Normal Thyroid Labs but extreme hypothyroid symptoms

[Steve-H]

Hi again, ontop of my unaswered question below could you please answer the extra few questions which i had a think about last nite relating to my indivudual case.

Could you answer or give to some explenation then if the full thyroid profile is normal, but now that i am on T3 thyroid replacement(92mcg) on a higher dose of your reccomended guidlines of 40-60mcg that 90% of my symptoms have subsided and my overall health has improved from about 1 out 10 to about a 7 out of 10 (1 being unwell, 10 being well).

My two new questions

When i went to the doctor and explained of my list of symptoms (yes i actually had a list as there were so many) because my thyroid labs were in range, the doctor said it was NOT thyroid related and offered me anti depreassants and offered to send me to a mental health clinic as i was "making my symptoms up" I did not take the anti depreassants or go the mental health clinic as i knew he was wrong. Fast forward to today after recieveing T3 thyroid replacement at 92mcg i am no longer depressed and my symptoms have subsided. Could you give an explantion.

Lastly if thyroid labs are normal how do you know how much of the T3 in the blood is actually entering the cells. Somebody could have partial cell resistance and while there thyroid labs would look normal there is no test at current (correct me if i am wrong please and name the test) that determines how much of the T3 is actually entering the cells and being used.

Thank you
Steve

[bikerchic]

Very good questions Steve,
I would like to hear the answers too

[motherelle]

Where are the answers there doesn't seem to be many answered questions !!!!!

Motherelle .

[Steve-H]

Bump ?

[Dr Graham Beastall]

I am happy to pick up the issue of the reliability of blood tests that is raised by Steve in the context of his own case.

I congratulate Steve on his research. I think that we can categorise his variables into three types:
1. Errors in sampling
2. Effect of other medical conditions on thyroid hormone results
3. Very rare disorders of thyroid function

1. Sampling errors are known but are (thankfully) very uncommon. They are easily addressed by repeating the test.

2. It is true that a wide range of acute and chronic medical conditions will affect the results of thyroid function tests. Thyroid function influences and reflects metabolic rate and so whenever any condition (other than thyroid disease) influences the metabolic rate then the thyroid will respond to that change. Therefore, routine or diagnostic thyroid function testing should be avoided in circumstances such as acute medical admission when the subject is known to have other health problems. The interpretation of the results of thyroid function tests should always take into account the overall clinical picture. Doctors are aware of the effect of illness on thyroid function tests.

3. Very rare disorders of thyroid function should only be considered when all other possible investigations have been completed and there is still an apparent mismatch between clinical features and thyroid hormone results. Referral to a specialist centre will allow the investigation of these possible rare disorders - but they are rare!

[Essexness]

Well I suppose the latest 'reply' to our question is a slightly new spin onthe usual " if your blood tests are normal your symptoms are not thyroid related " but it still amounts to the same problem . None of the so called "experts " I have seen are prepared to Listen to my symptoms or examine me much less even consider the "rare" causes so the net result is that I continue like many others on this forum to live what I consider to be a 'half life'. Gone is my figure, hair, vim & vigour & please don't insult my intelligence like many have, with comments like ' well it's only part of ageing , menopause, etc etc. " The sad reality is that most physicians within the NHS stick rigidly to guidelines to cover themselves & are so hidebound by targets such as patient turnaround time that their patients either give up & suffer in silence or seek out alternative treatments via the Internet or seek help from private practitioners in a desperate attempt to regain their well being . Clearly none of the practitioners I've come across have suffered in the same way as the patients posting on these forums or they wouldnt be so many posts . Perhaps if a few of them had thyroid disease & were treated(or should I say mistreated) like us, things might change!