We have a similar case, confirmatory results received from Addenbrooke's today:
Female, aged 53 on thyroxine (not sure what dose)
TSH <0.01
FT4 <2.5
Total T4 1.7
FT3 2.2
TPO and TSHR negative. All other pituitary function normal.
These results have been confirmed on 3 different assays (Delfia, Centaur and Roche).
The patient, unsurprisingly, feels extremely lethargic (going to bed at 2pm). She says she is fully compliant with her thyroxine and denies taking any other medication. She has a history of taking herbal supplements but claims to have stopped taking these some time ago (not sure how long ago).
Any suggestions?
Fiona Davidson
Trainee Clinical Biochemist
Kingston Hospital
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