Thyroid results

Hi I am new here. Nice to meet you all.

I've had terrible fatigue all year. It's worse if I exercise, for days I feel floored. I feel flat at times and just generally Blurgh. I suffer anxiety but it's recently got worse since the fatigue increased. My gp thought I had an underactive thyroid as my mum and all aunties do too and I match the symptoms. Well my results came back and my resukts are...

TSH - 5.33 mu/L

T4 - 11pmol

My parathyroid is 2 pmol.

I've read 5.33 is an indication of underactive thyroid. I am speaking to my gp next week to disuss the results. Can anyone tell me if my results are normal?

Thank you

Julie

[Clutter]

Welcome to the forum, Jingyd35.

Do you have the lab ref ranges to go with your results? They're the figures in brackets after the results.

[Hidden in reply to Clutter]

Yes it days the tsh is 0.35-5.50. Mine is 5.33.

[Clutter in reply to Hidden]

Jingy, and the T4 and parathyroid?

[Hidden in reply to Clutter]

My serum free T4 is 11 pmol (nhs range is 7.0-17.0) and my parathyroid is 2 pmol (ranges are 1.0-9.3)

Thanks.

Julie

[Clutter in reply to Hidden]

Julie, your results are 'normal' because they are all within range. However, TSH 5.33 is at the top of range and means your thyroid is struggling to produce hormone and FT4 is less than half way through range. NHS doesn't usually make a diagnosis of hypothyroidism until TSH is over range ie >5.50. I can't guess whether your GP will start Levothyroxine now or ask you to wait and repeat the test in 3 months. Ask for thyroid antibodies to be tested to confirm or rule out autoimmune thyroid disease (Hashimoto's).

If you are asked to wait and retest make sure you arrange very early morning testing and make it a fasting test (water only). TSH is highest early and drops after food and drink. Read the links below before you see your GP.

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

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

Parathyroid hormone (PTH) is low in range. Ask your GP to check your calcium levels. Low calcium and low PTH indicate hypoparathyroidism.

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Thank you so much.

Could I have symptoms with my levels?

My ferritin is 15 ao that is low but according to range it's 15-300 so classed as normal. It was 8 last year.

My bone profile was also tested. My calcium serum level was 2.33 (2.20-2.6).

My gp marked all my results as normal. He hasnt even told me if I am borderline or if they need repeating.

I had my test at 9am after a small breakfast. Next time I will fast though.

Thanks for your help.

Julie

[Clutter in reply to Hidden]

Julie, TSH 5.33 is borderline for subclinical hypothyrodism ie TSH >5 and <10 with normal FT4. I would be very surprised if you weren't symptomatic. I included a link to a symptom checker above.

Calcium is normal.

Iron should have been prescribed when ferritin was 8. 15 is far too low, it should be between 100-150. Supplement Ferrous Fumarate and take each iron tablet with 500mg-1,000mg vitamin C to aid absorption and minimise constipation. If you start taking Levothyroxine take it 4 hours away from iron.

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Thank you.

I am feeling awful recently. I suddenly can't workout. If u workout I feel unwell with fatigue for 3 days. That's been happening thr last few months. On a good day I can manage yoga. On bad days I dread even going to thr kitchen to male lunch. I feel fatigue, weakness in my legs, tingling like blood rushing in finger tips alot, brain fog, can't think straight, anxiety through the roof. I get anxious leaving the house feeling so fatigued. Just a general blurgh feeling. Sheer exhaustion. My mum has an underactive thyroid as do my aunties. My auntie had her thyroid removed.

Yes I am on iron but only spatone as I can't take the tablets. I tried fumarate and glucose qnd both gave me diorrheoa. Spatone has increased it but not by much. My hb is 14.4 so normal. I just struggle with low ferritin.

Your help has been great. Would you suggest I see my GP and challenge these results?

Thanks.

Julie

[Clutter in reply to Hidden]

Julie, they're typical hypothyroid symptoms. You should see your GP about the thyroid results and symptoms and ask whether he will give you Levothyroxine. If not ask to be retested in 3 months.

Ask for the thyroid antibodies test, vitamin D, B12 and folate to be tested. Vits/mins are often low/deficient in the months prior to a hypothyroid diagnosis.

Tingling in fingers can also be due to B12 deficiency.

b12d.org/b12-signs-symptoms...

[Hidden in reply to Clutter]

Thank you next week I shall speak to him.

My b12 was tested amd the result was 212ng/L (150-900)

Serum Folate 23.20ug/L (> 3.0)

He didn't check vitamin d he said he couldn't until doing a bone profile. Which was fine I think. Calcium was ok.

Is the b12 levels and folate normal?

I do feel extreme fatigue most days and it's ruining my life. My fatigue is causing me extreme anxiety. I had anxiety diagnosed 3 years ago after a stressful time and I am on medication but it's got worse since the fatigue hit.

Thank you.

Julie

[Clutter in reply to Hidden]

Julie, Cut out the exercise for a while. It depletes T3 which is already likely to be low and that's why it can take 2-3 days to recover from exercise.

Increased anxiety is a hypothyroid symptom and should improve once you are optimally medicated. Use the symptom checker I linked to prompt your discussion with your GP or just hand it to him/her.

