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Posted 3/20/2024 10:15 AM (GMT 0)
I know there have been previous discussions re thyroid and this isn't specifically about Lyme, so I hope it's okay if I post about this here? because I know that some people here have thyroid issues so I thought you might be able to help me out!

My GP referred me to an endocrinologist due to low T4 and normal TSH levels which can indicate an issue with the pituitary gland causing thyroid disorder.

TSH my result 2.00 reference range - 0.27 - 4.20

T4 TOTAL my result 81 reference range 66 - 181

FREE T4 my result 11.1 reference range 12-22

FREE T3 my result 4.12 reference range 3.1-6.8

Anti-Thyroidperoxidase Abs my result 15 reference range <34

Anti-Thyroglobulin Abs my result 14 reference range <115

I had the appointment with the endocrinologist, who said that if there was an issue with the pituitary gland then other hormones such as oestrogen would also be off so I would have issues with menstrual cycles which I don't. Is this correct?

He also said that I would be gaining weight which I'm not. Is this correct?

He also said that my T4 would continuously be decreasing, which it's not it's stayed the same for the last year.

Due to these reasons he said he doesn't think I have subclinical / central / secondary hypothyroidism. Is this correct? What do you think?

I'm thinking of seeing Georgina Conway at The Thyroid Clinic for a second opinion. Any input, suggestions or advice would be appreciated! thank you!
Posted 3/20/2024 12:43 PM (GMT 0)
no elevated thyroid antibody levels - so in theory no active auto-immunity - which is good

but still a just slightly higher than ideal TSH - indicating your body is asking for a bit more thyroid hormones
(real actually fully healthy people have a TSH below 2)

Free T3 and T4 both a bit low in range - as is total T4 ( though still considered "normal" by the NHS because of the poor general health of the reference population - which, unbelievably, includes people with diagnosed thyroid disease) so all consistent with a slightly underactive thyroid output and possibly mild conversion issues

my guess is some other condition - like ongoing chronic inflammation is just messing with the levels a bit - chronic inflammation messes with the regulation of all hormones.

nutrition is the other factor - some things are necessary for proper thyroid hormone production - eg minerals - like iodine and selenium - probably magnesium - and some things - like goitrogens in the diet - can block thyroid hormone production. cruciferous vegetables and pseudo grains like millet(is from same family is mustard, broccoli etc) being the best known ones.

i think the endocrinologist's statements are broad rules of thumb they use - rather than statements of fact

i hope its of some help
Posted 3/20/2024 2:35 PM (GMT 0)
No active antibody levels to be concerned about.

TSH varys per individual and is not a good way to judge thyroid levels. FT3 and FT4 rule over it. You are slightly hypo.

Your labs look like mine and anyone's who is currently using a combo pig thyroid of T3/T4 hormone, and needs more of it.

Are you on any type of thyroid hormone or a sup that contains it?.

Your T4 is hypo, but your TSH is somewhat normal because your body is currently operating from T3.

T3 is made from T4 in your body, (unless a person takes additional T3)

Endos always like a baseline Pit organ test and or image. Its what they do. Not a bad idea.
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If your Ft3 elevates more, while Ft4 is low; get a reverse T3 test. A stressed body can go hypo with T3 not being used (just accumulating in blood). Cell T3 receptors can get plugged. Endos are NOT schooled in this part. It is real, Ive had it. Alternative Drs usually know rt3. Stop the thyroid maddness site shows how to calculate it.

Post Edited (astroman) : 3/20/2024 8:31:36 PM (GMT-8)

Posted 3/21/2024 12:40 PM (GMT 0)
yep - i think a RT3 test makes sense

inflammation actually drives the conversion of T4 to more RT3 and less T3 - so you can end up with less free T3 and what T3 is there being less effective - because the reverse T3 is blocking the T3

there are reference ranges for what ratio your RT3 and T3 should be in - so its a fairly straightforward test
my guess is yours is likely to be a bit higher than ideal - in line with the above chronic inflammation scenario

UK endocrinologists - especially those on the NHS - are generally very poor and very dogmatic

let us know how it goes
Posted 3/29/2024 5:54 PM (GMT 0)
thank you so much for your responses! I haven't decided what Im doing yet but I'll keep you updated

I found this article which I thought might be helpful or of interest

Hypothyroidism of the Muscle? A New Thyroid Subset Emerges in ME/CFS
Posted 3/29/2024 6:04 PM (GMT 0)
interesting article

i maintain that many people with lyme etc have many auto-antibodies circulating and contributing to their symptoms- just that we do not have tests or names for most of them - so they go under diagnosed
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