"Higher than optimal TSH level. Suspect: Possible low grade/sub clincal hypothyroid state in absence of any other causes, since the TSH level is the most sensitive indicator of thyroid function."
So you're saying that these results look unusual i.e. not the typical hypothyroid case? The test was taken around the same time 9-10am. You'd expect TSH to be near it's peak therefore. One thing is clear, based on TSH levels alone the system is amiss, shouldn't a healthy state warrant a TSH of 1-2? My Total thyroid output looks normal but possibly a bit sluggish? If my FT3 is high/optimal then that means i'm converting well - perhaps this is due to lower than normal (for me) TT4 output, resulting in this compensatory mechanism?
Another thing, how does RT3 factor into this if at all? Levels appear normal and my understanding is that RT3 is only useful to know if there are conversion problems and there don't appear to be any
Yes clearly I don't have Hashimoto's or any other autoimmune process.
Do you know how adrenal fatigue affects TSH? If one is hypothetically suffering from it would that reduce thyroid production and thereby raise TSH? A higher than normal FT3 could then be a compensatory mechanism as mentioned. All of this is just my supposition.
I have several symptoms of hypothyroidism but also of low adrenal reserve (Dr. Peatfield's book).
Great, so according to Panel 7- Normal or raised TSH, raised free T4 or T3...
Possibility 1 - antithyroid hormone antibodies
"If results of the free T4 and T3 assays are widely discordant with each other, or with the clinical status, then antithyroid hormone (anti-T4 and anti-T3) antibodies interfering with the assay should be suspected. Interference can cause considerable confusion, since it is more common in free rather than in total thyroid hormone assays, and autoantibodies develop in individuals who already have autoimmune thyroid disease and disturbed thyroid
function."
My TG and TPO are within optimal range which suggests I don't have autoimmune thyroid disease. If antithyroid hormone antibodies can be present in the absense of autoimmune thyroid disease/autoimmune thyroid antibodies i.e. TG and TPO, then this could be one possibility.
"Discordant free T4 and T3 results are also seen in familial dysalbuminaemic hyperthyroxinaemia, in which the individual is euthyroid but a defect in albumin
results in increased affinity for T4. This disease causes interference with both total and analogue free T4 assays, but free T3 concentrations are usually normal."
T4 and FT4 looked normal i.e. mid-range and FT3 was to the right of both. Although my symptoms appear to be congruent with hypothyroid not euthyroid. The disturbance appears to be to the FT3 only.
"The two rare but important clinical conditions, in which detectable TSH is associated with raised free T4 or T3, are thyroid hormone receptor mutations that lead to resistance to thyroid hormone and a TSH secreting pituitary tumour. Features that distinguish these two conditions, and favour resistance to thyroid hormone include: family history of thyroid hormone resistance (dominant inheritence); absence of a pituitary lesion shown by computed tomography or magnetic resonance imaging; a normal -subunit/TSH molar ratio; a normal
sex-hormone-binding globulin concentration; a normal or exaggerated TSH response to TRH; and inhibition of TSH secretion following T3 suppression. The concentration of thyroid hormones or of TSH (usually in the laboratory normal range) does not differ significantly between the two conditions."
No mention of adrenal fatigue as a possible source of interference???
Thankyou, I'm most certainly not hyperthyroid despite my elevated FT3 and all my symptoms point towards a hyperthyroid state. Reading Dr. Peatfield's book has made it all clear:
"The blood levels depend mostly on what's happening to the thyroid hrmones. If the cellular receptors are sluggish, or resistant, or there is extra tissue fluid together with mucopolysaccharides, the thyroid won't enter the cells as it should; so that part of the hormone is unused and left behind, giving a falsely higher reading to the blood test. It is simply building up unused hormone. This may apply to both T3 and T4. Further complications exist if the T4 -> T3 conversion is not working properly, with a 5'deiodinase enzyme deficiency. There will be too much T4 and too little T3. If there is a conversion block, and a T3 receptor uptake deficiency, both T3 and T4 may be normal or even raised. The patient will be diagnosed as normal or even over-active, in spite of all other evidence to the contrary.
Adrenal insufficiency adds another dimension for error to the T4 and T3 tests. Adrenal insufficiency, of which more anon, will adversely affect thyroid production, conversion, tissue uptake and thyroid response. It may make a complete nonsense of blood tests."
So my guess is that I either have a tissue uptake (thyroid hormone resistance) or pituitary problem. Any clue as to how to test for these?
I've only just realised that we've corresponded before on other threads!
I would say you probably have more of a problem with adrenals and stress than with your thyroid. The two sets of problems have a huge range of overlapping symptoms. However, you've mentioned losing weight under stress ather than putting it on, and that seems to be the biggest clue, pointing to adrenals rather than thyroid.
I'm a hypoadrenal person, and probably have been my entire life. I inherited some of this from my mother, who had chronic fatigue, and I nearly died at birth... a stressful start in life kind of wrecks your adrenal function. I've been able to manage it more or less, it's just been part of who I am.
