Need the low down on my thyroid numbers

[dickielongate]

In another thread about metformin I started, I had some helpful suggestions to look into thyroid.

At the time, I'd had two prior tests during the last 6 months, and was advised here on Excelmale things were worse than I thought. Looking into things away from the standard clinical approach, I came to agree.

I had:

Jan '19
TSH H 6.21 0.27 - 4.20 mIU/L
Free T4 17.80 12.0 - 22.0 pmol/L

March '19
TSH H 5.27 0.27 - 4.20 mIU/L
Free T4 13.80 12.0 - 22.0 pmol/L

There were cries of 'Hashimotos!'. I duly went off and did a more in depth test. Unfortunately I chose one without the RT3 test, because it was about 4x cheaper. I was mostly interested in antibodies in the short term.

TSH 3.46 mIU/L (Range: 0.27 - 4.2)
Free T3 3.96 pmol/L (Range: 3.1 - 6.8)
Free Thyroxine 17.100 pmol/L (Range: 12 - 22)
Thyroglobulin Antibodies X 491.000 kU/L (Range: < 115)
Thyroid Peroxidase Antibodies <9.0 kIU/L (Range: < 34)

As you can see, if you believe the standard stuff, everything is 'normal' now, thyroid hormones wise. But as many here will agree, 3.46 TSH is still not normal, and I at the lower end of FT3, and that's without even checking for RT3. Besides I started metformin (off label) two weeks ago, and I understand that its reductive effect on TSH can be visible fairly early on. I also understand, and if I'm honest I think most people don't, there is no evidence metformin's impact on TSH translates to a lowering of T4 and T3.

To my surprise, looking around a the standard diagnosis checklist for hashimotos, I cannot decide if that's a diagnosis which applies to me. You can guess probably that I think it does. What do you think? High TG and low TPO?

 

[Vince Carter]

I still think you need a in depth medical opinion on Hashi's, best any one here can do is refer you to a good Dr though I think the indications are good that something is wrong with your Thyroid and that that is likely what is wrong.

 

[Vince Carter]

Antithyroglobulin Antibody Test: Purpose, Procedure, and Risks

 

[dickielongate]

I still think you need a in depth medical opinion on Hashi's, best any one here can do is refer you to a good Dr though I think the indications are good that something is wrong with your Thyroid and that that is likely what is wrong.

Thanks Vince, what you say makes sense. Some more detail for the benefit of any other UK readers perhaps...

I have an appointment set up with my TRT provider's doctor. The TRT guys said my high TSH might be because of high E2, and he wanted to watch it. I am very happy with my TRT people, they are great, but I'm not convinced they handle thyroid problems as well as TRT.

You kindly pointed out in my other thread that you thought there was good evidence to look for other conditions. So I did my tests myself, and have now sent the results back to my TRT doc. I'll update this thread once I've had the appointment.

Thankfully I am better prepared for the conversation now, because I have a pretty good idea about how advanced the standard view point is on hypothyrodism/hashimotos in the UK. Case in point it is difficult to get them to test antibodies in the first place, and good luck persuading them to prescribe NDT, with all the usual false and outdated reasons likely being cited.

If I showed up with my TSH and FT4 results from any of my tests they would likely send me away. They would wait until my TSH was 10+ then offer me levothyroxine for life without ever looking at the causes of hashimotos. I have learned this through research, but found out this weekend my mother is hypothyroid, and this is EXACTLY what happened to her. She's never had her antibodies tested, something we're now going to put right.

I don't know how to go about finding a 'good' doctor in the UK. We have this thing called the NHS. You register with a doctor that handles your street. If you tried to register with a doctor that handles a different area, the answer is no. Even if you find a 'better' doctor that handles the same street, you are not permitted to transfer.

Other than that we have private health care, which I cannot afford. I'm not even convinced that standard private health care would provide any different outcome. Thank god for the internet. I contacted a couple of functional medicine clinics in the US, and they were kind enough to recommend some books, but couldn't point me to any providers in the UK. You guys don't have it so bad in some respects.

By the way, my NDT arrived from Thailand today, so I will start with this and see if it changes my fatigue.