Blood tests - would appreciate help - Long post

Hello,

I have been feeling rough for the past two years - have put some posts on here previously and everyone has always been very helpful, was hoping someone knowledgeable would be able to glance over my test results and tell me what you think? I'm very tired all the time, brain fog, dizzy, feeling cold, hair loss, lots of symptoms consistant with hypothroidism.

My TSH levels when tested initially in Jan 2013 were over the range, however GP was very much of the mindset of wait and see. Since then they have diagnosed me with fibromyalgia and depression and anxiety - all of which I have contested. I really don't feel depressed - just tired and fed up with not being listened to by the GP practice. I have seen various Dr's there and am seriously considering changing practices but my options are really limited locally and dont know whether I will be making a wise move. They are currently exploring the possibility of an internal bleed and I am waiting to hear from the hospital regarding the appointment but unlikely to be within the next month. I feel I really need to stay with my current surgery until the hospital either rule out a bleed or confirm it. A few weeks back I was having difficulties with my sight and went to the optician who said he actually thought it was thyroid related, GP did test thyroid but ruled this out as within range. Most recently I've noticed i'm getting a lot of hair loss, literally a big handful each time I wash my hair, does anyone know what else this could be due to? I'm ata bit of a loss - excuse the pun! I still think its the effects of my antibodies but dont know how to get my GP to listen to me.

I have asked GP whether my symptoms are due to my fluctuating TSH and in the particular the level of TPO antibodies (am presuming hashimotos) but 3 GP's have point blank refused to consider this, I have asked whether my levels are simply too high for me but again they have refused to accept this, one GP told me that I simply had to get thyroid out of my mind as it could not possibly be causing my symptoms, my family all have underactive thyroid (but with different GP surgery).

I am currently on ferrous sulphate 2 x 200mg daily for anaemia and have just been told to boost my Vit D level by either supplements (SunvitD3) or diet.

Sorry there are quite a lot of results.

Jan 2013

TSH 6.5 (0.25 - 5.0)

fT4 at 17.4 ((9.0 - 23.0)

TPO level 257 iu/mL (no range but noted borderline)

April 2013

TSH 6.10 (0.25 - 5.0),

fT4 15.2 (9.0 - 23.0)

Oct 2013

TSH 4.03 (0.25 - 5.0)

fT4 17.6 (9.0 - 23.0)

June 2014

TSH 4.74 miu/L (0.25 - 5.0)

fT4 19.6 (9.0 - 23.0)

tests taken Sept 14

Serum ferrritin level 10ng/mL (13 - 150) -

TSH level 3.86 (0.25 0 5.0)

Serum free T4 level 17.8 pmol/L (9.0 - 23.0)

Tests Nov 2014

haemoglobin concentration 145 g/L (115.0 - 160.0)

Total white blood count 4.3 10*9/L (4.0 - 11.0)

Platelet count - observation 153 10*9/L (135.0 - 450.0)

Red blood cell count 4.87 10*12/L (3.8 - 4.8) Above high reference range

Mean cell volume 86fl (80.0 - 100.0)

Haemocrit 0.42L/L (0.35 - 0.45)

Mean cell haemoglobin level 29.8 pg (27.0 - 34.0)

Red blood cell distribution width 15.9 (10.0 - 15.0) Above high reference limit

Neutrophil count 2.3 10*9/L (2.0 - 7.5)

Lymphocyte counte 1.3 10*9/L (1.0 - 4.0)

Monocyte count - observation 0.6 10*9/L (0.1 - 1.0)

Eosinophil count - observation 0.1 10*9/L (0.0 - 0.5)

Basophil count 0.1 10*9/L (0.0 -0.2)

Erthrocyte sedimentation rate 5mm (1.0 - 19.0)

Calcium profile 2.26 (2.2 - 2.6)

Serum calcium level 2.24 (2.1 - 2.6)

Serum albumin level 43g/L (35.0 - 50.0)

Serum Creatinine level 76 umol/L (45.0 - 84.0)

GFR calculated abbreviated MDRD 72 mL/min

Serum 25- Hydroxy vitamin D3 level 45.9 nmol/L - Insufficient (greter than 75 nmol/L optimal)

Serum folate level 14.2 ng/mL (4.8 - 37.3)

Serum vitamin B12 level 323 pg/mLL (191.0 - 663.0)

If anyone could offer any advice/suggestion I would be very grateful.

Thanks for taking the time to read.

Ax

[Hennerton]

I think you must either change your GP or go the self medication route. Your current GP is keeping you ill. Is there any chance of visiting the practice your family use, just as a visiting patient? As they know your family, they may look at you with a different view.

Could you see someone privately? I ask this because it can be a bit scary just buying a bottle of thyroid hormone, although you would get help here. There are definitely ways of starting you off by seeing a doctor on the TUK list, held by Louise Warvill. I do not want to put you off helping yourself but see if you can find another way to begin with - but definitely bin the current GP!

[Hidden in reply to Hennerton]

Thanks Henneron. Yeh its such a mine field, I'm concerned about self medicating because I don't feel I know enough and have enough time on my hands to make myself more knowledgeable - damn brain fog!

