Advice on my Daughter's results please...

[Dar68]

My Daughter is 20 years old and 4 years ago was diagnosed with PCOS due to her having irregular periods for 3 years. These were her main symptoms but she was still diagnosed and left to get on with it.

Even though she hates to admit it she sufferes with terrible mood swings. She is over weight and has tried various diets but struggles to even lose a few pounds which upsets her.

Last year I did attend a doctors appointment with her not because I am a pushy mum but I have never been happy about the PCOS diagnosis and with my daughters agreement wanted to ask some questions, this the doctor didn't like. She had various tests but all came back normal and back then I believed what doctors said. Her periods are sill irregular and she is unable to take the contraceptive pill because she suffers with really bad migraines.

Recently she has started to have pins and needles in her hands, arms and feet and her hands do shake at times and she is also more tired than usual and most of the time has to have a sleep in the day. She is due to start Uni in September to study Special Effects. (I know everybody needs their hands but she needs a very steady hand so I advised her to see the doctor).

She had various blood tests which came back normal according to the doctors;

Serum cholesterol - 4.1 mmol/L

Serum FSH level - 6.6 iu/L (1.0 - 11.0)

Serum LH level - 2.9 iu/L. (2.0 - 13.0)

Serum vitamin B12 - 249 ng/L (190 - 900)

Serum Folate - 4.9 ug/L (2.0 - 19.0)

Serum TSH level - 3.49 mu/L (0.35 - 5.50).

Plasma fasting glucose level - 5 mmol/L. (3.6 - 6.0)

She has also been checking her basal temperature which has been between 35.6 and 35.9.

She wants me to attend her next appointment with her, I am just asking if anybody can advise me and her on what questions to ask or any more tests.

Thanks,

Angela x

[Clutter]

Dar, your daughter's TSH 3.49 and her symptoms indicate hypothyroidism. Make sure her next thyroid bloods are taken early in the morning when TSH is highest and it may just push her >5.5 for a diagnosis. There is a connection with thyroid and PCOS too.

thyroiduk.org.uk/tuk/about_...

Pins and needles and tremors may be due to low B12 and folate. B12 <500 needs supplementing with methylcobalamin sublingual lozenges, patches or sprays. 5,000mcg daily for a month to build up and 1-2,000 daily thereafter. Methylfolate is preferable to folic acid.

thyroiduk.org.uk/tuk/go_sho...

thyroiduk.org.uk/tuk/diagno...

Ask your GP to test your daughter's ferritin and vitamin D as deficiencies cause fatigue and low mood and often present with symptoms similar to hypothyroidism.

[Dar68 in reply to Clutter]

Thanks clutter for your reply, always good with your advice. Will ask for tests when I go with her to the doctors .

Thanks

Angela x

[shaws]

PCOS can be due to hypothyroidism. Others will reply re your daughter's blood tests although I can see B12 and folate are low and this is an excerpt re PCOS as I don't have the link:-

Multiple Ovarian Cysts as

a Major Symptom of Hypothyroidism

The case I describe below is of importance to women with polycystic ovaries. If

they have evidence, such as a high TSH, that conventional clinicians accept as evidence

of hypothyroidism, they may fair well. But the TSH is not a valid gauge of a woman's

tissue thyroid status. Because of this, she may fair best by adopting self-directed

care. At any rate, for women with ovarian cysts, this case is one of extreme importance.

In 2008, doctors at the gynecology department in Gunma, Japan reported the case

of a 21-year-old women with primary hypothyroidism. Her doctor referred her to the

gynecology department because she had abdominal pain and her abdomen was distended up to the level of her navel.

At the gynecology clinic she underwent an abdominal ultrasound and CT scan. These

imaging procedures showed multiple cysts on both her right and her left ovary.

The woman's cholesterol level and liver function were increased. She also had a

high level of the muscle enzyme (creatine phosphokinase) that's often high in hypothyroidism. Blood testing also showed that the woman had primary hypothyroidism from autoimmune thyroiditis.

It is noteworthy that the young woman's ovarian cysts completely disappeared soon

after she began thyroid hormone therapy. Other researchers have reported girls with

primary hypothyroidism whose main health problems were ovarian cysts or precocious

puberty. But this appears to be the first case in which a young adult female had

ovarian cysts that resulted from autoimmune-induced hypothyroidism.

The researchers cautioned clinicians: "To avoid inadvertent surgery to remove an

ovarian tumor, it is essential that a patient with multiple ovarian cysts and hypothyroidism

be properly managed, as the simple replacement of a thyroid hormone could resolve

the ovarian cysts."[1]

This is a link from Thyroiduk.org and if in the USA she would be treated with a TSH of 3.

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

Doctors should, first take clinical symptoms into account and our TSH varies throughout the day.

[Dar68 in reply to shaws]

Thank you Shaws for replying, yes I have read somewhere that there is a connection between the 2. I have just never been happy with her PCOS diagnosis and I don't think she has either as she has just been left to get on with it. I've got her reading up more about thyroid before we go back to the doctors.

Thanks,

Angela x

[Duchy82]

Her fasting glucose level is a little high and this is also a sign of pcos as it comes with an increased risk of type 2 diabetes, usualy the first line of treatment for pcos would be to try weightloss and the pill and if she is struggling with weightloss she could ask the gp for metformin. As the pil isn't an option due to migraines the gp has definitely not given her other options although usually they will only treat pcos if she wants to conceive as fertility is affected. but i don't understand if she is suffering with it why no treatment options besides the pill been offered to her.

I'm assuming as fasting gluc was tested that she went for a very early bloodtest im usually gagging for a brew and get the 8am appointment so im assuming thats as high a tsh as the gps will ever see it is still classed as normal and the gp wouldn't action that but i would be floored with a tsh like that. Im sure i have read a paper about treating pcos with t3 I'll see if i can find it for you.

[Dar68 in reply to Duchy82]

Sorry for late reply suffering with my own thyroid and low iron so very tired. Thank you for your advice I was worried about her glucose level I think I will bring it up with the doctor. Think we have another battle on our hands with getting treatment. If u could find the paper it would be really helpful

Thanks,

Angela x

[shaws in reply to Dar68]

Read down this link to PCOS, Thyroid, and Insulin Resistance

hypothyroidmom.com/pcos-and...

[Dar68 in reply to shaws]

Thankyou, that was an interesting read

Angela x

[Duchy82 in reply to Dar68]

I have scoured the internet for days now and I just can't find that paper, sorry, sods law you come across it when not actually looking for it in particular but when you actually want it, it is nowhere to be found!

[Dar68]

Thank you for looking. Have got lots of information from this site ready for her appointment on Monday so fingers crossed that something will be done. But we all know what doctors are like so won't hold my breath.

Thanks

Angela x