B12 212 is very low. 1,000 is optimal. Ask your GP to test intrinsic factor and anti-parietal cells to confirm or rule out pernicious anaemia. If GP refuses to test supplement 5,000mcg methylcobalamin sublingual lozenges, spray or patches for 8 weeks and then reduce to 1,000mcg daily. There's no toxicity from high B12, excess is excreted in urine. Take a B Complex vitamin to keep the other B vitamins balanced.

Folate is good.

[Bluedragon]

Hi, your B12 is too low. Will your doctor give you the loading injections? You should have an active B12 test, methymalonic acid (mma) and homocysteine (hcy). These can be done at St Thomas's or online, privately. This will tell you how low you are at cellular level.

Pop over to the Pernicious Anaemia Society forum on here and someone will post the BSCH and NICE guidelines for you.

Don't take B supplements until had further tests as will slant results.

Read Could it Be B12 by Sally Pachlok. Be prepared to read lots about Thyroid/B12 deficiency and vitamin D..... We have to as rare doctors know enough.

[Hidden in reply to Bluedragon]

Thank you for your reply.

Would you say I have hypothyroidism at a tsh of 5.33 and t4 of 11?

My b12 is 212 but my gp has said it's normal. When I rang for my resukts the receptionist said all are fine. No action needed so I asked if I could have a print out.

My ferritin is 15 and has been shockingly low for 10 years. It was 8 last year.

I shall look at that board. Thank you. My serum folate is 23 which I have just read is high and in brackets on my resukts it says (>3) and my gp has still marked results as normal.

Thanks

Julie

[Bluedragon in reply to Hidden]

Hi Julie, yes to hypo. The advice given to you was good, Clutter is great! Like I said, Dr's know little. Be prepared for battle...

[Hidden in reply to Bluedragon]

Your advice and Clutters has been most helpful. Thank you 😊

[Clutter in reply to Hidden]

Julie, folate 23 is fine. >3 means anywhere above 3 is good but below 3 is deficient.

[Polaris in reply to Hidden]

Others have already mentioned B12 deficiency. What many GPs consider normal B12 results are not, as "deficiencies begin to appear in the cerebral spinal fluid below 550 pg/ml." - 'Could it be B12?', by Sally Pacholok and Dr J.J. Stuart.

It seems likely that the severe fatigue and anxiety, etc are neurological symptoms of B12 def. which very few GPs understand and are only looking for anaemia and large red blood cells. This is the last stage, may never appear, or be masked by high folate. Devastating neurological symptoms can appear before this stage and should be treated aggressively without delay.

It is essential to research as much as possible to be able to fight your corner and these links might help:

b12deficiency.info/b12-writ.... (List of symptoms and an excellent film)

ukneqas-haematinics.org.uk/... :

chriskresser.com/what-every...

cmim.org/pdf2014/funcion.ph... :

Latest BMJ research document with useful summary if GP won't read the whole document.

[Polaris in reply to Hidden]

PS. Re. family history - four members of our family have thyroid/autoimmune/B12 issues. Many researchers believe leaky gut/intestinal disease is the ground zero of autoimmune disease and thyroid/PA/B12 def. Is often linked both ways with symptoms overlapping. Not surprising as vitamin B12 builds DNA.

[Hidden in reply to Polaris]

Thank you for your advice.

I shall read those links. Thank you.

I am thinking thid could well be my b12 being low and possible underactive thyroid? I am nervous about speaking to my gp as I know he will be playing it down saying I am just worrying as I am an anxiety patient in their eyes.

Thanks again

Julie

[Hidden in reply to Polaris]

I should also mention my MCV is 88fl (80-100) and I read b12 usually comes with a high mcv result? Could that be why my gp isn't treating my b12?

[Polaris in reply to Hidden]

Yes, you're right, high MCV is another sign of B12 def.

Extracts, again from 'Could it be B12':

"The major problem - indeed, the most important factor - is that most physicians fail to contemplate B12 deficiency, are poorly educated about it, and therefore fail to test for it."

"Many physicians tend to treat the paper laboratory report rather than the patient. Numerous times in our experience, a symptomatic patient's serum B12 was between 200 pg/ml and 300 pg/ml and the doctor told the patient, "You do not have B12 deficiency". Given the remarkable safety of B12 treatment and the horrific consequences of ignoring a deficiency, it is always best to err on the side of treatment".

[Hidden in reply to Polaris]

Thank you.

I don't know whether my symptoms are due to my tsh being 5.33 or my b12 at 212. I'm sure my gp will say neither are to blame.

[Hidden]

Clutter, thank you. So 23 folate is normal? Good to hear.

I'm actually nervous about chatting to my gp as I an sure he is going to say your tsh and t4 are normal and your b12 is fine. He will tell me to stop googling I bet. It's how he is if I question anything.

I have a dry mouth alot is thid common with thyroid? I noticed it was on the symptom checker. I suffer daily recently. At first I worried I was diabetic but I don't have any of the other symptoms. I had my glucose tested I think last summer.

Thanks again. I am so nervous about challenging my gp.

Julie

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I've just re read my results and under my b12 it says 'intermediate b12 level consider treatment if other evidence of neuropathy or microcytosis'