Blood results. Comments welcome!

[N321]

Hello - Second post, so please bear with me.

Suffered with depression and anxiety for many years, prescribed antidepressants to little effect. Also have weight gain, and zero energy...

Last 12 months problems have got worse, eventually diagnosed with low Testosterone levels, and treated with Testogel by an endocrinoligist but with no effect on the symptoms.

Started suspecting thyroid issues.

Parents both had thyroid issues, father treated despite no symptoms, mother eventuall treated despite similar symtoms to me and a normal TSH!

So decided to have the full Blue Horizons thyroid tests, results below.

The Blue Horizons doc added this comment - bear in mind I'm NOT on any meds apart from vitamin D (800u/day):

"The free T4 level is low. In the presence of a normal thyroid stimulating hormone level (TSH), and normal free T3 level it would not surprise me to learn you are taking liothyronine (T3) instead of levothyroxine - is this the case? If you are taking a form of thyroxine medication already, you may need to adjust your dose – a discussion with your usual doctor would be sensible. If not, I also suggest you make an appointment to see your doctor – at least surveillance of thyroid function would be wise, as it would seem in this scenario that an underactive thyroid gland might be developing."

Now booked to see an endo in London next weekend.

Any comments welcome!

[ITYFIALMCTT]

I'm asking very obvious questions here - but from what you've said, you don't have a thyroid-related diagnosis and you don't currently take any thyroid hormones?

That was a genuinely fasting insulin level? Do you have a diagnosis for it or do you take any medications for anything relating to diabetes or metabolic syndrome related conditions? Did the BH report not say anything about the high insulin level (assuming that it was your fasting level)?

I'll be interested to see what experienced people comment as I know nothing about the impact of using hormone products such as Testogel.

[N321]

Getting a real diagnosis is the problem... The Dr did mention the insulin: " The insulin level is high however. There are a number of potential causes of high insulin levels, but most common are insulin resistance (the stage before Type 2 diabetes develops) and obesity"

[ITYFIALMCTT in reply to N321]

Was that the comment from the BH doctor?

Yes - and it's hard to interpret that (or consider another cause) in the absence of a fasting blood glucose level (little bit surprised that wasn't included in the panel as insulin is a far more elaborate test). Your HbA1c is high within the range but still in range.

There are other contributors to high insulin (including sex hormones like testosterone) and other matters - but it might have been difficult for BH to cover that if they didn't know about the medication.

[Redditch]

Double your vitamin D intake yours is far too low to feel well you should be at 80 according to Barry Durant Peatfield

( He writes books on Thyroid issues)

Your folate is a bit low too

You should definitely be on Thyroid replacement you are struggling

They should test your TPO antibodies as with both parents affected it may well be Hashimoto's.

Can I ask where you were brought up?

You didn't live in a cave in Orkney did you?

[N321 in reply to Redditch]

Close, Wolverhampton... I do work in a windowless office...

[Redditch]

Oh and I forgot....You didn't fast for the test? I think you were supposed to.

If you did fast for the test it's a good job you're seeing and Endocrinologist soon you have quite a sugar issue going on

[N321 in reply to Redditch]

Yes I did, 11 hours... "" The insulin level is high however. There are a number of potential causes of high insulin levels, but most common are insulin resistance (the stage before Type 2 diabetes develops) and obesity""

[Redditch in reply to N321]

Right you should probably get at ANA test as well. Good job you've got an Endocrinologist lined up. Windows don't help with vitamin D., You need to get out there. It's lovely this morning, off you go, face in sun 15 minutes......

[radd]

N321,

It is interesting that FT3 is higher than T4.

I have read of an interesting paradox when pre-proceeding full blown hypothyroidism, the body works harder in order to meet the demand of the much required T3, and converts too much, so exacerbating the problem by reducing a low level of T4 further.

Blood sugar issues and low thyroid hormone problems are common. HbA1c is high indicating a high blood glucose level over the previous 2–3 months. Insulin result is high and can eventually lead to insulin resistance, which will cause low blood sugar and your adrenal glands will respond by secreting cortisol, telling the liver to make more glucose.

Ferritin, Vit D, Vit B12 and folate are all too low. Many people with hypothyroidism suffer deficiencies in these as they are required for good thyroid hormone synthesis. These should be supplemented and if you repost, members will comment on what they take.

All this may have over worked your adrenals glands and continued elevated cortisol levels will slow TSH production by messing with hypothalamic-pituitary feedback, leading to lower TSH production. Yours is not especially low but should be showing higher given that your T4 & FT4 are both below range.

Also low thyroid hormone and over worked adrenals can lower sex hormones and a testosterone deficiency is common in hypothyroidism. It usually reverses when thyroid hormones become optimal.

Possible pituitary issue ? ? … Either way, I would say you need Levothyroxine to bring FT4 into normal range and balance hormones.

[N321 in reply to radd]

"Possible pituitary issue ? ? " The first endo I saw was totally confident there wasn't...! We'll see what the new one says next week...

[N321]

An update further down the line.

Still feeling awful, anxiety and depression getting worse.

Some here suspected central hypothyroidism.

Ended up having an MRI, results all negative.

Recent tests have shown TSH at 1.24 (0.27-4.2) and T4 at 11 (9-20) and T3 3.5 (3.1-6.8)

Taken off Testosterone as it put my PSA up.

Now being investigated for possible prostate cancer...

Endo flatly refuses Levothyroxine as numers are 'within range'...

Almost at the end now with the lack of energy and depression.

Badly affecting life...

Any thoughts??

Anyone???

[N321]

Anyone...??