A few questions

Sorry to post again. I posted a week ago and on Tuesday about my blood results. Which I will attach here rather than repeating my story.

GP as you all know said to just leave things and repeat in 6 months. I won't be leaving it 6 months. The GP who rang wasn't my usual GP, so would it be wrong of me to call and ask again to have a phone appointment with my actual GP? I hate to call them again. Also if he says 6 months too, is it unreasonable to ask for a repeat thyroid test in 3 months? my TSH was 5.33 and the GP I spoke to said I wouldn't be symptomatic.

Also, can these be symptoms? I have low ferritin and borderline TSH according to the GP. Since the fatigue hit earlier this year I have also had everytime I stand up and horrid heavy rush to my head and chest, like a big drop in BP. This happens everytime I stand up even if just from sitting. It always panics me. My GP said this is just postoral hypotension and very common. I have had it before and not worried. I just worry as it seems much worse since the fatigue. My anxiety is really high, it's a physical anxiety, I seem to be worrying over every symptom and panicking I will die. Urgh.

I also am worrying because 2 years ago I had my cholesterol tested. My uncle had a massive heart attack at 51 due to a hyreditary condition that causes high cholesterol. He didn't smoke or drink and was slim. All our family were tested and a few of us were high. Mine was 5.8 and my GP said it was fine. I asked him earlier this year if I could be retested and he said no need to at the moment. Again I am panicking what if i go bang like my uncle if 5.8 is high. I will be insisting he retests this at my next bloods.

Sorry to post again, just feeling a tad anxious and worried about things.

Julie

[Barrister]

There will be some knowledgable people along I'm sure. Meanwhile, your B12 is very low so you could try taking some B12 supplements. Likewise, your ferritin needs supplementing.

Regarding your cholesterol, 5.8, whilst slightly raised, isn't very high. Ive had high cholesterol for years and it was much higher than that before I was given statins. I didn't know then that when you have an underactive thyroid, you often have a raised cholesterol. So perhaps you could ask for a telephone consultation with your GP and point out that you are concerned due to your family history and request that it be tested again (I don't think that it's unreasonable as it was last done 2 years ago.) and also you could point out that you've been researching high cholesterol and have noticed that there is a connection with raised TSH. That's what I would do. Clemmie

[Hidden in reply to Barrister]

Thank you.

Yes I shall contact my GP for a chat. I shall raise my concerns about the cholesterol.

He has treated my ferritin with Ferrous Gluconate but not the B12 as he said that was normal.

Thanks

Julie

[Clutter]

Julie, the GP who says you will not be symptomatic with TSH 5.33 is wrong. A lot of people wouldn't be able to get out of bed with TSH >5.

Elevated cholesterol is a typical hypothyroid symptom, increased anxiety is typical, and so is fatigue. High cholesterol (sometimes over 244) was a defining characteristic in clinically diagnosing hypothyroidism before blood tests were invented. Your cholesterol will drop when your thyroid levels are treated. In the meantime, 5.8 isn't going to kill you or damage you.

It's certainly worth asking for a repeat thyroid test in 3 months. No point in waiting any longer than necessary to start treatment when TSH is over range.

[Hidden in reply to Clutter]

Brilliant. Thank you.

Is it likely the TSH would raise in just 3 months, enough to go over that 5.5 range? It is at 5.33 (I had the test at 9.10am and after breakfast so I read it could be higher if I hadn't eaten?). The GP I spoke to said there is no need testing every 2 minutes when I asked why I had to wait 6 months for a retest.

Thanks re the cholesterol, that is reassuring about the level not being dangerous.

Julie

[Clutter in reply to Hidden]

Julie, it's impossible to guess whether TSH will rise or fall. It is usually higher in the autumn/winter. TSH is highest early and before food/drink, so book the earliest appointment and have a fasting test (water only).

[Hidden in reply to Clutter]

I will, thank you.

Another question. A pharmacist friend of mine said they won't say I have hypothyroidism as my T4 at 11 is normal? I am confused. He ssid they wouldn't diagnose it just based on TSH high which he agreed was too high. I am not sure what to think now.

[Clutter in reply to Hidden]

Julie, subclinical hypothyroidism is diagnosed when TSH is >5.50 with FT4 in normal range. Overt hypothyroidism is diagnosed when TSH is >10 and FT4 below range. Most GPs will treat subclinical hypothyroidism but some GPs insist TSH is >10 before they will diagnose. If yours is one of the latter, I suggest you find a new GP.

[Hidden in reply to Clutter]

Thank you. That clears that up. Can I ask what subclinical means?

[Clutter in reply to Hidden]

Julie, borderline ie above normal range but below overtly hypothyroid range.

[Hidden in reply to Clutter]

Thank you 😊

[shaws]

He has a cheek not to give you medication with a TSH above 5. This is info and I would certainly see another doctor (besides your very low B12 and ask if you can have an intrinsic test to exclude having pernicious anaemia before supplementing with B12).

thyroiduk.org.uk/tuk/testin...

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

In other countries when the TSH is around 3 patients are treated.

[Hidden in reply to shaws]

I know, he said it would just be my ferritin causing my symptoms but I have had lower ferritin than 15 and not felt so fatigued and unwell.

I once asked for a test for perenicious anaemia and the GP refused saying I had no symptoms or indication of it, as it was just my ferritin that was low. Again I am scared to ask for that test but I guess I need to be more assertive. Will I be ok not supplementing my B12 for another 3 months? I am guessing he will do my cholesterol, thyroid, ferritin etc.. all at once.

Thanks for your help again and for those very helpful links.

Julie

[shaws in reply to Hidden]

Well, I had no symptoms whatsoever of P.A. and was being investigated for something else when my blood cell test showed that something wasn't quite right. I was then given a test which showed I had pernicious anaemia so not everyone has symptoms. I had many symptoms of hypo but no-one ever did a blood test, that's because they haven't a clue what a clinical symptom is and will diagnose us only upon a TSH blood test usually. Excerpt from following link:

Your doctor may recommend other blood tests to check:

Your vitamin B12 level. A low level of vitamin B12 in the blood indicates pernicious anemia. However, a falsely normal or high value of vitamin B12 in the blood may occur if antibodies interfere with the test.

Your homocysteine and methylmalonic acid (MMA) levels. High levels of these substances in your body are a sign of pernicious anemia.

For intrinsic factor antibodies and parietal cell antibodies. These antibodies also are a sign of pernicious anemia.

nhlbi.nih.gov/health/health...

[Hidden in reply to shaws]

Thank you. That's great information. The rest of my bloods were normal ao is that why he's not thinking I have PA? Do they test the MMA levels?

Thanks again

Julie

[shaws in reply to Hidden]

Normal doesn't come into it if we have symptoms.

Doctors used to know by the look of the patient plus their symptoms that they were hypothyroid. Now it appears we are machines in that we are diagnosed mainly by the TSH.

On HU communities there is also a P.A section who will be helpful too if you are worried.

[Hidden in reply to shaws]

Thank you for your help. I shall take a look.

Julie