Test results make hypothyoidism unlikely

Hello, well I saw my 'proper' GP last night and we went through the results and had a good talk about my symptoms. She compared the recent results with those done in 2014 and there was little difference. They were Serum TSH level 1.7miu/L (range U 0.35-4.94), Serum freeT4 level 12.3pmol/L (range U9 -19), and Thyroid peroxidase anti bod lev (Readcode ~43Gd) Negative. Coeliac antibody test - negative (I have a coeliac daughter)

It did however show raised white blood cell count and enlarged red blood cells. The GP suspects Pernicious Anaemia or Fibromyalgia as more likely diagnosis. I'm having a further blood test for B12 and Folate levels which would confirm the former along with my presenting symptoms. Failing that she will refer me to a rheumatologist.

I've been given Duloxetine 30mg to help with the neuropathic leg and feet aches and boost my low mood. Took the first last night and woke up feeling woozy and nauseous so probably won't bother with any more. I really can't cope with feeling any worse, but I'm feeling cautiously optimistic about a proper diagnosis. Don't know what you wonderful helpful people think? Thank you for all your helpful support so far and I hope everyone is having one of their good days today xx

9 Replies

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  • Sounds a sensible gp to me. Don't take B 12 or folate till tests for PA are complete. Read up on the PA forum. Remember that the intrinsic factor test is only 50 per cent accurate, can rule pa in but not out. MMA test better.

    Since celiac test negative you could try going g free for 8 weeks or so to see if any symtoms improve or if there is a reaction when u return to it, as u cld still be gluten sensitive. It is a real thing.

  • B12 is only one of the causes of PA. You really need the anti-bodies testing for Intrinsic Factor and Parietal Cells - albeit one of the tests is unreliable :-) Pop across to the PAS forum here on HU and to the PAS website for more information ...

    Albeit your TSH is not high - your FT4 is LOW. You also need a FT3 result to really see what is going on. If all 3 are low in range then Central Hypothyroidism should be considered. Fibro symptoms can be caused by a LOW FT3 result :-)

  • Angste,

    It can take a few days to get used to a new medication and for adverse effects to stop. You could try taking half the tablet for a few days and then increasing to the full dose.

  • Angste But the blood draw for that test was at 3 o'clock the afternoon wasn't it, when TSH is lowest? I'm not saying that a pre-9am blood draw would give you a TSH over range, but it would be higher than that. And your FT4 is low, in the bottom third of the range. TPO negative but they don't test TG antibodies and they could possibly be positive. I reckon if you had an early morning blood draw the TSH result would show that your thyroid is struggling, as your symptoms do.

    It's good that she's testing B12 and Folate but you also need Ferritin and Vit D testing.

    I would be concerned about Duloxetine for neuropathic leg and feet aches, this is much more likely to be low nutrients and as a search shows it's "mostly prescribed for major depressive disorder" isn't that a bit OTT for your "low mood". I would agree with you not taking any more, but it's a shame it's now on your records :(

    See if you can get the other tests done but I doubt you'll get TG antibodies. Consider a Blue Horizon test as mentioned in your previous post. If you can't get Ferritin and Vit D done then do the Plus Eleven, if your GP does all the nutrient tests then I'd get the Plus Six which does TSH, Total T4, FT4, FT3, TPO and TG antibodies.

  • Since you suffer from neuropathic pain in legs and feet I would have gone for B12 deficiency or Pernicious Anaemia as the most likely problem, if thyroid dysfunction is ruled out. In my opinion, for what its worth, thyroid dysfunction hasn't been ruled out until you've seen your Free T3 level and antibody levels and they show up as okay.

    Duloxetine, also sold under the name Cymbalta, is a horrible drug :

    en.wikipedia.org/wiki/Dulox...

    drugs.com/sfx/duloxetine-si...

    I noticed hypothyroidism as a possible side effect in the second link.

    The main characteristic of fibromyalgia is (I think) severe muscle pain and joint pain. Before taking anti-depressants like duloxetine for the pain it would be better to concentrate on getting nutrient levels up to optimal. Some people with muscle and joint pain find it disappears when they get their Vitamin D levels up to optimal.

    Another cause of peripheral neuropathy is low vitamin B6.

    You can pay to find out your Free T3 levels, and basic nutrient levels with either a finger-prick test (microtainer test) or a test using a blood sample taken from the arm (vacutainer test). You can order by phone or over the internet, no doctor required. Lots of us do this. If you order a vacutainer test you will either have to pay for phlebotomy or know someone who can take blood for you, which is why most of us opt for the finger-prick test.

    bluehorizonmedicals.co.uk/T...

    bluehorizonmedicals.co.uk/W...

    bluehorizonmedicals.co.uk/e...

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

    I was prescribed duloxetine once. I took one tablet then baulked at the idea of taking something with such severe side effects which was also addictive and had dreadful withdrawal symptoms. I've never regretted it. I was also shocked when I found out my doctor hadn't mentioned the addictiveness, hadn't explained that side effects were common, and hadn't explained that the pills were really hard to come off of.

  • Once again, thank you for taking the time to reply, it's all really useful information. My vitamin D was tested last April when I first complained of aching legs - my level was 'in your boots' (as the GP said)...12. I've been on Vit D tablets since and a retest after six months showed normal levels restored, although it made no difference to the way I feel. If my GP is doing blood tests on the NHS at the moment I'm not inclined to rush off and pay for private testing, but I will certainly do that if progress grinds to a halt. I am ferreting about on the PA sites too!

  • Angste Last April your Vit D was 12, on Vit D tablets six months later your retest showed 'normal levels restored'. What was the result? Were the tablets stopped or are you still supplementing to keep your levels 'normal'.

    I ask because my level was 15 - privately tested, GP not involved. I started a loading dose of 40,000iu daily for two weeks then went down to 5000iu daily and in 2.5 months my level was 192. As the recommended level is 100-150nmol/L I reduced my dose a bit and now take 2000iu most days throughout the winter and may reduce again, after testing, during the summer months when we get some natural Vit D from the sun.

    You should be on a maintenance dose of Vit D to stay at the recommended level.

  • hi, I can't remember the dose I was put on to improve my vitamin D level but since that high loading dose I've been on a daily 800IU capsule of Fultium-D. When I see my GP next I'll discuss whether that is adequate. They will only test at six monthly intervals here. Thank you!

  • I believe the current advice is to take higher doses of vit d than was previously thought ideal. If we're saying that healthy individuals need 1000IU per day, 800IU is unlikely to maintain good levels of d in someone who is deficient.

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