What is a normal Thyroid test result? Can anyone help explain it T4/TSH etc?

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hello, I have been on lithium for a few years for Bipolar 1 and about a year ago my thyroid test (which I have done every few months at the same time as my lithium blood level test) came back what my GP described as 'borderline low'. Because hypothyroid is a common side effect of long term lithium therapy he put me on 25mg levothyroxine to start, and then raised it to 50mg about 6 months ago. But I am still very overweight despite a really strict diet, totally exhausted to the point of near-narcolepsy! (i can fall asleep standing up!) my skin is so dry i leave white dust over all my clothes, my hair has gone grey and thin and my nails are brittle and curl over at the ends! (and i used to have such beautiful hair and nails, somehow its the final straw!) I just feel completely worn out all the time and cannot summon any energy or stamina at all - if i try to persevere I feel sick, dizzy and faint.

But GP says my thryoid test levels are now fine - but I cant challenge or query him on it because I cannot get my head around all the different test results and normal guidelline levels. Can anybody please try and explain it to me in a way I can remember when I talk to the doctor next week? Id be so grateful for some advice.

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  • Posted

    I feel very sorry for you but I do wonder if it is the treatment for your bipolar that is causing the problem rather the thyroxine. A friend of mine's son is also bipolar and although now pretty well medicated for the condition has flaky skin and a lot of your other symptoms.I am not a doctor but getting to grips with more than one set of symptoms can be confusing. All I would suggest is that you persist, I had years of trying to get my thyroid problems sorted out, the difficulty being that even within the parameters of normal levels there is a lot of variation as to where one individual will feel good.Maggie

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  • Posted

    Hi Maggie

    You have hit the nail right on the head there! Its like untangling an algebraic equation in my case because I have: Bipolar 1, osteoarthritis, carpal tunnel syndrome, serious joint degeneration in my spine, and methadone therapy (i used heroin in my twenties to self-medicate my bipolar). So interpreting symptoms from side-effects is...... complicated!

    However: i didnt have any of these physical problems for 2 full years on lithium - and when they began, my GP said 2 years was about the normal timeframe for lithium to start affecting the thyroid. (its well known to induce hypothyroidism, so he was ready for it). He was happy to prescribed thyroxine until my blood tests came to 'normal' - and yet i am still symptomatic.

    the problem is, he is concerned not to raise my thyroxine too high in case it triggers, or masks, a manic episode - and my mania is spectacular and destructive, so he has my best interests at heart - but I cannot go on like this. I feel about 103!!!

    Im sorry to hear about your own thryoid battle - its becoming to seem like a common theme. Ive heard of a book called 'Stop this Thyroid Madness now!' but im scared to buy it n case it jst makes me even more desperate and angry and powerless!

    The test results are just incomprehensible to me and i wonder if you would please try to explain to me the variation and different tests - it sounds like you have a lot of knowlede that I could tap into, if its not too unpleasant to go over old ground again? (The last thing I want to do is ask you to dredge up memories of a painful struggle with the medical profession).

    Id also b interested to hear if you have any experience with NDT (porcine thyroid supplement)? Some people swear by it, but it seems very difficult to obtain on the NHS - is it possible to buy it, for example?

    Thanks so much for replying - Its all new to me and i am facing a big learning curve!


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    • Posted

      How about you read a little book I got from Amazon which was written by the Dr who solved my thyroid problems after I had struggled for at least 5 years, I am now 73 but got treated properly almost 9 years ago by Dr  Anthony Toft.  He is a consultant Endocrinologist and well respected in the field and his book is called Understanding Thyroid Disorders and is in the Family Doctor Series and  was the President of the British Thyroid Association and a President of the Royal College of Physicians of Edinburgh. It only costs about £5 and lays out fairly straightforwardly tests done for underactive thyroid function and also comments on different types of treatment.  It has to be said that he is not a fan of Porcine thyroid supplement.  I myself tried it when I was having major problems over 13 years ago but I was never happy with it although better than when on only  synthetic Thyroid supplimentation. I saw a Dr Skinner privately who has had many people feel heaps better when taking NDT under his direction, and I certainly wouldn't try buying it without the support of a medic, you might land up with anything if you bought it over the internet. 

      What was marvbellous for me was that Dr Toft started me off on a reduced dose of Thyroxine(T4) and added just a little  triiodothyronine(T3). I have been on the same level of medication since I saw him in 2006.  The T3 is what the naturally secreted thyroid in the body needs to function and it is made normally by the thyroid gland and then converted when necessary by the body in order to make all the organs function.  For some reason it is thought that some folk are not good at doing this conversion although even Dr Toft has said it is not absolutely proven but a small percentage of people feel better when it is part of the mix of their medication.  My husband and also my son both are on thyroxine and are perfectly well on that but it could be that you might be better on a mix.  HOWEVER I think that the first thing I would push for is an appointment with your psychiatrist and if possible with an Endocrinologist because no GP is going to prescribe anything other than Thyroxine and unfortunately as is proved by all the unhappy patients still suffering from symptoms, not enough referals are made to the specialists, Dr Toft was quite cross about this. Dr Toft is now not in the NHS in Scotland but there are others who will prescribe  Best of luck. I hope this helps a bit.  I don't feel bothered by painful memories, it is just so nice to feel well.  Maggie

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    • Posted

      Wow Maggie thank you SO MUCH for such a helpful and infomative reply. Thats so useful - I will be off straight away to order the book you recommend. Theres so much nonsense on the internet I really do prefer to do everything properly through the medical system if possible, but its not going to happen unless I educate myself and know what to ask for!

      So yr advice is just what I needed - many thanks. I will read up, talk to the Docs (GP and Psychiatrist), and see if I can get that referral. You are quite right that Thyroid problems do seems to have a trail of unhappy, still ill patients not getting proper releif from symptoms, but I fought the docs for 20 years to get my Bipolar diagnosis, so I am not afraid of a fight!!

      Thanks again - and I am so glad you (and your husband and son) are now feeling well. And I promise not to buy anything over the internet except that Dr Tofts book!!!


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    • Posted

      I am so glad I may have been of some help,

      I wish you all the very best. If it helps please free to continue this conversation. Unfortunately no ones journey is the same but ! could have done with encouragement all those years ago. Maggie

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