Questions about TSH and other test results

[WiscGuy]

In the spring of 2021 I had been having periods of fatigue that would put me in bed for two or three days at a time, and then suddenly things would be better again. This was a repeating pattern. I took this complaint to the doctor and was diagnosed with B12 deficiency. I was initially put on the treatment regimen for hematologic symptoms: the plan was daily injections for a week, then weekly for a month, them every other week for a month, then monthly. Things went well for the daily injections, ok for the weekly injections, and poorly for the every other week injections. I requested a return to daily injections, and the doctor went along with that. Several symptoms improved (eg, sensation in feet), some didn't change much (eg, proprioception balance). One that improved, but didn't resolve, was the periods of fatigue. Since then, brain fog that limits functioning occurred most days, so that traveling is nearly impossible, and fatigue most days makes even simple things like going to hear music in the park out of the question. Last summer I got a pacemaker.

Recently, for the first time since I began injecting B12, the multi-day fatigue returned and I was in bed sleeping for most of three days; then, as back when I first went to the doctor with this complaint, the fatigue lifted and yesterday morning I was pretty much back to my current normal. On the evening of the second bed-ridden day I called the clinic and was allowed a rare "same day" appointment for the next (third of being sick) day, which appointment I wanted so that blood for testing might be drawn while the period of illness was occurring. One of the tests was TSH, May 17, 2023.

I have had the following TSH test results (normal 0.3 - 4.2 mlU/L)

May 2021 3.1 mlU/L

Feb 2022 3.4 mlU/L

May 2023 2.3 mlU/L

These test results have apparently been interpreted to mean that I have no thyroid problems. Is the TSH test the last word in assessment of endocrine problems, especially thyroid?

Other selected test results from May 17, 2023:

Vit D (20-80) 54

Ferritin (31-409) 274

Chloride, P (98-107) 107

Bicarbonate (22-29) 23

Alanine Aminotransferase (7-55) 13

RBC Distrib Width (11.8-14.5) 11.1

Neutrophils (1.56-6.45 x10(9) ) 6.44

Any comments on any of these test results are appreciated. Also, any suggestions of what I might want to do next would be very helpful. I am planning to request a referral to the Endocrinologist.

[Star13]

I strongly suggest you copy and paste this whole thread over to the Thyroid UK platform here on HealthUnlocked. There are some very knowledgable people who can answer your questions on there.

Are you on any Thyroid meds at the moment as I think you should be from my limited knowledge? From what I understand although you are in the “normal” range for TSH most people find they need to be at around 1 or just under to feel well.

Also your Vit D could do with an improvement. Are you supplementing that?

As I say go to Thyroid Uk as they will help you with this.

[WiscGuy in reply to Star13]

I have never been diagnosed with thyroid trouble, probably because I was in the reference range, and so I have not been prescribed thyroid medication.

My total vitamin D results (20-50):

Feb 2022. 44

Apr 2022. 37

( I had begun taking supplement vitamin D, 25mcg x2)

May 2023 (20-80) 54

(I had increased supplements to 50mcg x2)

[Nackapan]

TSH levels seem okay .But thorough tests are explained on the thyroid forum.

Was folate tested?

Mh bloods often do not show anything.

I still can't go to music in the park either.

Am doing more bugt nowhere near functioning at s level acceptable to me .

Even with pacing . Good diet ect .

Mord b12 more time

[WiscGuy in reply to Nackapan]

I didn't think to ask for for folate. It's in a couple of the supplements I take, but I suppose it's good to track it, since it is so central.

[Jillymo]

Hi,

My advice is to post your thyroid concerns together with results onto thyroid uk. Click on my hub at top of page, I found them very helpful in translating my results.

Have you thought of having a private thyroid test carried out ? They have only tested your TSH, my ignorant Dr does the same, to my annoyance.

I have suffered both hyper and hypothyroidism since the 1970s.

TSH, T3, T4 and thyroid antibodies should be checked.

If you want a really thorough test........

The Thyroid #4 Comprehensive Blood Test Panel includes a Thyroid Profile with TSH, Tri-iodothyronine (T3) Free Serum, Thyroxine (T4) Free Direct Serum, Thyroid Peroxidase (TPO) Antibodies, Thyroid Antithyroglobulin Antibody (TAA) plus Reverse T3, Thyroxine-binding Globulin (TBG), Thyroid-stimulating Immunoglobulin (TSI

[Sunshine1932]

I'm not a Dr but I would say your range is good.My range is below the starting range which would make me have an overactive thyroid but my UK Gp Dr doesn't seem arsed at all. It baffles me why they have ranges if mine came back abnormal. My main symptoms is fatigue but also heat intolerance.

I would suggest going to the thyroid thread like someone else has suggested.

[Gambit62 Administrator]

On the face of it the results don't suggest a thyroid problem. A general set of tests is done to identify likely candidates for further investigation. Using it to rule out things is a bit more problematic - more a question of persue the obvious and come back to the less obvious if things are still not right.

Thyroid hormones do vary throughout the day etc so you expect some variation. They are within the normal range. People being treated for hypothyroidism can often feel that they need to have TSH in the lower part of the range or they don't function well but using ranges for people without conditions and applying them to people with conditions can sometimes be problematic - applies to both PA and thyroid conditions.

Thyroid UK forum is the place to ask about thyroid results though.

[Hectorsmum2]

You might be treated for a thyroid condition in another country where above three is considered a problem but this country, the UK, has a very wide range of normality.

[WiscGuy in reply to Hectorsmum2]

I am in the US.

[WiscGuy]

Thanks to all who offered comments. As suggested, I copied (with a brief intro added) to the Thyroid Forum.