When we visit our GP with a list of symptoms, the first thing a GP will do is get you to have a blood test. Most bodily functions will be tested including the thyroid.

There are two tests for the thyroid – TSH and T4.

Let me explain:

The pituitary is a tiny gland in the brain behind the eyes and its principle role is to respond to the hypothalamus and send out hormones to glands around the body in response to various needs.

The hormone it sends to the thyroid is called the Thyroid Stimulating Hormone (TSH). TSH tells the thyroid to send out T4 (tetra-iodine-thyroxine or thyroxine) to combat the problems the hypothalamus is sensing by our symptoms. Conversely if the pituitary senses too much T4 in the blood then no TSH is released.

The thyroid has two hormones T4 and T3 (tri-iodine-thyroxine). T4 is converted to T3 in the thyroid and it is T3 that is needed by the body.

Selenium is the mineral that converts T4 to T3 and a healthy thyroid is packed full of it.

There are 7 computations of TSH and T4 levels in the blood that need to be checked:

1. Euthyroidism – T4 normal, TSH normal (this is a healthy person with no thyroid related symptoms)
2. Hyperthyroidism – T4 high, TSH 0
3. Hypothyroidism – T4 low, TSH high
4. T4 normal, TSH low
5. T4 normal, TSH high
6. T4 high, TSH high
7. T4 low, TSH low

The USA has two ranges of what normal is for TSH:
Old Normal: 0.5 – 5.0
Under 0.5 = hyperthyroidism
Over 5.0 = hypothyroidism

New Normal: 0.3 – 3.0
Under 0.3 = hyperthyroidism
Over 3.0 = hypothyroidism

(The normal range for T4 ranges from 4.6 – 12 see:Endocrineweb)

I think the range for the UK is as follows:
TSH – 0.35 to 4
Free T4 – 11 – 24

There are other conditions that might cause an imbalance to the thyroid, and that is a tumour on the pituitary. However the symptoms of that are dizziness, increasingly poor eyesight and headaches.

What we need to ask our GPs:

1. A blood test to show TSH and T4 levels.
2. What the exact results of the blood levels of TSH and T4 are
3. What the testing lab’s normal range is for TSH and T4
4. What the GPs diagnosis range is for a normal thyroid and how do they arrive at their diagnosis of normal.

Also 5th question to ask your GP:
5. If my symptoms present a thryoid condition, and my test appears normal, why isn’t the test more thoroughly explored for slight discrepancies; that if dealt with may improve my symptoms?

The symptoms of hypothyroidism are:
Fatigue
Feeling cold, unable to get warm
Weakness
Weight gain or increased difficulty in loosing weight
Coarse dry hair
Dry rough pale skin
Hair loss
Muscle cramps and frequent muscle aches
Constipation
Depression
Irritability
Abnormal menstrual cycles
Decreased libido

The symptoms of hyperthyroidism are:
Palpitations
Heat intolerance
Nervousness
Insomnia
Breathlessness
Increased bowel movements
Light or absent menstrual periods
Fatigue

Signs:
Fast heart rate
Trembling hands
Weight loss
Muscle weakness
Warm moist skin
Hair loss
Staring gaze

Now what a coincidence, these lists of symptoms and signs are uncannily similar to my ME/CFS list of symptoms. So has my normal result from my thyroid test been misunderstood?

What you can do.

Go for another thyroid test.

Ask your GP the 4 questions:
1. A blood test to show TSH and T4 levels.
2. What the exact results of the blood levels of TSH and T4 are
3. What the testing lab’s normal range is for TSH and T4
4. What the GPs diagnosis range is for a normal thyroid and how do they arrive at their diagnosis of normal.

Also 5th question to ask your GP:
5. If my symptoms present a thryoid condition, and my test appears normal, why isn’t the test more thoroughly explored for slight discrepancies; that if dealt with may improve my symptoms?

When you receive your results, check with the 7 points above as to which category your test falls into. Unless it falls into the category of Euthyroidism, your thyroid is not behaving normally and something needs to be done.

There are natural supplements to take that supposedly have helped a number of people and this is the website that I feel offers the best help and understanding of under or over acting thyroids: Wellness Resources as they put selenium into their products which would seem to be essential for a healthy thyroid.

I have placed an order and am waiting for it to arrive. I will let you know if there are any benefits or differences to my ME/CFS symptoms.

For more information see Endocrineweb

and: Fibro and Fatigue

and: Healthy.net concerning the role of selenium in our bodies.

and finally: Hashimoto thyroid

A reader wanted me to add this information to this article:

I was found to need thyroxine when I had an Autoimmune Profile done which showed that I had antibodies against my thryroid gland. Maybe this is something you could add as I’ve heard this is the most common reason for thyroid deficiency. My thyroid readings were still relatively normal at this time but the doctor put me on thyroxine nevertheless.

The more I read about the Thyroid the more I could weep. I am sitting here nearly in tears remembering the conversation yesterday with my daughter who has had her thyroid tested and has been told it is normal. She was offered counselling for her symptoms of feeling cold all the time, tired, unable to cope, depressed. I know my daughter and this just isn’t her.

Of-course she will get a second opinion and of-course, now armed with more information, will demand further testing. And of-course I will be with her at her next GP appointment.

And of-course I will go and get my thyroid more thoroughly examined.

But I sit here, exhausted, tired and practically weeping. Why on earth should we have to go through this when we have this O so WONDERFUL NHS healthservice?

The problem is that when you are not well and you have a knock back from your GP basically telling you are stressed and so need counselling and so isn’t listening to you, you don’t have the confidence let alone the energy to argue with your GP and get them to listen and demand further testing. If they don’t know what further testing is needed, you the patient who is ill will have to lead them all the way.

This is why it is always vital to take someone with you when you see your GP, so that they can fight for you. Although why we would have to ‘fight’ our GPs is beyond me.