I've been feeling really rough for years with various symptoms related to thyroid (although I didn't relate them to thyroid at the time). I'm been signed off work for months with chronic migraines and so am under constant review at my GP for that. When I mentioned how bad some of my symptoms were- my GP suggested blood tests for thyroid.
My results were
TSH 8.3 ( 0.3-6.0mu/L)
T4 11.3 (10-20pmol/L)
TPO antibodies 71 lu/mL (<60iu/mL)
So the doctor's conclusion was that, despite me meeting the list of signs and symptoms of hypothyroidism which would explain my current condition, I am only classed as subclinical hypothyroidism. The procedure is to repeat tests in 6 months.
I felt like I finally had a chance of improvement in some area of my health and now I feel like I'm stuck feeling awful.
Is my GPs decision final here? Is the blood test the only argument I can make for me needing treatment?
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Raggy-Doll
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The definition of any "sublinical" disease is that the patient is asymptomatic but lab results are out of range. ncbi.nlm.nih.gov/pmc/articl... "Patients with subclinical thyroid disease have few or no symptoms or signs of thyroid dysfunction and thus by its very nature subclinical thyroid disease is a laboratory diagnosis. "
Clearly that does not apply to you as it was your symptoms that sent you to the doctor in the first place.
It is likely you have Hashimotos as you have elevated antibodies. I'd suggest you try going gluten free as I believe this helps a lot of people with auto-immune thyroid problems.
The "reference" range for your TSH has an upper limit of 6 - and this is the range that covers 95% of the population (that's what the reference range is).
Ask your doctor why, as you clearly have an elevated TSH that places you in the 5 percentile category plus you have clear symptoms of hypothyroidism, he will not try treating you to see if it improves your condition.
If you are feeling bolshy, you could simply ask why he refuses to treat you since he has clearly found the cause of your symptoms.
(Or you could do what I did and simply lose it. Mine put me on thyroxine to shut me up!)
If you email louise.warvill@thyroiduk.org and ask for a copy of Dr Toft's Pulse online article, wherein he says that if you have antibodies you should be given levothyroxine. Discuss this with your doctor as your antibodies are attacking your thyroid gland. The fact that you have such a high TSH is the proof.
I'm coming at this as a newbie myself, but the doctor told me this is exactly what happens to everyone. I don't understand it. I don't understand anything these days though.
Exactly what happens to everyone??? What is he talking about? That makes no sense. Of course it doesn't happen to everyone, only people with thyroid issues, which you clearly have. He's a numpty! He has no idea what he's talking about. I would have called him on that one, and asked him what exactly he meant. And asked for proof of it - where is the science? Give me a reference, an internet link, so that I can see for myself.
You have antibodies, your TSH is over-range, your FT4 is much too low - so god knows what your FT3 is like! All this is causing your symptoms. If I were you, I'd go back and demand (well, ask nicely first) that he explains himself. This is just not acceptable.
And while you're at it, ask him to test your iron, ferritin, vit D, vit B12, folate, zinc and selenium. Make him work for his money! Because at the moment, he seems to be copping out.
Have you also had the usual culprits tested ? B12 - Ferritin - Folate - Iron - VitD. When these are low you can so often feel unwell. When Hypo these things are usually low. Do not allow your GP to say normal when you have them tested. When Docs say normal - they mean in range - and they could be at the bottom of the range. This is not good for us Hypos. Insist on copies of your test results and post them here in another post - unless you already have them. B12 needs to be around 800/900 to prevent cognitive decline - Ferritin around 80/90 and VitD also needs to be at the top of the range.
Having Low B12 can mimic being Hypo too....symptoms overlap.
Hope you soon get the treatment you need. Having the above nutrients at an optimal level will set the scene and make things easier for your thyroid treatment to work efficiently.....
It specifically says, in the section on subclinical hypothyroidism :
"Consider offering a trial of treatment if the person has symptoms compatible with hypothyroidism."
You could print out the page I linked to and use it to support your case for a trial of levothyroxine. The fact you have a brother with an underactive thyroid is also worth mentioning, because a family history of the problem increases your risk of developing overt hypothyroidism yourself.
Don't forget to ask for vitamin and mineral testing as given by Marz above. And make sure you always get copies of the results, including the reference ranges.
As the article humanbean has posted states your GP can treat you with a TSH between 4.5 and 10 if you are symptomatic. A GP at my surgery treated me when my TSH got to 7.5 when I practically begged her to. Good luck.
Learn from my experience - I first went to the Quacks (and I use the term advisedly) in 2007 with symptoms coupled with a family history of hypo. He told me I was 'normal'. I carried on going and asking but still told I was normal. I noticed I'd lost around 30% of my eyebrows and a lot of hair on the side of my head in Feb 2010 I was told I was 'stressed'. I also complained about ever increasing severe hormonal migraines (by the end of not being diagnosed they lasted 7 days and occurred every 14 days) and I was told these were due to me having an early menopause. By 2012 I spent every evening with 2 hot water bottles (one front and one back) secured to me by a jacket for polar explorers and several blankets. I was sleeping mostly 12 hours per night (normal 8). I was putting on 1-2 lbs per month despite being on a sub 1500 calorie diet. I put on over 4 stone in total. My symptoms were suddenly all explained by my weight. In Jan 2013 I got very abnormal liver enzymes. I was now diagnosed as an alcoholic in denial who was also lying about her calorie intake.
In June 2013 I changed GPs.
In my first appointment with my new GP he asked 3 questions: what were my symptoms? was there any family history of thyroid issues? How long had this been going on? He stated that it was my thyroid. This took 5 mins. I, having been lulled into brainless stupor, stated that this could not be so as the previous Quacks had said that this was not possible as I was 'normal'. He sent me for bloods. My results showed 'sub clinical' results but he prescribed Levo anyhow on the basis that I was borderline. 100 mcg later and I got to the 'right' level but I felt better after 2 weeks on 25 mcg - not cured but better as my brain started to clear. I'm now on NDT and that's much better than Levo but that's a whole other story.
I know it's difficult when you feel so crap especially when you're having bad migraines (I lost the ability to speak sentences on some days and would vomit every 10-20 mins for up to 8 hours so I do really understand) but if you've got someone who's telling you it's not hypo but you're symptomatic demand a second opinion. Don't do what I did and just think that they know what they're doing. They don't. I saw three different doctors at the Quack practice. They all diagnosed me differently but basically I was a menopausal/over eating/alcoholic/attention seeking waste of space as far as they were concerned. Before I changed GP surgeries I asked everyone I knew about how good their docs were; I picked the one recommended by a friend who has, shall we say, a challenging personality. It was the best thing I've ever done.
So, I know it's difficult but maybe ask a friend/partner to go with you and demand that you're treated in accordance with NICE and given a course of Levo to try. If this one won't do it then demand a second opinion. If they still won't treat you move surgeries to a good one.
btw - I got all my blood test results and have a complaint in with the NHS Ombudsman because my results weren't 'normal', they were borderline and I should have been treated in 2007.....
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additional test results
Thyroid Symptoms with normal blood tests
Results advice and a few more questions, warning long post!
Could I be Hypothyroid?
