Do these bloods look normal? Seeing Endocrinologist on 5/12/2013 for the first time, what to expect?

[shorty1979]

Hi there, I'm new to this forum, but could really do with some advice.

I've felt shattered for a long time now, but put it down to having 3 daughters, youngest is 3 yrs and bad birth with her, she came very fast, but then I ended up in surgery as the afterbirth would not detach (sorry TMI), Basically, my doctor agreed to start testing me for my thyroid (hypothyroidism) even though she did not agree with me and tried to say it was depression.

My test results are:

TSH, 1.5 (0.2-5.5)

FT4, 12.2 (10.0-24.5)

FT3, 4.6 (3.9-6.7)

Serum Cortisol 1097 in the morning (morning range 170-540)

C reactive protein level 9mg (<5) High

TPAB <20 (<60 negative)

Also had thyroid scan and all came back normal, tired all the time, hair falling out, excessive sleepiness, 2 stone gained in 2 months (diet still the same), toenails crumbling, dry itchy skin, swollen scalloped tongue, headaches, dizziness, feeling of something in throat, low body temp 34.8-35.9, low pulse rate 54bpm, massive night sweats, heart palpatations. Please help!!

Thanks in advance

Carrie

[RoloHibbs]

Hi Carrie, Whilst I'm not a doctor, I'd be suggesting to your Endo that your FT4 is far too close to the bottom of the range; your cortisol is high; as is your CRP. That's a good starting point! Have you got yourself a copy of Dr. Toft's book, Understanding Thyroid Disorders? Dr Toft published this book in association with the BMA, so there's nothing there with which your GP/Endo can disagree. Dr Toft suggests that most people will feel better if their FT4 is near the top of the range (some people need to even be over the range). You can purchase this book at Amazon, or from your local pharmacy. (Amazon link - amazon.co.uk/Thyroid-Disord.... It's a good place to start if you haven't already got a copy. As for your CRP levels - Mine is high and my GP said this morning that it always gets his attention if CRP is high - he's written on my blood test results "something is inflamed in your body", so that's also something to ask, too! As a lay-person who has experienced all that hypo can throw at you, (and I had all of the symptoms you've listed) I'd say that your symptoms are screaming 'hypo' at you, but I'm no doctor(!) - my blood tests only caught up with my symptoms a couple of years down the line, where they went from 'TSH and FT4 are normal', 'TSH and FT4 are normal', 'TSH and FT4 are normal' to all of a sudden there was a panic phone call from the surgery when my TSH was 50.8 and FT4 undetectable - this happened within the space of 4 weeks between blood tests. This is why I wish that doctors would take more notice of our symptoms, rather than depending on these ridiculous 'normal' ranges. (I'll stop here before I get on my high horse, lol!) Have a read of the book - and others on here with more experience than I will no doubt be along soon to give some more advice. So good luck - hope your Endo is a good one! Kx

[Mini1]

Hi I can't really help you, but just want to say that I could have written your post! My blood results are very similar to yours and my symptoms are much the same. I also have awful muscle pain and lethargy! My GP says my thyroid is fine!! Hope you get some answers. X

[Hidden]

Yes, the Endo should certainly start with your high cortisol, and investigate for Cushings Syndrome:

patient.co.uk/health/cushin...

Normal or low TSH, coupled with low range FT4 and FT3, can sometimes be due to nutritional deficiencies which play havoc with our endocrine system. So you should ask your Endo to also test your B12, folate, iron/ferritin, and vit D/calcium for starters.

Here's a B12 deficiency symptom checklist so you can see how similar it is to hypo:

b12d.org/b12-signs-symptoms...

Hampster

[shorty1979]

I've had all my b12, ferritin etc tested and they all came back fine apart from the ferritin, so have been on iron tablets for the last 5 weeks with no improvement. I'm having that retested on tuesday to check levels, but everything else is looks fine. I will take a look at that link for cushings though (this has never been mentioned by my doctor) thanks Carrie x

[Hidden in reply to shorty1979]

Hi Carrie, do you have the other results to post? Still could be issues even if in range. x

[shorty1979 in reply to Hidden]

Hi Hampster1, results for other bloods are:

B12 491 ng/L (180-1000)

Serum Folate 4.3 ug/L (4.00>)

GFR 87mL/min (no reference range)

1st TSH (27/9/2013) 1.2 miu/L (0.2-5.5)

Liver function

Serum total protein 75g/L (60-80)

Serum albumin 39g/L (35-50)

Alk Phos 57u/L (30-130)

Serum ALT level 20 u/L (<33)

Serum total bilirubin level 4 umol/L (<21)

Urea and electrolytes

Serum sodium 140 mmol/L (133-146)

Serum potassium 4.8 mmol/L (3.5-5.3)

Serum Urea level HI 7.9 mmol/L (2.5-7.8)

Serum creatinine 67mmol/L (45-84)

I couldn't upload a picture, there are more results coming, but these are some of them

[Hidden in reply to shorty1979]

Folate jumps right out, it's not going to be doing you any favours at that low level. You should ask your doc for a 5mg folic acid supplement to correct the deficiency, this takes about 4 months and then you can go onto a maintenance dose. Info here:

patient.co.uk/doctor/folate...

B12, folate and iron deficiencies usually co-exist, they work together. B12 looks OK on the face of it, but the serum B12 test is very unreliable. It measures both active and inactive B12 in the blood, so only a small portion (the active part) is available to use. It also doesn't tell you anything about how much is getting to the cells where it's needed. Information on more accurate B12 testing can be found in these 2 places:

thyroiduk.org.uk/tuk/testin...

b12deficiency.info/testing....

Note in the second one a link to an official warning about the inaccuracy of the serum B12 test:

ukneqas-haematinics.org.uk/...

I would recommend having further tests done if you can, particularly as you say you've been taking a B-complex which might have falsely elevated the results. Having said that, it's done nothing for your folate level!

I would also ask to be screened for Coeliac disease which can be the underlying cause of malabsorption.

Finally, did you have your vit D and calcium tested before you started taking any vit D supplements? This is important to rule out any parathyroid issues.

Hope this helps, H x

[shorty1979]

I don't think the doctors gave me those printouts. But i'll try and upload pics of all the results i have so far. I've always taken a complex b vitamin supplement also and i take vitamin d as Seasonal affective disorder is rife in my family. Bear with me lol, i'm useless with technology haha

[eeng]

You need to try to always get your blood test done first thing in the morning. The TSH level will be highest then, so if you do have an underactive thyroid it is more likely to show up in the blood test.