In the last few years, my digestive system started to fail. There are bunch of nutritional deficiencies that cause low body temperature (iron, zinc, copper and vitamin B1), and low cortisol output seals the deal. I went seriously hypothermic from lack of iron and zinc, and still have days when I'm very cold. Cortisol output definitely still affects my body temperature. On a "public" work day, such as attending a conference, I'm mildly stressed out, but warm for a change!
Of course, I'm not saying that you are like me and have the same problem - we've never met and there are 1000s of possible underlying health conditions that you might have. However, whatever health problem you do have, adrenals usually come into things at some point.
To answer your earlier question, I don't think adrenal problems really affects TSH until they are extremely advanced and you have full blown chronic fatigue bordering on adrenal insufficiency. At that point I believe that you will start to see TT4 come down (that's total T4) and then TSH might start to go up a little. However, in some people they might produce more RT3, and the TSH will stay low.
Adrenal fatigue does involve the pituitary in the brain... but it's not broken, everything gets downregulated due to your body's reaction to stress. In chronic fatigue, those reactions become over-reactions and eventually lead to mitochondrial failure (low energy output from every cell). There are no good tests for this kind of thing. You cannot easily measure tissue uptake of thyroid hormones, and even if you could, I doubt that adding more hormones is the correct treatment.
If you have adrenal fatigue, then this is an adaptive mechanism - albeit one that makes you feel rotten. There's an interesting book called "CFS Unravelled" that looks at the nervous system response to stresses and the various physical malfunctions that tend to crop up when the adrenals are struggling. I thought it was good - although it was also free when I downloaded it. Otherwise you could read Dr Myhill's guide to CFS. Whether or not you actually have CFS, I'll bet there are parts of those books that resonate with you.
Hi, funny, I can remember communicating with you before.
Even without testing I'd definately agree with the premise of adrenal fatigue interfering with thyroid function, possibly causing diminished number of receptors/less tissue uptake of thyroid hormones....this could explain why I had a high blood FT3 level. Otherwise, if cells were uptaking thyroid hormones adequately then I'd presumably have hyperthyroid symptoms which I clearly do not.
But one thing doesn't make sense, according to Dr. Rind's thyroid scale matrix
drrind.com/therapies/thyroi..., if I were to have adrenal fatigue then I'd expect low TSH, T4, T3. The most fitting category is "poorly effective thyroid hormone" which would suggest either nutrient deficiency, viral damage to mitochondria, toxic burden or diminished cell receptor sites to thyroid hormones. I may have an overlap between adrenal fatigue and hypothyroid, because I clealy have symptoms of both conditions. Like you said adrenal fatigue downregulates every process in the body and thyroid uptake could be one of the consequences. I'm expecting the results to the 24 hour adrenal test soon, this could confirm my suspicions. And i'll be seeing an endocrinologist at some point, i've requesting a referal, who knows how long that would take, but i'd imagine i'll be waiting months for an appointment.
I don't see a problem with thyroid hormones in the upper third of the reference range - that's what all the hypO people are aiming for! Mine are up at that level too. I find the comment that good hormone levels reflects poor tissue uptake totally bizarre.
I've found a bunch of things that affect my body temperature, but my thyroid hormone levels aren't one of them. My thyroid keeps getting tested because I complain that I'm cold, but my TSH has been remarkably stable over the years - it only changes a little bit according to time of day.
Llike I said, I believe that adrenal fatigue only affects thyroid output when it's turning into more advanced chronic fatigue. The effect on TSH and hormone levels may vary according to what degree of illness you have. Dr Rind has tried to simplify things, but we are individuals, and so I don't think it's possible to generalise completely and absolutely.
I have the chronic fatigue prone personality, and the inheritance. So far, I've managed to dodge that one. Fingers crossed for us both!
Well ok, I agree it might indicate good thyroid regulation, however then the question remains, why do I have hypo symptoms? I was refering to a quote from Dr. Peatfield (see above)...
"The blood levels depend mostly on what's happening to the thyroid hormones. If the cellular receptors are sluggish, or resistant, or there is extra tissue fluid together with mucopolysaccharides, the thyroid won't enter the cells as it should; so that part of the hormone is unused and left behind, giving a falsely higher reading to the blood test. It is simply building up unused hormone. This may apply to both T3 and T4."
He mentions T3 and T4 but what about FT3 and FT4?
In the two times I've tested TSH they've differed in value by >1.0, whilst being taken at approximately the same time 5 weeks apart. I don't know if this is significant or not as hormones fluctuate throughout the day? What is your typical TSH?
I think I might have full blown chronic fatigue, it's almost impossible to wake up in the morning and I routinely wake up during the night around 2-4am. Now i'd be disappointed if my 24 adrenal test came out "normal" that wouldn't explain anything. I think you must never discount genetics in any health ailment, in the end our genes only evolved to fit a particular environment that bares no resemblance to modern day lifestyles.
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Confused by thyroid test results
Confused by thyroid test results
Full set of test results finally
Full thyroid test results - advice please
full thyroid blood test results. HELP. 
