Consistently sub clinically hypothyroid...

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Hi all,

​I've had three blood tests done over the last year or so and each time my TSH has been in the 6-7 range and Free T4 in the lower end of the range around 13 (in a 12-22 pmol/l) Free T3 in the middle of range and Total T4 at 80 or so at the lower range end (64-142 nmol/l). Antibodies virtually not there.

The endo I saw suggested trying 25mg of levo to see if my now permanent symptoms were eased but my GP wasn't happy about doing this.

​I'm not asking for any medical opinions but is it possible this "sub clinical" hypothyroidism can really wreak such havoc with my life? Dizziness, foggy head, tiredness etc etc. Some days like today I can't do much at all, others I can function, others I'm ok aside the constant hangover from hell feeling. My temperature is running 1.5c below normal but the endo said this wasn't clinical evidence of anything. And to be fair I don't suffer cold extremities.

​I'm a 53 yr old male if that means anything!

​Thanks for any thoughts.

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  • Posted

    Chris, I would take your endo's advice. All the reading I have done suggests that TSH around this level shows your thyroid is struggling and would benefit from a trial of 25mcg thyroxine. If uou do so, take it one hour before food and don't eat for four hours afterwards as food can impair the absorption of thyroxine. Also avoid iron and calcium supplememts for four hours. Get yiur Ferritin kevel checked as it needs to be 70+ for your body to process thyroxine properly. Get vitamin B12 and vitamin D levels checked.

    Look on website tpauk, register and look under resources to find out more. All the best.

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  • Posted

    By the way the symptoms you describe are all those of hypothyroidism. Which fits with the rwised TSH.
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    • Posted

      Thanks Barbara, my ferratin is 112 in a 30-400ug/l range and B12 is 960pmol/l or so due to me supplementing as I had a radiologist suggest deficiency as a neck MRI showed cord T2 intensities that the neuro couldnt explain so I decided to take the initiative, it was 260 previously. Apparently not MS just now - this was one of the routes of investigation. Vitamin D was ok.

      ​I also get pins and needles, hot spots, twictching and a weird facial tightness/tingling and oddly plantar fasciitus which I have read as being linked to hypo. You can probably see why they looked for lyme/MS etc!

      The endo was quite firm that I didnt have hypothyroidism but suggested a trial run!

      ​Thanks again.

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  • Posted

    I can only say a little because I haven't learned about what T4 and T3 levels mean - but my TSH was a little over 4 and I was having all those symptoms that you described plus weight gain and stiff muscles and joints, I am already on levothryroxine 112 but with the symptoms my doctor raised my dose to 125. So having a TSH in the 6-7 range sounds crazy and horrible to me. Yikes. 

    And that would not be subclinical where I am, that would be full blown hypo, my lab says anything over 4.5 is hypo. But again I don't know what the T3 and T4 mean...

    But did your GP give you a reason for not wanting you to take the levo?

     

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    • Posted

      Hi liza....I forgot to mention the stiff muscles and joints!. I have put on 8 pounds in 3 months despite forcing myself to exercise and keeping the calories down.

      Hair loss I'm afraid is a given at my age being male so I don't really worry about that one!

      ​In the UK the sub clinical range is up to 10 hence the GP not wanting to prescribe anything. The low range T4 also is an indicator that things arent right.

      I'm tempted to buy levo online and just go with what the endo said though that would leave me some explaining to do at my next blood test!

      ​Thanks for your reply, it is appreciated. 

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    • Posted

      I'm in th UK and at my lab the TSH range is 0.4-4.9. As you are between 6-7 you are likely to feel sub-optimal (understatement!). Research shows that most people who are subclinical go on to develop hypothyroidism and need thyroxine. However not all people do and with your lack of antibodies I suspect your GP is hoping it will sort itself out. The two main causes of hypothyroidism are iodine deficiency and autoimmune. If you have the autoimmune type your antibodies would be high. Which leads me to ask which antibody tests you had done. There are two tests and it is possible to be low on one and high on the other. Hypothyroidism is diagnosed if you are high on either. The tests are TPOA and TGab. What us your iodine level like? You may want to take a multivitamin. Note too much iodine is toxic. Like with everything there's an optimal level. Talking of which, my lab's range for B12 is 200-900 so your results would be above the high limit, so you may want to reduce the dose of B12 you're taking.
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    • Posted

      Have another chat with your GP. As your endo recommended thyroxine, if you say you feel rough and ask to try it your GP should let you.
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    • Posted

      For info, subclinical hypothyroidism is where TSH is high but T4 is in range.
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    • Posted

      Hi Barbara...just quickly my anti thyroglobulin is less than 10 ku/l normal less than 115 and anti peroxidase is 10.9 kui/l normal less than 34.

      I'm not sure iodine was tested, is there a shorthand lab code for that, I could check in the morning?

      Yes the lab I use has tsh at 4.2 as the higher range limit but the GP doesn't want to prescribe below 10.

      Thanks very much for your help!

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    • Posted

      Barbara

      You are very knowledgeable about the thyroid issues. I was wondering what you thought about the following .

      TSH, T3, T4, Thyroid antibodies.

      I do not understand these values at all.

      How is a subclinical hyperthyroidism diagnosed and what is the treatment/management?  Many thanks

       

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    • Posted

      Sub clinical hypothyroidism is diagnosed when TSH is above normal but T4 is in range. In UK, NICE guidelines suggest a trial of 25mcg thyroxine to treat sub-clinical hypothyroidism. If you want to know more about how it all works, register on tpauk and read the articles under the 'resources' title.
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    • Posted

      I am inbthe UK with a very supportive GP running all my blood tests. Iodine test is very specialised and even my GP can't getit done. As you can't get the blood test to test for iodine deficiency, I suggested taking a multivitam in to see if it improved matters. Another thing that mght help is avoiding gluten as I've read there is a protein in gluten that is similar to that in the thyroid. If I were in your position, depending on how bad i felt, I would do the following: if I felt bad pursue the GP for a therapeutic dose of thyroxine. If that fails, or you don't feel too bad, try the multivitamin for 3 months (but stop your other vitamins) to see if there is any improvement.

      Alternatively, could you get your endocrinologist to prescribe thyroxine?

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    • Posted

      Hi Lucy...sub clinical hypo is a blood test and is called sub clinical as generally t3 and t4 will be in range but tsh will be higher than it should be. Also antibodies will be normal so no Hashimotos. I was told by my GP it was due to my pituitary gland working harder than it should and producing too much tsh and that the thyroid currently was ok as the t3 and t4 were ok. Hence she didn't want to medicate...even though I feel crap much of the time. I guess you meant hypo and not hyper?
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    • Posted

      Hi Chris

      Thanks for your reply.

      I did mean HYPER not hypo but thanks for taking the trouble to reply.

      I have been unable to get any answers about subclinical HYPERthyroidism so decided to enquire about the condition on this forum hoping that someone may be able to assist me.

      My TSH was low being 0.12 . The antibodies were within the normal reference range. However I do not understand why the antibodies were there in the first place!!

      I feel mystified at all this. I also have a multinodular goitre. 

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    • Posted

      Hi Chris

      Why won't the dr treat you it is very unfair to let someone suffer these horrendous signs and symptoms. have you seen TPAUK?

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