Help Feeling Overwhelmed and GP thinks I'm fine

[AnnaBeth]

So I'm far from fine with periods of brain fog which thanks to this site I've looked into and do now unfortuantly feel quite daunted but it is what it is.

Here are my blood results below, any feedback would be useful because I feel clueless:

November 2016:

- Serum TSH 1.57 {norm range 0.3 - 3.94}

- Serum Cortisol 213 nmol/L {193-690}

- Ferritin 34ugL {13-150}

- B12 499 {197-771}

- Serum Calcium 2.25 {2.15 - 2.55}

- Monocyte 0.4 {less than 0.95}

- Eosinophil 0.1 {0 - 0.710}

- Basophil 0 {less than 0.2}

- Nucleated RBC 0 per 100 wbcs

- Serum C reac protein 1 mg {less than 10}

- Serum albumin 48 g/L {35-52}

- Serum adj calcium conc 2.09 mmol/L

- HbA1c IFCC standardised 38.8 mmol/mol

- HbA1c DCCT aligned 5.7%

FBC:

- Total White 6.4 {3.7 - 11.11}

- RBC 4.43 {3.88 - 4.99}

- Haem estimate 127g/l {120-150}

- Haematocrit 0.4 iL {0.36 - 0.46}

- Mean Corp Volume 90 fL {82 - 98}

- Mean Corpus Haemoglobin (MCH) 28.7 pg {27.3 - 32.6 pg}

- Mean Corpus Hb conc (MCHC) 319 g/l (320 - 350) (this was picked up by lab as outside normal range but 1 point GP said made it normal)

- RBC dist width 12.3 % {9.9 - 15 %}

- platelet 298 {150 - 400}

- Neutrophil 4 {1.5 - 7.4}

- Lymphocyte 1.8 {1.1 - 410}

Plasma Glucose in June was 5.3 mmol {3 - 6} (wondering if this was a bit high but not sure)

S total 25-OH vit D {normal range isn't given}

November 2016: 43nmol

March 2016: 22 nmol (this has an asterisk but nothing was done about it think the feeling was it would be low in March anyway)

August 2016: 56 mol

I have definitely been far from fine the last few weeks. GP happy that all is normal he's going to write to an edno but said the referral was up to me as nothing has shown in my bloods.

I explaiend I would like to try to concieve next year and asked if I would need to up my thyroixine at this point he said no as I'd be seen by an abs/gyn at booking in who would check and maybe up it.

Bear in mind I have always been taking my thyroxine prob 2 hours pre these bloods and I am on 75mg.

Any help/ideas/inspiration would be so gratefully received I'm feeling desperately in need of an answer.

Have ordered a recommended book so will be doing some research over the next weeks/months before poss embarking on a immune paleo diet although it looks v radical not sure if its a good plan however I can't live with the threat of a serious slump/brain fog hanging over me.

Am also going to get back into meditation.

[AnnaBeth]

Can't see any test for antibodie how woul dit show?

Does that mean I don't know if hassimotos?

When I asked my gp if I was autoimmune thyroid he sadi unless cancer or removed then yes would be autoimmune ......

[greygoose in reply to AnnaBeth]

Oh dear. These doctors are so ignorant! He has to test for it! It isn't a given.

Antibodies would be called something like : TPOab. I don't see it in your list of tests above. But, your doctor only knows about one tenth of the story, because he isn't doing the right tests. He should at least test the FT4, if nothing else! I gave you a list of tests to get in reply to your last question.

Taking your levo before the test, won't affect the TSH, but were he to do the FT4, it would be falsely high. So, not a good thing to do!

The time of day affects the TSH, and eating or drinking anything but water. So, you need an early morning test - before 9, but preferably more like 8 - and fast over-night. That way you will get the highest TSH.

There's not much more that anyone can tell you that hasn't already been said on your last thread. Your TSH is good - to a doctor, anyway. Personally, I would like mine lower. Your B12 could be a bit higher - it's best over 500. Your cortisol is on the low side, but I wouldn't worry too much about that at this point.

However, your ferritin and vit D are much too low. And that will be making you feel bad. But, don't expect your doctor to know anything about that - they don't do nutrition in med school! Just supplement them yourself. I'm sure lots of others will come along to tell you what to take. Your ferritin should be at least mid-range. And your vit D up around 100.

[AnnaBeth in reply to greygoose]

Thank you for such a speedy response feel better already! Maybe I just need a good sunny hol

[greygoose in reply to AnnaBeth]

Nice idea. But, unfortunatley, you'll have to come back at some point.

May as well get it sorted, now.

[shaws Administrator]

When you have a blood test for your thyroid hormones you should allow 24 hours between the last dose of levo and the test and take it afterwards. It should also be a fasting test.

If you take thyroid hormones before the test it skews the results and causes the doctor to adjust doses unnecessarily, or not increase when we do need an increase. The following is a link re hashimoto's or hypothyroidism:-

verywell.com/hashimotos-vs-...

I assume your GP has never tested for antibodies. Also because your range is 0.3 - 3.94 and most doctors mistakenly believe anywhere in the range is fine if patient is on levothyroxine, it doesn't mean they shouldn't increase the dose if its around 3 but should increase dose to bring TSH to 1 or lower and most of us feel well but some need it suppressed. The range should really be used for diagnosis and that means the patient isn't on thyroid hormones.

If you email [e-mail] and ask for a copy of Dr Toft's article on treating patients and I think within question 6 he gives a number to aim for.

[AnnaBeth]

Everyone is so helpful!

I've had a look at older tests seemingly Free T 4 hasn;t been tested recently but was tested when I was diagnosed back in March last year and repeated again April 2015:

Thyroid function test05 Mar 2015 - POINT OF DIAGNOSIS

Serum TSH level97.59 mIU/L {0.3 - 3.94mIU/L}

Serum free T4 level3 pmol/L {12.3 - 20.2pmol/L}

April 2015:

Serum TSH level6.89 mIU/L Abnormal result0.3 - 3.94mIU/L

Serum free T4 level15 pmol/L12.3 - 20.2pmol/L

Maybe these are too old to be of any use but thought would add them as found them.

Def haven't had antibodies checked for.

[Learner1]

Are you on a gluten free diet? Low iron, vitamin D, and thyroid issues are clues. May be worthwhile. I like the idea of an autoimmune Paleo diet - it's not so hard once you get used to it. Try upping your protein and healthy fats first, then you won't crave all the stuff that's not on the diet.

I agree about testing thyroid antibodies, as well as free T3, reverse T3, and a 24 hour saliva test. You could also have a full hormone panel, including pregnenolone, DHEA, and testosterone, which could all affect brain fog.

And get D up to the top of the range - may take 10,000 IUs a day. And since you want to conceive you need to have good B12 and folate levels. B12 should be 800 to 1200. I don't see folate, but you could test RBC folate, FIGLU, or homocysteine. Making a healthy baby means proper folate levels. Not high, and definitely not low. You can supplement with folinic acid or better yet, 5-MTHF.

Best wishes.

[AnnaBeth]

Would you request these tests from GP or go elsewhere?