Diagnosed Hashimotos 30 years ago. On T4 only. What blood tests should should I try and get from my GP

Hello, this is my first post. I am feeling quite unwell and too tired to take in a lot of the information on this excellent site, just discovered by myself!.

My first symptoms of hypothyroidism showed when i was about 17 (this is with hindsight of course!) Puffy hands and feet, always cold, tired, very irritable, quite mentally unstable at times. I always remember a woman colleague looking at me and saying 'Your face is getting fat.' I was about 8.5 stones at the time so a weird place to initially put on weight. I was not diagnosed until I was about 30, this after paying to see a psychiatrist as I became convinced I was insane.

I am on t4 only and despite never really being free of symptoms, I have never been referred to a specialist. I was on 1.5 mcg eltroxin for years. Had one test where TSH high and dose reduced to 1 mcg. Now on levothyroxine 1 mcg per day.

I have never been tested for B12 or any of the other tests mentioned in several posts (please see question below). I have not eaten meat for the last ten years although I do eat fish occasionally.

Recently had breast cancer and now on Letrozole and two Calcium/D3 tablets. I am just so fed up of pain and feeling so down and depressed with a lingering dread and anxiety. I feel I have to fight every day to try and be a 'good' person and be grateful for how lucky i am. I am not starving, homeless,etc......I bought a dog and walk every day to make sure i keep trying and lessen the pain caused by the letrozole.

Just received reminder to go for thyroid function blood test. Have you any advice as to what other tests may be useful for me to request?

Sorry for long post and any help would be so gratefully received, thank you.

[Clutter]

Hi Firecrest and welcome to the forum.

I'm sorry to hear you had breast cancer and the drugs are causing you pain. I'll keep it simple with a brief reason why your GP should do the following tests:

TSH, FT4 and FT3 to check you are converting in view of your ongoing symptoms, recent surgery and possible conversion inhibition caused by Letrozole. Your GP should note on the blood requests that he needs FT3 status as labs often decline unless TSH is suppressed.

You can ask for thyroid peroxidase (TPOab) antibodies to be tested but as you already know you have Hashimoto's it seems a bit pointless unless you want to know your current antibody levels.

B12 and folate re your vegetarian diet and because nitrous oxide in general anaesthetic strips the body of B12.

VitaminD as low levels can cause pain, fatigue and inhibit conversion of T4 to T3.

Ferritin as iron may be low due to vegetarian diet and breast cancer.

Ask for a printout of your results with the lab ref ranges and post them for comment when you're ready. VitD can take a week to 10 days to come back but you can post your other results.

As for feeling you ought to be grateful because others are worse off, that's plain daft. You feel very unwell and are trying to heal yourself but if you need to let off steam and vent go for it. We all need to at times.

[shaws Administrator]

Welcome to our forum

I am sorry you have been unwell for many years, despite being on medication. Are you from the UK?

Have your blood test as early as possible and don't take your medication until afterwards. If you take your meds at night, miss this dose and take after blood test. Ask for a Vitamin B12, Vit D, iron, ferritin and folate.. Get a copy of your blood test results, with the ranges (labs differ throughout the UK and ranges are important as it makes it easier to comment)

Post your blood test results on a new question for comments.

Levothyroxine should be taken around 1 hour before breakfast with one glass of water and no supplements/other medications for around 4 hours.

Don't worry as all of your symptoms you detailed above seem to be clinical symptoms of hypothyroidism. You may well be undertreated.

Best wishes

[Hidden]

Thank you both, very much. I meant 150 mcg and 100mcg respectively in my post, not 1mcg as stated!!!

Sorry, I am always doing that, ridiculous after thirty years of medication .

I could not get a Drs appointment ( after printing out your advice to take with me and feeling fully prepared for once). He did phone me later as promised and I grapped my print out but could not find my glasses (aagh). I tried to read the relevant tests and mentioned a couple of symptoms and he said 'So really you want a complete MOT of tests I think'.

Anyway, I am going to the nurse on Friday and will see which tests he has included. B12 was the one I stressed but wanted T3 as well. When I get my results I will post on here and ask for your advice again if that is OK.