Advice needed regarding test results

[Hellobarfi]

Hi

I just wanted some advice regarding my latest results, and would be really grateful if anybody could help.

I was diagnosed with hashimotos in 2015. At present i am not taking any medication. I am currently 6 months pregnant and had this latest round of bloods done by my GP as he was concerned about some of the symptoms i was showing eg exhaustion , very cold, hair loss etc.

TSH- 0.05 ( 0.2 - 4.0 miu/L)

FREE T4 - 14.1(10 - 20 pmol/L)

FREE T3- 4.1 (3.0 - 6.0 pmol/l)

TPO ANTIBODIES - 146iu/ml (range below 30)

FERRITIN- 7 (range above 11-200 approx) LOW

VITAMIN D- 25 - LOW

I have been given prescription iron aswell as vitamin D to take as they are both quite low.

My GP says he is not going to treat the thyroid right now because my tsh is too low and showing signs of overactivity. He says we will wait till the end of the pregnancy to see if the TSH corrects itself. I still feel that my free t4 and t3 could do with a boost.

Do you think i should go with the GP'S opinion and wait it out , even though i have all the symptoms of underactivity? Or will the iron help ?

Any replies greatly appreciated. Thanks .

[shaws Administrator]

You have hashimoto's and the recommendation from the ex President of the British Thyroid Association was that if antibodies were present the person should be prescribed thyroid hormones. Email [e-mail] and ask for a copy of the Pulse Online article. Highlight the appropriate part and request GP to prescribe - probably a low dose,. Hashimotos is the comonest form of thyroid dysfunction.

The antibodies wax and wane, so that sometimes they attack the gland and then rest but they are destroying your thyroid gland. Going gluten-free is helpful in reducing the antibodies.

[Hellobarfi in reply to shaws]

Hi

Thanks for your reply. i will email Louise and get a copy.

[jimh111]

As you are six months pregnant the baby will now have its own thyroid. However, you have signs of hypothrodism and your fT3 and fT4 are inconsistent with your TSH, suggesting some form of central hypothyroidism (a weakened response from the pituitary). This can happen in depression and strict dieting. As your blood results are inconsistent and beyond the expertise of a GP I would ask for an urgent referral to an endocrinologist.

I'm not sure but I think it is possible that the TSH result can be inaccurate due to antibodies sometimes. Diogenes is an expert in this field and may be able to advise.

[Hellobarfi in reply to jimh111]

Hi

Thanks alot for your reply. I suspect the TSH result is due to hyperemesis ( severe sickness) which i had until around the 20th week of pregnancy.

I told the GP about this but he doesn't seem to agree.

However what he has agreed to do is have a consultant manage my thyroid care from now onwards because of the pregnancy.

My gut is telling me that i need to be on thyroid replacement hormone but i do not want to harm myself or baby through mismanagement or self diagnosis. However getting the DR's to prescribe is a headache in itself.

[Hellobarfi in reply to Hellobarfi]

ncbi.nlm.nih.gov/pubmed/121...

supported by this study

[jimh111 in reply to Hellobarfi]

Interesting. A quick glance of the paper shows that the fT4 normalises before TSH. It's good that you will be seeing a consultant (an endocrinologist I assume). Your fT3, fT4 suggest you are currently a little hypothyroid. If your TSH picks up soon you may recover. If they give you levothyroxine now it may delay your TSH picking up, on the other hand if they don't you will feel hypo for a while. I don't think it will affect the baby but please take the specialist's advice. I would suggest you keep yourself on the specialist's books until some time after the birth just in case you have thyroid problems.

I know nothing about hyperemesis but it would explain your unusual blood tset results.