need help understanding results

This is for my mum in UK. She is 74, diabetic x 20 years (insulin 2 x day) Her B12 last Oct was 243g/l (range 190-660) so GP refused to do anything. I gave her sublingual B12 which have helped a lot in the beginning, but less now. Her recent serum B12 was a bit under 2000 so GP told her to stop, but she hasn't. She had gallbladder removed in 1965. Symptoms now: legs feel weak, dizzy, loses balance easily, forgetful, depressed at times, sore itchy scalp, painful joints but she is overweight too. Her recent TSH was 3.3 and her free T4 was 12. Just wondering if I should talk to her GP about possible thyroid problem? Any advice would be great. What reaction can I expect from her GP? I live abroad so can't check NICE guidelines myself. Thank you.

[Clutter]

DebraNL,

TSH 3.3 is within range and FT4 12 is within range. TSH rises in the elderly and 3.0 is seen as euthyroid whereas it would be 1.5 in younger people. NHS doesn't usually diagnose hypothyroidism until TSH is >5.5 or FT4 is <10.

You were right to get your mother to supplement B12. I would continue supplementing to maintain levels but perhaps at a lower dose.

Elderly people often have low or deficient vitamin D which can cause joint pain and fatigue. It would be worth arranging for your mother to have her vitamin D checked.

If her GP won't test vitamin D you can order a private test from City Assays via thyroiduk.org.uk/tuk/testin...

[SeasideSusie Remembering]

Hidden You should be able to see the NICE guidelines if you put "NICE guidelines Hypothyroidism" into Google.

Those results are unlikely to get a diagnosis but you can point out that her TSH has risen and her FT4 is at the bottom of the range. You can tell him that NHS Choices recommended source of information for thyroid disorders says that most people feel best when TSH is low in range and FT4 and FT3 are in the upper part of the range.

For any blood test for thyroid, it should be done at the very first appointment of the day and fast overnight (water only). That gives the highest possible TSH which is needed when looking for a diagnosis.

You could ask for ferritin, folate and Vit D to be tested as these are frequently low in hypo people. When taking B12 we also need to take a B Complex to balance the B vits - a good brand like Thorne Research rather than a supermarket or Boots or H&B own brand.

[Hidden in reply to SeasideSusie]

She does also take vit D and B complex. Forgot to mention that. I have also given her some magnesium too, the gentle remag formula. Her ferritin and folate are both fine too.

Unfortunately you have to physically be in uk to access Nice guidelines.

Thank you both for a quick reply.

[galathea]

You will have a job finding NICE guidelines, because there aren't any!! Ther e are some fairly biased reccommendations, but nothing which has been properly researched and considered by different groups as per NiICE

You can try talking to the doc but unless she has positive antibodies the doc will leave her to get worse.. The figure for treatment is when tsh goes past 10, but my mums doc left her struggling to recover from major heart surgery with a tsh of more than 30.

You mum looks to be going slowly downhill, with a decreasing free t4 and an increasing tsh.

My mum gave up with the doc, bought some ndt and just self medicated. She is doing fine. She's 83years old and says she hasnt got time for the doctor to make up her mind.

Buy her a copy of Dr Barry Peatfields book... "Your thyroid and how to keep it healthy". Less than £10 from amazon.... Easy to read and understand and very re assuring.....

Xx g

[Hidden]

excellent. I will definitely get the book. Thank you so much.