Endo appointment on Thursday - please arm me with right questions/interpret blood tests beforehand

[Annie8ell]

I was diagnosed with hypothyroidism in Australia in 2008 just after second baby (TSH was 38.45 and raised thyroid antibodies, also had low ferritin and high cholesterol). At time, was busy juggling newborn and toddler so I saw an endo for a few months to settle on a dose of levothyroxine of 100mg a day Mon - Fri; 200 mg on Weekends and thought no more about it. Been treated via GP ever since.

I think though I've still had symptoms of an underactive thyroid for years and it's come to head for me since having baby #3. I stopped breastfeeding in March 2016 and still felt knackered, sore joints, cold, brain fog and most of all for me, thinning hair. I really want to feel as well as possible as I juggle three children/work/life. I started to lobby GP and been on iron tablets (ferrous sulphate) since August 2016 as iron store was very low (23!), it's since gone up to 57ug/l after taking 3 tablets of ferrous sulphate a day (200mg x 3). But my hair is still rubbish and also my diet is iron-rich so I don't understand why my stores are low. I went to see a dermatologist who told me I had female pattern baldness.

Quietly devastated, but also really thinking they haven't looked at me holistically. Am I still showing signs of underactive thyroid, could I feel better? Really don't want to discover high cholesterol/heart disease as just turned 40. So at great expense have private appt with endo on Thursday. Have had following bloods done in prep via GP:

Feb 2017:

TSH - 0.4 miu/L (0.2-5.5)

Serum free T4 - 17.2 pmol/L (10.0-24.5)

Serum cortisol - 234 nmol

October 2016:

TSH - 1.1

Serum ferritin - 57 ug/L (10-300) *been on 300 mg daily of ferrous sulphate tablets since Aug 2015)

April 2016:

cholesterol - 5.3

Also back in August 2015:

B12 - 451 ng/l (180-1000)

Serum folate >23.2 ug/L (>4.00)

Have had a few other tests over last 18 months, where every so often I get concerned, but am now galvanised to try and make sure I'm on optimal treatment/anything I'm missing especially in terms of vitamins. I know this is a big ask and long email! Please help!

Annie

[bluebug]

If you go to an endo with all these figures s/he will likely say everything is normal.

You are missing some test results which would be useful for others to see:

1. Free T3 the active thyroid hormone

2. Vitamin D test results

3. Whether you have thyroid antibodies.

On this board we tend to find that people feel better when:

1. Their vitamin B12 level is at least over 500 but preferably at the top of the range.

2. Their ferritin level is half way in the range. Trichologists state it should be around 75-80 to get good hair growth. However this is presuming all other factors e.g. hormones, other vitamins are optimal.

In regards to cholesterol I suggest you read up and do your own research especially if:

1. You are not menopausal.

2. You have no family history of heart disease especially before the menopause.

[Annie8ell in reply to bluebug]

Thanks bluebug!

I had thyroid antibodies measured back in 2008 when originally diagnosed. Would they change?:

Anti Thyroglobulin - 163 (<60 iu/ml)

Anti thyroid Peroxidase 310 (<60 u/l)

Never had Vit D and my GP said he'd ask for T3, but lab may choose not to report it (which I'm guessing is what happened - grrr!)

Am not menopausal and have noticed that I've had high (ish) cholestrol the couple of times I've had it measured (5-7), even though I'm very fit and eat pretty healthily, so worried something will creep up! No history of heart disease in family.

Seeing a private endo is costing £220 and juggling childcare/work logistics to travel to appointment is a Big Thing so I really don't want to waste my time/money and not sure if better to see a hair specialist if my hair loss is being caused by something other than well-managed thryoid and an endo will fob me off. What do you think?!

Thank you!

[galathea]

Are you sure you have enough stomach acid to absorb the vitamins, minerals and meds? Not taking antacids are you?

Your ferritin is too low to help your hair and the b12 is too low to make you feel well. Both of these need good levels of acid and gut flora to be absorbed.

Xx

[Annie8ell in reply to galathea]

Thanks glathea! Nope - not antacids - how would I check stomach acid/gut flora? My ferritin levels have probably been low for years, despite eating lots of red meat/spinach/ etc etc, so do you know why they're low?

I am a bit lost - and really don't want to throw money away on an endo appointment if there's nothing to be done!

x

[bluebug in reply to Annie8ell]

While seeing the endo may help you are better of getting your FT3 and vitamin D level done before even if you have to have have private blood tests.

In fact if you had posted these test results before making the endo appointment you would have been advised what vitamin and minerals to take plus what extra tests to get and what to read up on so you can decide whether you need to see an endo.

In regards to FT3 - NHS labs have guidelines so unless a doctor has a good reason to get a FT3 test for a patient they will not do the test if TSH and FT4 are within range. If you want a T3 test done the only guaranteed way is a private blood test.

No doctor will try to check gut flora especially on the NHS unless you have a serious bowel problem. This is because the gut flora hypothesis is still being researched.

If you have autoimmune thyroid disease, which your antibody test results indicate, then you are more likely to have poor gut flora and difficulty absorbing nutrients. This explains why your iron level is so low. In addition if your FT3 is low then your metabolism will be sluggish.

Finally your cholesterol isn't high and total cholesterol numbers are meaningless anyway. I'm writing on a phone so can't easily provide links but if you search through others posts you should find information and links to read.