Hiya

After some advice re: my Free T4 level.

I had my routine quarterly check up with my diabetic nurse yesterday. Bg's are fine and all other bloods had been marked as normal. However I have been feeling emotionally and physically exhausted for about a month now and was concerned about my thyroid function. My TSH was bang in the middle at 2.1, but my Free T4 is 10 (Range 10-24). I'm in the UK and presume we use a different unit of measurement.

Anyhoo, my question is, altho marked as normal (and indeed my TSH seems to be) can I still be having thyroid problems with that Free T4 level? I'm seeing my doctor tomorrow and would like to know a little bit more before i go. Forearmed and all that....

Thanks

Yes, your Free T4 level is low. It would be considered borderline low because it is still what they would call within the normal range. They can give you T4 only to help bring that level up. That is why you are exhausted. I just went to my endo. yesterday and have been on Armour a little over a year and a Compound T4 for about 3-4 months. I told her that I felt like I wanted to take a nap around 4 and so she up my T4 by 5mcg. and hope that it will help.
Nat will be joining this conversation soon. I guess I may have beat her again. She has awesome advice and is very knowledgeble.
Keep us posted.
Dolores

Hi Fletchi! As Dolores has said that FT4 is low. I would go one further and say it's not just low, it's VERY low (regardless of what the damned range says!). It is most definitely the cause of your extreme fatigue. Women typically feel best when their FTs are in the upper 3rd of the range, for you that would be 19.3. You can see you're pretty far off that number!

As for your TSH, it is not 'normal', it's elevated. The lab range most commonly in use is much to wide. It's so wide it actually contains 'sick' people. The American Association of Clinical Endocrinologist has recommended that the lab range be changed to .2-2.04 and ANYONE with a TSH over 2 should be given (and would probably profit from) a trial of replacement thyroid hormones.

Further if your problem is related to hypothalamus or pituitary your TSH would be meaningless. TSH is a measure of how well your pituitary thinks your thyroid is doing. A TSH of 2 indicates that while you're not 'normal' your pituitary thinks that a FT4 of 10 is OKish and it is not telling your thyroid (via more TSH) to make more thyroid hormones.

What you want, ideally, is to have your FT3 levels tested and antibodies. If you have autoimmune hypothyroidism (the most common type) then antibodies will be present before TSH starts going haywire. Most Drs wont go this route, but it never hurts to ask. FT3 levels would tell you if you are converting what little FT4 you have to T3. Low FT3 is connected with depression, anxiety, moodiness and bloating.

There is another member here from the U.K. (JayKay) who went through the very same thing you might be headed for (unresponsive drs). She managed to find a great specialist with the help of the TopDoc list of thyroid-info.com. I would suggest having a peak there. I'd also check out her posts. (initial post: http://forum.lowcarber.org/showthre...ighlight=Jaykay and most recent results: http://forum.lowcarber.org/showthre...ighlight=Jaykay)

Cheers,
Nat

Thank you both for your replies and the very useful info. As I say I'm seeing my doc tomorrow. She has always been very good before....

I'll be sure to let you know how it went

Thanks again

Hi Fletchi - just caught my name on this thread! The ThyroidUK forum has a list of good thyroid doctors in the UK and where they practice - many of them private unfortunately. I went to see Dr Wright in Bolton privately, though to be truthful he's branched off into chronic fatigue and infections causing these so maybe doesn't focus on straight thyroid problems as much as he did, though he was great with me and answered all the questions I put to him (instead of refusing to countenance what I was suggesting, which is what my GP's have done). The other forum I belong to, which is much more active and also discusses which docs to go to, is http://forums.about.com/ab-thyroiduk/start/
You could just put a thread on there saying you were looking for a good thryoid doctor in x area and someone would know one - they seem to have found good NHS people too.
All the best, Jay

Thanks Jaykay for the info.

I went to my doctor today and it went well. She did seem surprised that I wanted further investigations re my thyroid, but she listened to what I had to say and read the post from natrushka that I'd taken along with me. I have always had a very good relationship with her and seems to respect the fact that I'm the best judge about what's happening with my body. ( two years ago I told her I was sure I had diabetes and that proved to be true so I have a good track record with self-diagnosis )

Anyhoo... i'm having Free T3 and antibodies tested (as per Nats instructions - thank you!!) and she is going to read up about thyroid and also adrenal fatigue because I asked about that too)

All in all, from what I've read about other peoples problems, I think my doc is a "keeper"

thanks again

Wow, Fletchi, I agree; she's a keeper! I'm also floored that she took my advice to heart and is getting you the tests that will really help figure out just what's up! Most Drs roll their eyes as soon as you say "online support forum" or even "internet". I sure hope I didn't make any spelling mistakes

Please let us know how the tests come out. I'm so happy for you!

Nat

Yeah!! Another great doctor!!!

Dolores

Good result Fletchi - i'm really glad! Put that lady's name on the UK thyroid websites, she might just get a flood of patients.
My doc rang me to see if she could come round 'for a chat about all of this, it looks really interesting and I've had several patients asking about Armour. I've said no so far but I'd be interested to know what you think of it....'. She just lives over the road - hasn't been over yet but I was out all last week. So - I hope she' s going to come and learn and be open minded - I'm hopeful she might!
Take care, Jay (who was born at her Gran's, in Chatham)