Any advice on potential hypothyroidism? I am losing my mind...

[KhloePolitan]

Hi,

Could anyone possibly interpret my thyroid results?

TSH 4.02
Free T4 11.0

I have all the symptoms of hypothyroidism, which my mum and aunt have, but my GP seems to think the reading is fine.

Over the past few years, my TSH has gone from 2.8 then 3.2 and now 4.02. My free T4 has gradually dropped too.

I'm 33, if that helps.

I would appreciate any advice.

Best wishes

My TSH is 5 after medication to reduce it from 11.9, I've just started an increased dose as it is 5.0 with medication. Mine was in the same region as yours for years & called borderline, it took my hair coming out in handfuls for them to retest & diagnose hypothyroidism.

Thank you for your response.

I am losing so much hair, especially in the shower while washing it. It is becoming quite worrying. I've gained weight, I'm constantly cold and tired, my muscles ache, my skin is suddenly dehydrated when I've always taken such good care of it. Feeling this way is getting me down. I don't see the sense in leaving me to get worse until they treat it? So frustrating.

Seek a different GP opinion. If you have clinical signs that are impacting on your daily living and ability to live life and work in a healthy manner, a responsible dr should take all of this in too consideration.
I was in similar position years ago , saw dr 4-5 times who kept telling me to go away and come back in 6 months, saw another dr who started me then on a very low dose of levothroxine my life and work were transformed.
sub-clinical blood analysis results still indicate changes are occurring. I absolutely would go to see another Gp in the practice.

I'd be concerned that your FT4 is below the reference range, in which case, regardless of TSH, you should be treated.

My TSH was 14 when diagnosed 26 years ago and still struggling to get right. It was 5.9 in last test. When it was 4 it was classed as controlled.

TSH is towards hypo side of normal and T4 suggests ever so slightly hypo. I'm surprised you're having severe symptoms with numbers so borderline, but in my experience doctors (an endocrinologist in my case) treat thyroid numbers not symptoms.

I've never been in this position seeing as my thyroid tends to go haywire within a couple of weeks but I can understand why they won't treat someone with such mild numbers. Can you push that your T4 is a bit low? Maybe get a full thyroid panel and see if anything else is slightly off? Have you had other bloods done to see if you have other deficiencies that may explain some of your symptoms?

You could be borderline ad has been said. Another thought, have you had Covid in the last few months? Every time I get it my hair falls out in handfuls. It's normal after virus infections apparently.

OP if T5 above 10 and below 20 they say you are within normal range. I feel ill if my T4 is below about 13-14. Yours is 11 so you will feel unwell. The TSH is the body screaming out for more Thyroxine. Yours is only 4 but it will go up if you are left untreated. Before my thyroid stopped working I was a size 12. I had loads of energy. I felt bubbly. Late during my pregnancy thyroid stopped working. After I gave birth I put on a stone in about 5 weeks. I was freezing cold, tired, skin so dry, hair dry and falling out, terribly constipated, dry eyes. I felt crap. Eventually they did a blood test my TSH was 26 and T4 4.7. They started me on Thyroxine 25 mg for 3 months during this time symptoms continued and I put on 8 more pounds. Then retested blood had improved a bit but not much moved up to 50 mg. Then 75 then 100. The moment my T4 reached 10 they would not give me a higher dose. I have gone through years of putting on about 1-2 lb every month. I have begged for a higher dose but told no I am within normal limits now. I still feel crap. By this time a size 22. I moved 2 years ago and have different GP now. This GP increased my dose and I stopped putting on weight. Still have to lose weight but feel a bit better. Now my T4 is 13-14. I am waiting for Endocrinology appointment. Previous GP refused to let me see one. I would advise change GP if you have to. Don't put up with it like I did or it will ruin your life.

Could you say you are TTC? This may make them more inclined to start thyroxine as the preferred TSH level for pregnancy is less than 2.5.

Alternatively there are supplements which support the thyroid, I’ve found them really helpful (especially with hair growth!) although I was taking them alongside thyroxine. this is the one I took. You could try those in the meantime and see if they help?

@caringcarer I'm so sorry to hear you have suffered so much. I can relate to everything in your post and completely understand. GPs need to sit up and listen when patients are telling them how they are feeling. It's all well and good to stick within 'guidelines' but if a patient feels ill, they feel ill. I think I am going to see a different GP for a second opinion.

