Help and advice

[Nadpa]

Hi.

This is a post for both the thyroid and PA forum.

I'd love a bit of advice and thoughts on my blood tests and history.

A bit of background: I'm a 38 year old woman. In May this year I was diagnosed with hashimoto's in the presence of high anti-bodies and pernicious Aneamia with a positive test to intrinsic factor. Was also found to be b12 deficient with a borderline low b12 and a high homocysteine. The reason why I was being tested was actually because of not getting pregnant even though trying for 5 years. All fertility hormones are normal, as is egg count and my uterus.

I had prior to testing had a mental and physical collapse. Very severe anxiety which rendered me totally invalidated. I've had it three times before in my life. First when 20. And then twice before within the last 5-6 years. I'm desperately ill for several months. Truly the worst nightmare. My mother had Addisons - another autoimmune disease - and she took her own life when I was twelve as she was so sick and the illness had thrown her into a depression. So some of my anxiety has to do with post traumatic stress due to that tragic loss.

I'm now taking sertralin - an antidepressant. That does help with my anxiety and I'm now back to a normal self though still not back to work.

6 years ago I was told there was something wrong with my thyroids. But not enough to treat. My GP back then said I needed to get tested regularly as I most likely would develop a condition. I did for a while. Everything stayed the same. I then changed doctor as I moved to another council. And in a busy life forgot about it. I never got the results of what was actually wrong and they have since been lost.

These were my blood tests from May 2015

(I'm waiting for results from a new batch of tests done a few weeks ago)

THYROID

FT4 20.8 (9.0-22.0)

FT3 5.79 (2.63-5.70)

TSH <0.01 (0.35-4.94)

Anti-thyroglobulin abs 361 (0-40)

Anti-thyroperoxidase 391 (0-35)

Anti-TSH receptor antibodies 0.98 (0-1.75)

B12

Vitamin b12 257 (187-883)

Homocysteine 18 (5.0-12.0)

Anti-gastro parietal cell abs POSITIVE

OTHER results at the border

25-hydroxyvitamin D 80 (75-150)

Phosphate 0.8 (0.8-1.5)

Glucose 6.0 (3.9-6.0)

Total bilirubin 7.4 (1.0-21.0)

Again I'm not being treated for anything relating to the thyroid as there isn't a real problem - yet. I'm slightly hyper which they're observing to see if it settles.

I've been given three shots of b12. One each month. And now with three month interval.

I've also had my thyroid scanned and it showed to function normally.

So my questions are:

Has anybody else lived with hashimoto's without it ever developing to hypo?

Should I be gluten free despite not having a "real" thyroid problem? Would that help me never become hypo for example?

If my anxiety breakdowns are a symptom of hashi and PA I'm concerned that the sertralin now suppresses that symptom - making it unclear how I'm actually doing in relation to the two autoimmune diseases. Does anybody else have experience with that?

Doctors seem to not be aware of the neuropsychiatric symptoms of b12 deficiency and my current endo dismisses it completely. Do you know of any scientific links - that a doctor would trust - I could send to her describing anxiety and depression in relation to b12 deficiency?

Can the antibodies I have and the low tsh and slightly raised FT3 be causing such severe anxiety in your opinion? Especially as b12 deficiency is also present?

Thanks for reading!

[Gambit62 Administrator]

Do you know what your folate levels were like - body needs folate in order to process B12.

Really don't know why you are being prescribed serataline if you are trying to get pregnant as it is contraindicated in relation to pregnancy and breast feeding.

It is also an SSRI - for some people SSRI's can affect their folate levels and actually make B12 problems worse as a result.

suggest you select some of the papers from this search

scholar.google.co.uk/schola...

this one might be a good starting point

jop.sagepub.com/content/19/...

The regime that you are being given for treating the B12 deficiency doesn't seem to be in line with best practice either - assuming that you are UK based

bcshguidelines.com/document...

refer to p 8 for treatment regimes.

Bit of a while since I looked at the article in depth but I think it also covers major groups of symptoms which will include neuropsychiatric so you could try giving that to your doctor as scientific evidence that there are psychiatric effects of B12

[Nadpa in reply to Gambit62]

Thanks for your reply and the links. They're great!

I didn't have folate tested. But now taking folic acid supplements.

There wasn't really any alternative for me regarding starting on sertralin. I was so ill I needed to get something to calm my anxiety, relieve my depression and help me be able to sleep and eat. However despite the bad press SSRIs are getting then they're not the worst when pregnant. However I would of course prefer not to take them. mothertobaby.org/sertraline...

[Gambit62 Administrator in reply to Nadpa]

The stuff about seratalin actually came from the NHS website.

I recently had a go at my mother's GPs because she was taking metformin and one of the arguments there was that the NHS website said that being elderly was a reason for not prescribing it ... seratalin came up the same in that respect - don't know if the reason in both cases is to do with B12 interactions - wouldn't surprise me if it was that and a whole bucket load of other things.

Anyway, know that the NHS website isn't the mine of information that it should be - but it does imply that your GP isn't bothering to keep up to date with things in the way they should.

[Nadpa in reply to Gambit62]

Thanks Gambit