After many years of being dismissed by various GP's I am finally being treated with Thyroxine by a Private Doctor. My symptoms are exhaustion, muscle fatigue, weight gain and inability to lose weigh, constipation and low mood. I have been on 25mg for the last 6 weeks but not feeling any better so far; Private Dr says I need another blood test before she can adjust the dosage.
From all the wonderful information on this forum I have self diagnosed Secondary Hypothyroidism; my test results have been:
21st July 2014
TSH 1.14 mIU/L Range .35 – 4.94
Free T3 4.44 pmol/LRange 2.63 – 5.7
Free T4 12.32 pmol/LRange 9.01 -19.05
17th July 2104
HbA1c 42 mmol/molRange 20 -42
Fasting Glucose 5.7Range 3 - 6
Vitamin D 227.2 nmol/LRange80-150
Ferritin 94ng/mLRange 20 – 204ng/mL
I had a previous very low result for Vit D so I have been supplementing prior to this result; HbA1c previously 45 so I have been a low carb diet. No weight loss despite this and keeping active.
Firstly does anything stand out from this results? anything else I should be looking at?
I'm seeing a new GP again this week who I feel might be open to this diagnosis and ideally I'd prefer to be treated by her rather than the Private Doctor, could anyone suggest any persuasive material regarding the treatment of Secondary Hypothyroidism I could take with me? I did see an article from N.I.C.E on this posted on here but I can no longer find it on the forum or on their website.
Many thanks for reading.
Written by
ljones3
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This is not secondary hypothyroidism. It may well be some form of hypothyriodism and a trial of thyroid hormone is the best way to see if it is. By speculating on secondary hypothyroidism (pituitary failure) you are setting yourself to be disproved and then losing credibility and future treatment.
She is prediabetic. The HgbA1c is high and her fasting blood sugar is high in range. Blood sugar issues will give the same sort of symptoms as low thyroid. Her thyroid function looks very reasonable for someone not taking anything. The pancreatic islet cells are inflamed and any inflammation will make a person feel unwell.
Going low carb means what? Who knows. If someone was consuming 80% carbs and they go to 60% that's still not low carb. All readily absorbed carbs and sugars need to be eliminated or reduced. Check the Diabetic Warrior. net site for information how to get diabetes gone. It's work and just thinking that somehow reducing carbs (and who knows what that really means) will do the trick. Or read up Paul Jaminet's Perfect Health Diet for diabetics.
Thank you for the links. Very interesting. I will discuss pre diabetes with my Homepath. He has just started me in NDT after my GP and Endo wouldn't treat me as TSH 3.4 and FT4 11.3 didn't warrant treatment.
At what number value would your doctors consider pre-diabetes? You maybe need to ask them that. Or have a glucose tolerance test done.
You wouldn't need to lose a lot of weight in order to lower your blood glucose level. Just increase physical activity and modify the diet. But old habits die hard and it takes time to get used to change.
I'm surprised your doctor agreed to a trial of Levothyroxine as your July results don't indicate primary or secondary hypothyroidism. Primary hypothyroidism presents with high TSH and low FT4 and FT3. Secondary hypothyroidism with low TSH, low FT4 and FT3.
VitD is optimal 75-200. >250 indicates toxicity so you may want to stop or substanially reduce your supplement. Ferritin is optimal at 70-90 so yours is good. It may be worth testing B12 and folate as low levels can cause fatigue and muscle pain.
Just a little more information as my first post was a bit blunt, sorry. If it is thyroid related you should notice some improvement with thyroid hormone, certainly by time you are on 50 mcg. Your low mood could cause your thyroid axis 'set point' to be lowered a little. This means your TSH, fT3, fT4 would all be a little lower giving some thyroid symptoms, I think these would be minor, especially with your numbers. An alternative underlying illness could also give the same effect. The only thing your blood tests might suggest is borderline diabetes (I have no knowledge of diabetes).
Hypothyroidism can be caused by environmental toxins that disrupt thyroid hormone binding without affecting the blood test results. In this case again you would see an improvement with levothyroxine and it would be quite noticable. I think you need to keep an open mind at this stage and try to avoid the temptation of jumping to a diagnosis.
Your fasting blood sugar is way high - should be no more than 4.7 ideally. Might be worth looking up metabolic syndrome/pre-diabetes. Your vit D is too high also, so stop supplementing if you still are (worth getting electrolytes checked too).
Well, you were very Lucky to get treatment with those labs! Doctors usually go by TSH only, but I suppose being private... Go slowly with your new GP. It's actually very unlikely she will be ok with your treatment given your TSH. And, as the others said, you don't actually have secondary hypothyroidism YET. Things could change either way.
Your Frees really are low, though, low enough to cause your symptoms, I would say. The FT3 is only just above mid-range, and most people need it up the top. I don't think you have a conversion problem, but your FT4 is much too low. It isn't even mid-range.
I doubt 25 levo is going to help you much. It's just going to stop your thyroid producing what it was managing to produce without giving you enough replacement to feel well. You'll know more when you get an increase.
Have you had yor B12 tested? That really is important. Low B12 can produce hypo-like symptoms. In fact, get as many vits and mins tested as you possibly can, they are all important for our general health.
Also, your diet. You said you've gone low carb - but don't go too low, we hypos need our carbs. But how is your fat intake? It's very important to get enough fat for various reasons. And that's where lots of people fall down in their 'healthy' diet, not enough fat because they think it's bad. It isn't.
Thanks so much everyone for the replies, it really is wonderful of you all to take the time to spare your expertise and experience.
Jim & Clutter,
Apologies I shouldn't have used the term 'self diagnosed'; my Private Doctor said my TSH and T4 were low but didn't use the term Secondary Hypothyroidism, that was all me! So what I meant was I didn;t diagnose myself based on my bloods I did call it the incorrect name. I won't mention this and will keep an open mind when seeing my GP. I take on board your point about the possibility of my thyroid axis 'set point' being lower.
I have stopped Vitd and will definitely get my B12 checked.
Gabkad,
My GP and Private Doctor were both happy when my HbA1 and fasting glucose were both back within range but I will raise this again as agree that they are high in range. My symptoms though predate any issues I've had with my blood sugar which first became apparent in my last pregnancy 5 years ago with late gestational diabetes; I have been having yearly checks since they and my blood sugars have been fine until this year.
There isn't, that I can see, a definition for low carb but it seems to be generally accepted that its in the range of 50-150g of carbs per day. I aimed for 50g while aiming to get my blood sugars back in range but I have gone a bit off the rails since my last blood test so thank you for those reading recommendations, just what I need!
Angel,
Thank you, I will raise this with my GP.
Finally Grey,
Yes GP said that there was no thyroid issue based on my TSH, it was my Private Doctor who asked me to have the T3 & T4 done. I'll just ask her opinion on treatment recommended by my Private Doctor. No 25mcg hasn't helped so I need to see what the Private Doctor says after a new blood test. I will definitely have my B12 tested.
As above I've been eating 50g of carbs a day which is basically only eating high fibre veggies, diary and protein. In your opinion is this too low? My fat intake is good (I need it to make up my calorie intake!). I'm obviously doing something wrong as even consuming 1500 calories a day and being active I'm not loosing weight!
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Opinion on test results please (First post)
High TSH with Low T3 & T4
Latest results full thyroid profile help please 
Advice please re B12 to supplement or not
