I have just had some blood tests done and was initially told everything was normal but then I received a letter from my Dr asking me to making an appointment to discuss my TSH results.
I've looked at my results online and it says the following
I have done some research (which led me here) and the test results seem to suggest hypothyroidism
I experience the following symptoms and have done for a considerable amount of time
extreme tiredness and fatigue,
weight gain,
always feeling cold,
Pins and needles/numbness in my arms/hands/legs and feet
constant nausea
Lack of appetite
Bloating and abdominal cramps
However I also suffer from other medical conditions (I have been diagnosed with Interstitial Cystitis, Fowlers Syndrome (bladder conditions), Idiopathic Hypersomnia' complex regional pain Syndrome and IBS) and my Dr has always attributed my symptoms to these medical conditions and the medications I take for them (Tapentadol, Modafinil, Erythromycin, Ondansetron (when needed), senna, paracetamol, monthly bladder instils)
I have a telephone consultation booked with my Dr on Monday - what is my Dr likely to suggest and what questions should I ask him.
I don't know whether it is related or not but I have also found a small lump in side my left armpit. It has only just appeared and is about the size of a pea, quite hard and tender to touch - could this be related to my thyroid results or is this just pure coincidence?
I would be extremely grateful for any advice offered and suggestions what I should do. Many thanks for your help x
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Jenb01
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There is a possibility your doctor might suggest treating you for hypothyroidism, if you are lucky.
But there is also a strong possibility that he will say your problem is sub-clinical hypothyroidism and you don't need treating.
He may say he wants to repeat the TSH blood test in 3 months or 6 months or in a year to see if it is getting worse. There are no official guidelines for the treatment of hypothyroidism and a lot of doctors just seem to make it up as they go along.
One thing you haven't mentioned is whether or not your doctor has tested thyroid antibodies. They are antibodies that some people have that attack and destroy the thyroid. The process of destroying the thyroid takes many years, even decades. It is thyroid antibodies that cause hypothyroidism (under-active thyroid) in 90% of cases in the UK, and in the USA and many other countries. Doctors refer to this as Autoimmune Hypothyroidism. Online it is often referred to as Hashimoto's Thyroiditis.
If your doctor fobs you off and refuses to treat your hypothyroidism, you should ask for your thyroid antibody levels to be tested. If the result comes back positive then some doctors will treat hypothyroidism earlier, and won't force you to wait for your TSH to rise and your Free T4 to drop.
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The pins and needles and numbness could be caused by low vitamin B12. Hypothyroidism reduces the production of stomach acid and we end up with low nutrient levels. It is also true that having one autoimmune disease increases the risk of getting another one, so you might have Pernicious Anaemia.
Ask your doctor to test the following : Vitamin B12, Folate, Ferritin, and Vitamin D. Make sure you get copies of the results including reference ranges. Once you have any results, either for thyroid or nutrients, post them in a new post on here and ask for feedback.
Thank you very much for the quick response and very helpful information.
I have been treated for low B12 and folate in the past (my last B12 injection was 3 months ago and I have been taking 5mg of folate acid daily ) but my Dr has now stopped the treatments as my B12 and folate levels are within normal range
These are all the results of my most blood test results if this helps:
You really need to discuss your B12 and folate treatment with the Pernicious Anaemia group on this site (you can join as many communities as you want). You'll find them here :
People who have needed injections of B12 shouldn't get them taken away just to save money because you will just become severely deficient again in no time flat. And deficiency causes neurological damage. So please post on the above group and ask for their help and advice.
Could you add the reference ranges to the results you have posted above? To edit your post, click on the v in a square just below the post, select Edit, make the changes, then Post the edited post again. Reference ranges differ from lab to lab, and without them people can find it difficult to give reliable feedback.
I can't comment on all of your results, I don't have the knowledge, but there are a few I wanted to comment on.
Your serum iron is low, and ideally it would be higher.
There is no ferritin result, which is a shame.
But your results are confusing generally, so I definitely wouldn't suggest you supplement with iron, which is a common deficiency amongst thyroid patients.
Your RBC being high is inconsistent with low iron. Do you allow yourself to be very dehydrated when you get blood tests done? That could raise RBC levels. And there are other reasons for high(ish) RBC if you do some googling.
Your haemoglobin and haematocrit are surprisingly good given the low serum iron.
MCV is 25.5% of the way through the reference range.
MCH is 34% of the way through the reference range.
MCHC is 42.5% of the way through the reference range.
One thing that makes interpretation of blood tests very difficult is that different conditions can push results in different ways. For example, if you had iron deficiency anaemia your ferritin level would be low. If you had anaemia of chronic disease your ferritin would tend to be high. Put them both in the same body and you could have a ferritin level which looks entirely normal. (I'm not suggesting you have either of these conditions - there is insufficient information to say.)
You should make an appointment with your GP to have the lump examined. It is unlikely to be related to your thyroid, more probably it's a swollen lymph gland, but lumps should not be ignored.
TSH 5-10 with FT4 in normal range means you are subclinically hypothyroid. Your GP will almost certainly want to prescribe Levothyroxine. Ask for it if it is not offered. Symptoms can precede abnormal TSH by years so many of your symptoms will undoubtedly be due to hypothyroidism brewing in the background. Interstial cystitis is a very common hypothyroid symptom and will hopefully improve once you are optimally medicated.
Ask your GP to test thyroid peroxidase antibodies to see whether your hypothyroidism is caused by autoimmune thyroid disease (Hashimoto's).
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 and oestrogen.
It takes 7-10 days for Levothyroxine to be absorbed before it starts working and it will take up to six weeks to feel the full impact of the dose.
You should have a follow up thyroid test 6-8 weeks after starting Levothyroxine and after every dose adjustment. Arrange an early morning and fasting (water only) blood draw when TSH is highest, and take Levothyroxine after your blood draw.
I am not a medical professional and this information is not intended to be a substitute for medical advice from your own doctor. Please check with your personal physician before applying any of these suggestions.
Thank you for your helpful response Clutter. I had the blood test done at 10am but I had fasted before the test (not by choice - my nausea is very severe In the mornings) should I mention that to the Dr when I speak with him?
My Dr has always said that my IC (Interstitial Cystitis ) is responsible for a lot of my symptoms I have previously described. The countless cystoscopies I have had all show that my IC is extremely severe and I have a sacaral neuro-modulation stimulator implant (SNS) to help with voiding problems but recently the implant has not been working effectively as it has done in the past. I have been advised to consider bladder diversion surgery. I have been advised that total removal and a ustomy bag is the best option for me due to the severity of my IC and the additional complication of Fowlers Syndrome.
Is there a chance that a thyroid problem can make my IC worse and impact upon the effectiveness of the SNS? This has never been mentioned to me by any of my IC consultants but as the cause of IC is unknown and some medical professionals believe that IC is an auto immune disease it makes me wonder if there is a link between the two.
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Thyroid problems can make most things worse but I don't know that they would impact on an SNS. I can only say that correcting low levels of thyroid hormone is likely to help rather than hinder.
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