what tests to request ...

[sallyulph]

Hi all,

I'm new here, so lots to learn! I was diagnosed with CFS, after many years of fatigue plus many symptoms. The more I learn, the more I believe that adrenal + thyroid issues are almost certainly a massive part of what I need to address. I recently had second spell of palpitations at night, that felt very much like people describe hashimotos 'attacks'. I'm going to the GP's next week to request another thyroid panel (I had one a year ago) so I want to check exactly which tests for thyroid and nutritional deficiencies I should request. (confused myself by reading too much and not taking notes so thought it best to check with you guys!)

thanks in advance

Sally

[shaws Administrator]

Before I was diagnosed with hypothyroidism that's what I was experiencing, palpitations which I never had before. This is also due to not having sufficient thyroid hormones circulating in our bodies and our body's attempt to try to rectify it.

Also hyperthyroidism also causes palps.

When you go for your test it should be as early as possible and fast (you can drink water). When on thyroid meds you allow 24 hours gap between dose and the test. The TSH is highest a.m. and food lowers it. Nowadays doctors seem to only take notice of the TSH and sometimes the labs don't do what he requests.

You need TSH, T4, T3, Free T4, and Free T3, iron, ferritin and folate, Vitamin B12 and Vit D.

For your information (Dr Skinner died two years ago) this doctor was brought into the thyroid world due to being sent patients for whom the other specialists hadn't a clue what was wrong - I assume because the TSH only was used for diagnosis.

worldthyroidregister.com/Go...

[Clutter]

Welcome to the forum, Sallyulph.

The recommended thyroid tests are TSH, FT4, FT3, thyroid peroxidase antibody and thyroglbulin antibody.

GPs will usually test TSH levels initially. If levels are abnormal, FT4 and thyroid peroxidase antibodies may tested, but patients are often asked to return for a follow up TSH in 3 months to rule out non-thyroidal illness like a virus or infection which may raise TSH. FT3 is rarely tested in primary care unless TSH is suppressed <0.03 which indicates hyperthyroidism.

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

The recommended vitamin and mineral tests to request are ferritin, vitamin D, B12 and folate. Levels are often low/deficient in hypothyroid patients and can cause fatigue, musculoskeletal pain, neuropathy and low mood similar to hypothyroid and CFS symptoms.

You can order thyroid panel and vitamin/min private tests from Blue Horizon and Genova via thyroiduk.org.uk/tuk/testin...

Palpitations can occur many reasons, including anxiety, stress, hormonal changes, low iron/ferritin, low thyroid levels, high thyroid levels, cortisol, heart rhythm disturbances etc. Occasional palpitations aren't usually indicative of anything and, although unpleasant and disturbing, are rarely damaging. Frequent or constant bouts should be investigated but often show normal heart rhythms on ECGs.

[sallyulph]

thanks for all that, these palpitations were of a very different nature to ones that i have experienced more generally (which I've associated with over exertion and adrenal insufficiency). I had an ECG last year but I've read that they are pointless for fluctuating heart dis-rythmias (however thats spelt!). its definitely not anxiety - generally I'm happier than I've been for years, I just would love a little more energy!!! I think I managed to get an understanding gp to do most of those tests last year so I will try again (didn't do one of the anti-body tests I think though).

thanks for your prompt replies