help interpreting these results please

[Poshpenny]

Hi this is my first real post.

have had terrible time with GP, this has been going on for 4 1/2 years now since I gave up smoking. I first went to Dr a year after I gave up as things weren't so good - tiredness, 3 stone weight gain being the main two things. blood tests followed and subsequently I found out I had borderline thyroid results (TSH 1.7 T4 8.1). I only found that out a year later when I went to see him about something else. I finally got him to feel my thyroid in February this year and he had to acknowledge there was a lump on my thyroid. sent for a scan which confirmed single nodule 18mm plus numerous little cysts. Yet another lot of blood tests done, which were "normal" as ever, but resulted in referal to an endo which went about the same as most people on here's visits to NHS endcrinologists seem to. the only thing that has really really made a difference to how I feel was going gluten free last October (but I had tested negative for celiac) plus starting to take vit/min supplements which between them resulted in a stone coming off in 3 months without giving anything up other than the gluten. I also felt a lot better and digestive issues resolved themselves. have now had follow up scan early July, nodule is now 16mm. I do have a bad reaction if I accidentally eat gluten, so there is some kind of issue there.

I started seeing a private dr in June, when I realised I wasn't getting anywhere with the NHS and am currently on alternate day doses 30g/60g erfa thyroid, plus nutri thyroid, adreno max and high doses various other vits and mins. There is an issue with my adrenals, I am in Resistance stage 3- maladaptation. Total daily cortisol 22.8 (range 21-41), mean DHEA 0.08 (0.30-1.00), DHEA:Cortisol ratio 0.33 (1.0-4.0). that was the Genova saliva test.

would appreciate opinions on these latest results please. results in brackets are July 2013 results where tests have been repeated.

TSH 0.46 (1.04)

T4 9.8 (10.2)

Vit D 81

Ferritin 57 (12)

folate 21.2 (7.9)

B12 523 (276)

vit D one is interesting I think, I work outside all year round so have grater than average sun exposure. I supplement 10600 IU daily and I would say this was the one thing that got me through the winter physically, if I missed a day or two, the aches and pains would come back. persuaded Dr to test it in April when it was 60. I think with my lifestyle, normal for me should be much higher than it is?

oestradiol <73 (295)

FSH 76.5 (36)

LH 30.1 (12.9)

the endocrinologist is claiming my results are "normal" However, and I quote "the blood tests suggest you may be going through the menopause as your oestradiol levels were undetectable with a raised LH and FSH. He has referred me for the short synacthen test. I'm sceptical though about him since he told me I was "better" since I changed to a GF diet. I am not ashamed to admit I cried at that point, because I'm not "better" just not as bad as I was before I changed.

I have also had official diagnoses of mild Carpal Tunnel both hands, Tennis and Golfers elbow both arms, Menorraghia. my guess is I have hashimotos, but they didn't take TPO test until April this year when I had been GF for 6 months and it came back Normal. I don't have the figures though.

what do you think is going on, what should I/we be doing next? sorry it is so long.

[cc120]

Did you get your current endo from louise's (moderator) list of worthwhile NHS Endos and private doctors. If not you should email her at [e-mail] and ask for her list of NHS Endos and private doctors.

[Poshpenny in reply to cc120]

The privAte dr I see is from Louise's list, the NHS Endo was not.

[cc120 in reply to Poshpenny]

Okie dokie, cool : )

[Poshpenny]

Sorry to be needy, but anyone?

[eeng]

Hi, sorry you haven't had many answers. Your 60g tablets of ERFA contain (as far as I can find out) 100mcg of T4 and 25mcg of T3. Your T4 and TSH readings are both low because you are taking both T4 and T3. Really what would help you is a T3 test (which you will have to pay for). If your T3 levels are not very high in the range then you would probably benefit from taking more ERFA. You say you are not feeling as bad as you have done. Taking half a grain and one grain on alternate days is not a huge dose. Increasing the dose is often done gradually, in half grain steps, every 2 weeks. Is your private doctor planning to do this do you know? He/She ought also to be planning to test your T3 levels soon. It takes a while for thyroid hormones to build up in your system (6-8 weeks) so you wouldn't expect your doctor to test you until 8-12 weeks after you started the medication, however it will need to be done because it's the only test that really means anything once you are taking T3. You can get a testing kit from Genova or Blue Horizon.

thyroiduk.org.uk/tuk/testin.... I hope you feel better soon!

[Poshpenny]

thank you for replying. I am due back in just over a week, so will see what he proposes then. I did do the Genova 24 hr urine T3 test before I started on the Erfa, result was low normal at 712 pmol/24h (592-1850). that was 2 months ago, so it is about time for another.