I have considered seeing my families GP but dont know whether they would test thyroid if just staying there for a short period of time, I think need to check this out, I am concerned though that if I was prescribed meds through another and then returned to my GP they would stop it. I really think I need to look into other GP's in the area as well.

Thank you. A. x

[silverfox7 in reply to Hidden]

I think it's shocking with your family history that your GP won't do the tests. I suspect it's because he's no idea what to do if you do show a problem! You certainly need another GP but it's difficult to know whether it's going to be out of the frying pan into the fire! In the mean time it might be worth having a private test done from either Blue Horizon or Genova Diagnostics-more info on the Thyroid UK site.

[Hidden in reply to silverfox7]

Hi,

Thanks for your reply. Sorry I was referring to my families GP doing the thyroid tests, I would need to register with them though as if I was staying there for a while as they live quite a distance from me. Am still a bit unsure about changing GP's for the reason you've outlined above! I think my TSH is fluctuating and really need to be tested when I'm feeling really rough.

Thanks, A

[Hidden]

Thanks for your reply reallyfedup123, I'm taking the Vit C with the ferrous sulphate to aid the absorption, must admit I'm not noticing any difference at the moment but its probably only been about 6 weeks or so, so may be early days.

I think my GP has always viewed my fT4 level as coping but my body really isn't. I am compiling some research to take in with me next time. I wasn't aware of the site you mentioned so thank you I will have a good read.

I'm trying not to self medicate at the moment as am fearful on how it will affect future results.

I hope your husband is now feeling better.

A.x

[Clutter]

Angie, Like the others I think your GP should have started you on Levothyroxine when your TSH was >5.0. However, your TSH has been dropping consistently and now it is 3.86 I think it will be difficult to persuade a different GP to diagnose hypothyroidism until your TSH is >5.0.

TSH 3.86 is certainly high enough to cause your symptoms and the fluctuations may well be due to Hashimoto attacks on your thyroid.

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

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

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

High red blood cell and width above range can be indicative of iron, B12 &/or folate anaemia. Your B12 is very low in range and it may be worth asking your GP to test antibodies for pernicious anaemia. If PA is ruled out you should supplement 1,000mcg methylcobalamin sublingual lozenges, spray or patches until B12 is high in range and take a B complex tablet for the RDA of folate and the other B vitamins.

Supplement 5,000iu vitD3 daily for 6/8 weeks then cut back to 2-2,500iu daily until April when ultraviolet levels are high enough to stimulate vitD.

[Hidden in reply to Clutter]

Thanks Clutter thats really helpful. I think GP's already ruled out pernicious anaemia by tests above, but to my knowledge antibodies for pa not done, what is this test called? I really don't have much confidence in my GP surgery anymore and have been labelled as anxious. Wish I had known more a couple of years ago to insist then on a trial of meds but felt so rough then that just wasn't able to take on board advice. Now TSH dropped really don't see me getting anywhere with these GP's unless it dramatically rises, just wish I felt better or was at least consistent with how I'm feeling - it seems to fluctuate so much.

I will try some of the lozenges for pa, I'm taking 1000iu of Vit D3 spray, but will up it and see how I get on.

Thanks, A. x

[helvella Administrator in reply to Hidden]

A B12 level of 323 is not sufficiently high to "rule out" pernicious anaemia.

The whole subject is complex. But if you start taking B12 before diagnosis, you can make it difficult to ever get a proper diagnosis. I suggest you hop over to at least have a read of some of the posts on the Pernicious Anaemia Society group here on HU.

Rod

[Hidden in reply to helvella]

Thanks Helvella, I'lll have a read on that group, before i do anything.

[Clutter in reply to Hidden]

Angie, those blood tests don't rule out pernicious anaemia. You need Intrinsic Factor and Gastric Parietal Cell antibodies tests to rule out PA. Don't take B12 until after you are tested or you may skew the results.

patient.co.uk/doctor/pernic...

[Hidden in reply to Clutter]

Thanks Clutter, I don't think my GP is planning on doing any other tests, feel really dismissed by him to be honest. I won't take any B12 at the moment though.

Thanks for your help.

A.

[Clutter in reply to Hidden]

Angie, In my experience GPs don't 'offer' to test, you have to ask. If the GP refuses then start supplementing.

[Hidden in reply to Clutter]

Thank you for your advice, I will ask. It makes me feel sick to the stomach when I think about going back to my GP, I know I need to but I just end up coming out feeling a failure, am sure I am not alone in feeling like this. I think I need to go prepared with research.

A. x

[Clutter in reply to Hidden]

Angie, don't feel like that, you're proactively trying to recover your health not pass an exam. It's true some GPs are more approachable that others, but if you explain why you think the test may help you to rule out or confirm something which may help you the GP should appreciate that and either do the tests or explain why it is unnecessary. If your GP feels it is unnecessary then you can start supplementing B12.

[eeng]

Did you have those blood tests done first thing in the morning? TSH varies during the day and is highest first thing in the early hours, so if you want to get treated you need the earliest blood test possible.

[Hidden in reply to eeng]

Hi, Yes I always get a n appointment first thing, round about 9am, so all my test results are consistent. thanks for replying x