Any more tests I should do???

[Tarajp123]

Hi everyone! I wondered if you could give me some advice. I've been hypothyroid for the last 8 years but progressively getting worse in my symptoms for the past 2 years to the point where I am where I am now. I'm usually in bed by 8:30 every night, have little desire to go out and socialise and a night on the town is my worst nightmare! By the way I'm 29!!!

I've finally managed to see an Endo and she is wanting to test a few things before assuming it's thyroid related. I know my cortisol Levels are high but the test for cushings disease came back normal. She's checked all my vitamins etc and all came back normal. The next thing she wants to test is sleep apnoea so I have an overnight test next week for that. Assuming that comes back normal too is there anything else that she should be testing? I've read about reverse t3 dominance so going to ask her about that. But any other things to rule out that you can think of. I basically suffer from all the hypothyroid symptoms including excessive weight gain despite being adequately treated and levels in range.

Any advice would be appreciated. I understand why the Endo is doing this because I guess the last thing she wants to do is put me on T3/NDT but I want to make sure I get tested for everything whilst I have the opportunity.

Thank you in advance xxx

[greygoose]

Hi tara, before asking if there are any other tests to do, how about listing those you've done - with the results and ranges.

First thing you should know is : there's no such thing as 'normal'. It's meaningless. And what she actually means is : in range. But, in range is not the same as optimal, and it's optimal that you need.

All those vitamins and minerals that came back 'normal', I'm willing to bet they aren't. Was your B12 1000+? If not, it wasn't optimal. And you don't have to have Cushing's to be suffering from adrenal fatigue. That's something that doctors just can't get their heads around.

I don't think rT3 would be helpful at the moment. The NHS doesn't do it, it's expensive, and I very much doubt your endo would understand the results.

So, let's have a look at those tests.

[Tarajp123 in reply to greygoose]

Thanks greygoose this is everything so far...

Hi all, 29 yr old female feeling 89 yr old! Been hypothyroid for 8 years and take 125 levothyroxine presently. I seem to have gotten worse over the last year. I've put on 4-5 stone in the past few years and I feel absolutely exhausted now to the point it is having a very negative impact on my life!

Story so far...

GP finally referred me to Endo

Endo requested Overnight Dexamethasone test to check for cushings plus other tests.

Results back so far are:

TSH - 0.08 (0.2-4)

Free T4 - 15.6 (11-22.6)

Free T3 - 4.4 (3.5-6.5)

No reference ranges provided for the below:

Overnight dexamethasone suppression test

Cortisol - 26 (normal)

Vitamin D - 69.7

B12 - 355

Folate - 4.2

Thanks in advance xx

[greygoose in reply to Tarajp123]

OK, so all of them, except the TSH - and we don't care about the TSH! - are in range, but far from optimal.

Your Frees are both below mid-range, when they should be up nearer the top of the range.

Your vit d should be up to at least 85, I think - not very good on vit D, but I know that is low.

Your B12 needs to be 1000 - that is dangerously low.

And your folate is pathetic!

Don't know about the cortisol without a range.

So, all those nutrients need supplementing. That B12 will be causing a lot of your symptoms.

The only other tests I can think of that should be done, are antibodies - TPOab and TgAB - and ferritin.

But, you definitely need and increase in levo!

[Tarajp123 in reply to greygoose]

Thanks so much greygoose for your advice. I really appreciate it xx

[greygoose in reply to Tarajp123]

You're welcome.

[SeasideSusie Remembering in reply to Tarajp123]

Tarajp123 Did you do anything about getting the supplements for your low levels of vitamins and minerals, which I suggested in reply to your quoted post from your previous thread, as none of them were optimal?

[Tarajp123 in reply to SeasideSusie]

No not yet, I wanted to wait to see the Endo again first before doing anything but I'm going to take all this information with me and I have requested he article that you recommended so please don't think I am not listening to your advice because I am honestly! I appreciate it so much xx

[Angel_of_the_North]

I've read that you can stop breathing several times an hour without being diagnosed with sleep apnea, so bear that in mind. Also, do you know how near the top of the range your cortisol is? it can be almost Cushings but the NHS won't treat if it is just in range.

Vitamins need to be optimal, not just in range, so post results here. but GPs are obliged to treat if results are in range (so they just say "normal").