P.A. and periods

[SAM2608]

Hi there

I wonder if I can ask a couple of questions on behalf of my daughter (she’s just 18) - you’ve all been so helpful and I feel there is nowhere else to turn to ask questions and have informed and meaningful answers.

She hasn’t had a period now for 3 months (not pregnant, always very regular) and she has a blood test booked alongside her b12 injection on Wednesday morning first thing. They are testing lots of hormone levels, ferritin (on iron tablets as this was very low at 13, now at 24) and TSH level (My mum has a thyroid disorder). Should she fast beforehand as no instructions given - she had her level checked 7 months ago and came back in range at 1.81.

Any advice very gratefully received as it seems to one odd symptom after another- really tough.

Thank you

[JanD236]

I think it’s recommended that TSH is tested early morning and as a fasted blood test. For a better picture of how the thyroid is working Free T3 and T4 should also be tested. thyroiduk.org has good info on this. There is also the thyroid forum on HU.

I had Graves’ disease (overactive thyroid) and my periods stopped for 3 months before I was diagnosed and treated. Other symptoms were palpitations, feeling too hot on the slightest exertion, unable to exercise, breathlessness and feeling jittery.

I wish your daughter well.

[SAM2608 in reply to JanD236]

Thank you very much - will look at thyroid uk and make sure she doesn’t eat beforehand. They didn’t say about T3 or T4 - is that something to explore if TSH. One back out of range - it is it another grey area like P.A.? Thank you again x

[Gambit62 Administrator in reply to SAM2608]

If your daughter is not being treated for thyroid problems I wouldn't bother about fasting and early morning. levels of thyroid hormones vary through out the day and tend to be higher in the morning - it can be useful for people who are having levels monitored as it means the same conditions for the test so makes it easier to spot differences ... and there are some reasons around the ways GP interpret the tests for people who have diagnosed thyroid problems ...

It is unlikely that the test will include any measures of T3 or T4 if it is a general blood test - it might be done as a follow up test if TSH comes back abnormal but a general blood test is just that - looking for clues that might indicate a problem so further investigation can be more targeted.

interpreting thyroid tests - particularly TSH poses similar problems to interpreting serum B12 - its an enormous range and different people are comfortable at different points in that range, so assuming normal range means okay for an individual has some logical problems. It could be argued as well that the fact that TSH varies during the day makes it even more difficult to interpret.

[Galixie]

I don't have any advice to offer, but can tell you that I skipped periods, averaging one every three or four months, for over twenty years prior to finding and correcting my b12 deficiency. There weren't any hormonal imbalances detected. Most doctors, since I was not actively trying to conceive, just shrugged their shoulders and offered birth control (which I couldn't tolerate). Eight or nine months after my deficiency was corrected, I started having them like clockwork.

[SAM2608 in reply to Galixie]

Ah thank you - she seems to be in reverse...regular as clockwork for years, but just started when she began iron treatment (maybe coincidentally) and b12 symptoms seem to have settled a bit. Such a puzzle this Illness! Really appreciate your reply 😊

[NovicePA]

I am a lot older than your daughter and thought periods had stopped. Funny enough when I am organised and take my iron and supplement my docs injections with my own my periods seems to start again. I think for PA sufferers it is important that iron levels are in the upper end of normal range. B12 and thyroid hormones are related. Saw a video a while back which explained the link but can’t find it now or I’d share. Essentially I think if B12 is low then the hormone that recognises thyroid not working effectively doesn’t kick in and stimulate the production of t3 and t4? Perhaps someone else with a bit more knowledge may be able to confirm that is the case?

[SAM2608 in reply to NovicePA]

Ah thank you for that - she had a blood test yesterday to look at her thyroid- TSH, T3 & T4 ( I think?) and then her hormone levels...hoping we can get to the bottom of it!

Thank you again