@minipie That might be worth a try. I just feel uncomfortable lying to the GP, but they don't leave you with much choice, sadly.

You need the thyroid forum on healthunlocked.com - masses of info and knowledgeable posters there.

healthunlocked.com/newsfeed

Sounds like it could be subclinical thyroid disease. Have they checked your antibodies? Also, have you had a full blood count done because a lot of those symptoms can also be a result of anaemia or vitamin D deficiency.

My numbers were ‘fine’ according to the GP, but I was cold, dry skin, hair falling out, irregular periods and had history of crazy swings in numbers and clearly abnormal antibody results, so I requested a trial of thyroxine. I took it for six months, and my TSH didn’t move far, but I felt my symptoms had improved so I was kept on it.

The GPS really don’t seem to be at all educated on this though.

OP, I recommend doing your own research. Thyroid disease demands you become your own advocate.

Healthunlocked.com - check out the thyroid board. It literally saved my life.

So, the GP called with the results.

TSH 4.89

Free T4 10

Given me family history, she has started me on thyroxin.

So glad you got it quickly and didn't have to battle for years feeling awful. I actually split my life in 2. Before thyroid problems and after thyroid problems.

OP, look at the website tpauk.co.uk - Thyroid Patient Advocacy. They will help interpret your results (really need to see your FT3 result and antibodies) and advise you on symptoms. Good luck - hope the levo works for you - it doesn't for everyone. TPA will help regardless.

@caringcarer Thank you. I've known something isn't right for around a year. I've become heavy and lazy, so to speak, but that just isn't me. I've also noticed that my head is foggy. I will go upstairs and forget what I went up there for. How long did it take for your levothyroxine to kick in?

I am so glad they’ve listened to you!

My numbers are pretty much identical to yours. Sometimes they were within range, but usually within the “sun-clinical”. With the same symptoms. My GP is lovely, so trusted that it wasn’t a concern.

I saw a consultant a couple of months back. As soon as he saw my blood test history he sent me straight to the pharmacy for levothyroxine and said take the first one immediately.

The first week I was still freezing cold. The second I was boiling hot. The third week I started to feel more normal. Two months on and I’m feeling like my old self!

My hair is still falling out, but not so much, my nails are stronger and longer. And I can eat normally again! For years I have been struggling to keep within normal BMI. If I had just one day where I wasn’t careful, I would be over the line and it would take weeks to get back under again.

I did find, in the first couple of weeks on levothyroxine, I gained weight more rapidly. I’m not sure how usual that is? Now I can eat adult sized portions and have been maintaining a steady and healthy BMI.

OP have they tested you for thyroid antibodies? This is to differentiate between a "generic" under-active thyroid, and Hashimoto's, which is an autoimmune condition where the body attacks and damages the thyroid until it can no longer function.

If the root cause of your thyroid issues is autoimmune disease (and the presence or absence of antibodies in a blood test gives a straightforward yes/no answer for this) then there are diet changes and supplements that can help.

I do have Hashimoto's and I'm still learning but it feels encouraging to know that there's stuff that I can take charge of that help me feel better - e.g. giving up gluten and dairy was an almost instant win!

Best of luck.

I was going to ask if they have tested your antibodies.
I have hashimoto's and as soon as my TSH goes above 3 I feel dreadful. So tired, brain dead by 4pm, flat mood, dry hair, itchy scalp, total feeling of inertia. In March I was feeling awful and had my TSH checked - GP tells me that a TSH of 6 was acceptable when I was feeling so crap. I was begging for a higher dose of thyroxine. Within a month of deciding myself to take an extra 25mcg a day I can't even tell you how good it feels to be 'normal' again. All those symptoms have subsided and TSH is now 1.3. Basically what I am saying is GP's appear to be woefully poor at managing hypothyroidism and don't even seem to follow national guidelines. If you can get a second opinion then it is definitely worth it, good luck.

I have had it since 2011.

I would get a full panel done with ft3 as well as antibodies. I use medichecks regularly especially now that I’m pregnant as want a full picture as my TSH fluctuates. Mary Shomon has good articles on this.

Yes this.

Can I ask how long does it take to start losing weight after starting levothroxine? I have been on 2.5 years & I have gained nearly 3 stone, my BMI is 41 now, I'm disabled & can't exercise.

I have not started loosing weight. I have stopped putting weight on. I am still very oversight from years of not being prescribed enough.