Mr Olly Jukes

[OllyJ]

Hi, just need some advice really:   For the past couple of years I've been feeling very fatigued, depressed and suffering from an anxiety disorder.  The doctor has put me various meds to try to counter this plus vit D.  My thyroid results have always come back as on the border so they don't do anything to investigate this further. I had another test this week and my TSH is 9.21.  From what I can tell without further tests that I guess will need to be done privately I have sub clinical hypothyroidism.   Nothing the doctor has given me over the past two years has stopped me feeling awful. Should I insist on going in a course of thyroid treatment??

[Clutter]

Welcome to the forum, OllyJ.

Ask your GP to test thyroid antibodies.  In the presence of positive antibodies most GPs will treat with Levothyroxine when TSH is 5 or 6.

I can't see any need for private testing.  TSH 9.21 is subclinically hypothyroid and FT4 should be tested to check it is not abnormally low.  It's brutal to be forced to wait until you are overtly hypothyroid with TSH >10 before you get treatment and it is worth seeing another GP at your practice for a second opinion.

Arrange future thyroid blood tests early in the morning when TSH is highest, and fast (water only) as TSH drops after eating and drinking.

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

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

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

_____________________________________________________________________________________________

I am not a medical professional and this information is not intended to be a substitute for medical guidance from your own doctor. Please check with your personal physician before applying any of these suggestions.

[OllyJ in reply to Clutter]

Hi, thank you for the reply!  My FT4 came out as normal but I still think that means sub clinical hypothyroid.  Do I need to check my FT3 level as well or just for anti bodies? I'll chase the doctor tomorrow if I can get hold of him. Thanks 

[Clutter in reply to OllyJ]

Ollyj,

Not much point in testing FT3 when TSH is so high.  NHS will decline to test unless TSH is <0.03 usually anyway.

GP should be able to order FT4 and thyroid peroxidase antibodies.

[OllyJ in reply to Clutter]

Went back to see a different gp today.  She was going to send me for another blood test to check for the antibodies but as she was checking my notes she saw from a test done 2 years ago that I had thyroid antibodies present then!  That was enough for her : So the long and short of it is that she's prescribed me 50mg thyroxine daily which is at least a start to hopefully a recovery !

Thanks again

[Clutter in reply to OllyJ]

Ollyj,

Excellent!

It takes 7-10 days for Levothyroxine to be absorbed before it starts working and you may find hypothyroid symptoms get a little worse initially as it takes up to six weeks to feel the full impact of 50mcg.

For maximum absorption Levothyroxine should be taken with water 1 hour before or 2 hours after food and drink, 2 hours away from other medication and supplements, and 4 hours away from calcium, iron, vitamin D supplements.

You should have a follow up thyroid test 6-8 weeks after starting Levothyroxine.  Arrange an early morning and fasting (water only) blood draw when TSH is highest, and take Levothyroxine after your blood draw.

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

Most people will find symptoms resolve after their TSH drops to around 1.0 with FT4 in the upper range but symptoms can lag a couple of months behind good biochemistry.

Positive thyroid antibodies means you have autoimmune thyroid disease (Hashimoto's) which causes 90% of hypothyroidism.  100% gluten-free diet can help reduce Hashi symptoms and antibodies.

chriskresser.com/the-gluten...

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

_____________________________________________________________

I am not a medical professional and this information is not intended to be a substitute for medical guidance from your own doctor. Please check with your personal physician before applying any of these suggestions.

[jannah in reply to Clutter]

So when your hav I ng these test you should drink water. What about when there ask for urine sample first thing in the morning. My blood pressure is high now and asked for blood test becuz I am taken thyroxine and thjnking of putting me on some tablets becuz my diabetes aregoing high.

[Clutter in reply to jannah]

Jannah,

When having a blood test it is necessary to avoid dehydration which can make a blood draw difficult which is why patients should drink plenty of water beforehand.

You'll have to ask your doctor or nurse whether you should drink water before a urine test.

[Jazzw]

Oh, for heaven's sake... Your doctor's an utter nob.

You have a TSH of 9 plus, and he's telling you you're depressed? Why oh why don't they get that feeling awful has a tendency to make you feel anxious and low?

OK. First step. Get hold of all the blood tests you've had over the past couple of years. If they've only ever tested TSH someone needs shooting, but it's horribly common.

Next - see what hasn't been tested. You'll need FT3, FT4, TSH and thyroid antibodies as a minimum, but B12, ferritin and Vit D would also be worth testing. If your GP won't test them, ask to see another GP in the practice. If that's not possible, register with another practice.

I think you've got lots of grounds for asking for a trial of levothyroxine. The TSH "normal" range goes up to 5 - so why isn't 9.21 being taken seriously? 

[OllyJ in reply to Jazzw]

Thanks for the advice ! Much appreciated. I'll respond again when I know more. M

[OllyJ in reply to Jazzw]

Done.   I got the doctor to check old blood tests and she noticed positive anti bodies from a test 2 years ago!! Anyway she started me on  levothyroxine - whew

[jannah in reply to OllyJ]

2years is long time the doctors should check you again.

Seriously these doctors should go back to schools I think there are taught to do exactly opposite to us the patient you don't know who to trust anymore just trust your instincts.

If we all continue to read and help us we will be better advance then thoseGP who sit on they backside do nothing. The only thing is we don't get certification for our knowledge.lol

Good luck

[SlowDragon Administrator]

If you can not get NHS to do these blood tests see 

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

Blue Horizon home blood tests are very easy to do 

Thyroid plus 10 

Or 

Thyroid plus 11 

These will give you necessary info to then see what needs treating

With thyroid problems it can be common to have low Vit D, B12, folate and ferratin - these need checking/correcting before thyroid medication can work properly 

Many of us here have given up the battle of trying to get GP's or NHS labs to do necessary blood tests. If you can afford it, just organise it yourself 

[OllyJ in reply to SlowDragon]

Hi Slow Dragon,  thanks for your mail.  If I were to buy one of the home testing kits  from Blue Horizon how would I take the blood?  Is it a pin prick ?

Thanks

[SlowDragon Administrator in reply to OllyJ]

Yes - you can do self pin prick - very easy doesn't hurt - or can be done traditional way (vacutainer) if you prefer and can find a nurse or hospital to do it for you. You just choose which option you prefer when you order test.

Thyroid plus 12 test apparently has to be done by vacutainer - this test includes for reverse T3 (RT3),  but is not essential test for most people.

[OllyJ]

Thank you - that's great information.