 1.21
EGFR COMMENT 3 eGFR is not validated in pregnant women.

HbA1c level (DCCT aligned)
Haemoglobin A1c level - IFCC standardised 31 mmol/mol [< 42.0]

Liver function tests
Serum total bilirubin level 7 umol/L [0.0 - 21.0]
Serum alanine aminotransferase level 16 iu/L [0.0 - 33.0]

Serum ferritin level
Serum ferritin level 34 ug/L [13.0 - 150.0]
Serum C reactive protein level < 0.3 mg/L [0.0 - 5.0]

Thyroid function test
Serum free T4 level 12.2 pmol/L [12.0 - 22.0]
Serum TSH level 2.21 mu/L [0.27 - 4.2]

My thyroid was only checked in May as the nurse taking blood said it was unusual that they hadn't inc. it with the hormone tests as it was standard to do so at his last place of employment.
Thanks again, feel much better knowing there's something I can do instead of just plodding on for months without answers.