Should any other tests be requested in my case?

[cc120]

I was advised by the members of this forum, mainly reallyfedup123; Jackie and Clutter (thank you) to request tests on the Thyroid antibodies; Ferritin; Folate; B12; Vit D3 , given my previous blood test readings of/and main symptoms:

TSH and FT4 blood test results over 10 year period -

30/10/2013 - TSH: 8.1 H mu/L (0.3 - 4.2); FT4: 15.6 pmol/L (12 - 22)

09/07/2012 - TSH: 2.5 mu/L (0.3 - 4.2); FT4: not given

30/01/2008 - TSH: 7 mu/L (0.3 - 4.2); FT4: 13 pmol/L (12 - 22)

27/07/2007 - TSH: 7.5 mu/L (0.3 - 4.2); FT4: 13.1 pmol/L (12 - 22)

11/06/2004 - TSH: 4 mU/l (0.3 - 4.2); FT4: not given

Main symptoms: very little energy, sudden energy slumps, excessive/chronic fatigue requiring over 15 hours of sleep and sometimes more, weakness, brain fog, dizziness, excessive sweating (cold sweat if anxious or during and long after physical activity), intolerance of excessive temperature, cold feet all the time.

Should any further requests be added to the blood test forms as pictured?

[Clutter]

That looks like the obvious suspects are covered. I hope it helps your GP to drill down to what's making you so unwell. At the very least, eliminating causes is helpful too.

[cc120 in reply to Clutter]

Thank you Clutter, should TSH be added, and should B12 be active B12, or will B12 do? Also I wouldn't be surprised if I am oestrogen dominant, would it be worth testing for this? Well it's a different doctor but he didn't want to get my hopes up that the new results would lead to any treatment or referral, as he said, they might be borderline and open up more questions without answers, still not leading to hypothyroidism. He said subclinical hypothyroidism means someone who 'may' develop hypothyroidism in the future, and high TSH might exist permanently for some people naturally. I did point out that in 2004 TSH I was in the normal range and 2012 I was below range. I asked that if hypothyroidism wasn't causing my chronic fatigue, what could be. He said, there is a condition 'chronic fatigue' and an exercise regime might be the treatment offered. I had earlier pointed out that my case should come under 'persistent' subclinical hypothyroidism and that with accompanying symptoms should be treated/referred. But he either missed this or wasn't convinced. He said that if the new tests point more towards hypothyroidism, that it might simply mean I'm monitored more closely, as in more frequent blood tests than the current annual review, but this wouldn't necessarily lead to treatment/referral. He also hadn't heard me when I explained that I had not been informed of the 2008 diagnosis of subclinical hypothyroidism, only becoming aware with the recent copy of past 10 year blood test results, of which he apologised, and couldn't understand as it was noted in my file. He seemed most perturbed that he hadn't received information from the specialist I saw, of treatment recommended despite my explaining that he wasn't on the medical register anymore. I explained I hadn't started the treatment (to begin with nutri adrenal extra) as I wanted to have these blood tests done first. I also asked, that if not hypothyroidism, what might have caused the state of my nails: very ridged, bumpy, rough and break off immediately, he said didn't know but he would have suggested the iron, folate, b12 tests that we will be doing. I explained that I had been hyperglycaemic but having abstained sugar for over a year, that seems to have cleared up as in I can eat highly sugary items without passing out and craving more immediately. Seemed interested in this but didn't comment. He said my heart rate was a little high.

[lynmynott Partner Thyroid UK]

I can't see that you have had a T3 test done. A homocysteine test might also be a good idea as this can show whether you are absorbing the B12 properly. If you have high thyroid antibodies, I can send you a paper that might persuade your gp to give you a trial of levothyroxine. I'm not in the office until Monday tho.... [e-mail]

[cc120 in reply to lynmynott]

Thank you lynmynott, is the homocysteine test anything I can click on in the current form format, or will it have to be written in the other requests part? I will certainly take you up on your offer form paper persuading gp to give levothyroxine trial, as from his attitude so far, it seems he would need convincing. I am hoping to have the blood test done on Monday.

[lynmynott Partner Thyroid UK in reply to cc120]

Hi cc120, I have just read Patrick Holford's book - The Homocysteine Solution. It's scary, very informative and excellent! If your GP won't do it for you, Genova do the test but you would need your doc to draw the blood or find someone else to do it. Here's some info: gdx.net/uk/core-uk/one-page...

[cc120 in reply to lynmynott]

Hi lynmynott, thankyou, I did add homocysteine to the list to be tested for, and I didn't eat or drink before the blood test which I had done around 9.30am, so in a weeks time will be eager to see a copy of the blood test to see what appears.

[cc120 in reply to lynmynott]

I see from this link members.upnaway.com/~poliow... that a fasting plasma homocysteine test should be requested? Perhaps I should leave this test request after the current one has been processed?

[cc120]

Thank you reallyfedup123, according to him only subclinical, 'may or may not' develop hypothyroidism in the future. But at least he requested the additional tests.

Is B12 OK or should active B12 be requested and do you know about homocysteine , anything to tick for this, or should it be written in.

[cc120]

Thank you again reallyfedup123. I have added homocysteine and probably won't eat before the test, hopefully an issue of 'my' adding it won't arise. I have been on anti-depressants for 21 years, starting before the hypothyroidism symptoms. But perhaps once my thyroid/adrenal glands are sorted, my mental state will miraculously improve also.

Yes, the chronic fatigue diagnosis he seemed keen on, even before seeing the rest of the test results, which was worrying. But fingers crossed that results will point to a more helpful diagnosis.

[cc120]

Thank you reallyfedup123, have you a good source of info on that? Also I have taken 1 x a day of Estradiol valerate 2mg / Norethisterone 700microgram tablets for approximately 2 years (1-3 years post menopausal). I started as I hoped it would help with the sweating symptom, and hopefully with fatigue though the GP did say not prescribed for fatigue. Should I stop these as I've just read: 'Estrogen increases a particular protein that binds thyroid hormone to it, making the thyroid hormone partially inactive.'