Medicheck Results - Advice please?

[littlepotofjelly]

Hello all,

My medichecks results are back (finally managed to do a finger prick test - thanks to everyone who gave me the advice on how to get it done - very hot water and pricking the side near the nail bed worked!). All in normal range and no antibodies - glad to know that in some ways but also disappointed not to have a more clear cut answer. And test was done first thing in the morning having fasted the night before. So just to clarify - i've not had any diagnosis and i'm on no medication.

Will post photo of the result below but some context:

- Last time my thyroid results were checked (around April last year but just TSH and T4) they were as follows: TSH 2.6 (range 0.5 - 5.0) and Free T4 12.4 (range 10-25) - so slightly different ranges from what medichecks use. I'm assuming any movement in the numbers is just natural variation/because of the different ranges?

- At the same time as I had my thyroid checked last year I also had B12 and Ferritin done - B12 was a bit below optiomal at 450 (range 150-900) and Ferritin was low at 14 (range 9-90). Oh and Folate at the time was 19 (high end of range was 18).

- I started supplementing B12 and Iron then and got those numbers checked again by the Dr this December to see if my levels had raised from supplementing and my results were B12 was high - 1288 (range 197-771) and Ferritin was good at 87 (range 13-150). Aware both of those results might have been influenced by the fact I was still supplementing when testing. My folate was 10.4 (range 3.90-20.00) so fine in the middle of range I think.

I stopped supplementing Iron and B12 back in December as doctor said to. Now both of these numbers seem a bit lower again but the ranges are also different for medi-checks so finding it hard to work out the difference.

Last year I was also below range on Vitamin D - I had a loading dose of 40,000 per day for a few weeks and took 5000 per day right up until last month, then went back to the Dr to get it checked again. Now waiting for that result (apparently takes 3 weeks to come back at my new gp!).

And a last piece of information - I am entirely gluten free already and have been for four years or so - I've never been confirmed as celiac (negative blood test) but do have severe reactions to eating gluten so I stay well clear.

Sorry for the long context - just think it helps to have a fuller picture.

If it's not thyroid, which it seems it isn't - does anyone have any ideas as to what to explore next to try and get to the bottom of this. The symptoms I'm having often are:

- feeling colder than other people, especially hands/feet/nose

- generally feeling fatigued, although how tired I am does fluctuate up and down, but i am always aware of feeling more tired than friends the same age as me, and some days I just feel like I can't get started at all

- low concentration

- low libido

- dry skin and hair and often itchy eyes/eye lids

- heavier periods (they are regular though, I take agnus castus to help with this)

- feeling low, sometimes accompanied with bouts of anxiety

- body aches - particularly in my feet and legs in the mornings

- intolerance to exercise/ feeling generally weak

- i'm only 30 but some days I feel like i'm over 100!

- constipation - sometimes followed eventually by an upset stomach and then back to being constipated again

- just generally not feeling like myself

I feel like it's a hormonal imbalance somewhere but I don't know which one or how to find out and this has been going on for about 6 years now. Feeling really exhausted from all of this and would hugely appreciate any help or suggestions people might have. I feel like I can't just keep pushing through like this everyday - my partner and I want to start a family soon and at the moment I don't know how I would have the energy to look after someone else at all

Thank you for your time. This forum has been a god send in terms of finding information.

[shaws]

Your TSH is high (never mind the TSH must be 10 for a diagnosis). Both FT4 and FT3 are low. I shall give you a couple of links from TUK.

thyroiduk.org.uk/tuk/about_...

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

[littlepotofjelly in reply to shaws]

Thank you, I have seen these links from TUK before - they're really useful. Unfortunately i'm not quite sure what to do with the information. From past experience i'm also 100% certain my GP will say - your results look great - and that will be the end of the discussion. Is it really just a case of waiting to see if the TSH eventually creeps up and the FT4 and 3 fall enough for a diagnosis...?

[Clutter]

Littlepotofjelly,

TSH >2 means your thyroid is beginning to struggle but your FT4 and FT3 levels aren't bad and are fairly typical levels for someone not taking thyroid replacement. NHS won't usually diagnose hypothyroidism until TSH is over range or FT4 is below range. Symptoms can precede abnormal bloods by several years. You might find supplementing 200mcg selenium helpful in supporting thyroid function.

Thyroid antibodies are negative for autoimmune thyroiditis (Hashimoto's).

Ferritin is optimal half way through range. If ferritin has dropped you could continue supplementing a maintainence dose of iron.

B12 was high in December because you were supplementing but B12 is a water soluble vitamin and excess is excreted in urine so high levels of B12 are not generally harmful.

[littlepotofjelly in reply to Clutter]

Hi Clutter, thank you for your reply. So do you think it's not hypothyroidism then and i should start looking for other answers since FT3 and 4 are both fine. Or do you think it could be hypo but i'll just have to accept that I need to wait a few more years until symptoms are represented in bloods? Thanks for the selenium tip - not come across that before so will check it out.

B12 isn't high now - see results in photo above - (it's 360 - range 140-724) - the high one was from back in December when I was supplementing. And Iron is about a third of the way through range at 49 (range 13-150), again the higher number was from back in December when I was still supplementing. Sorry if I confused things with the picture plus the narrative.

Thanks again.

[Clutter in reply to littlepotofjelly]

Littlepotofjelly,

I do think it is hypothyroidism as your TSH is >3.0 but NHS won't help you until TSH is abnormal.

Ferritin was was over halfway through range in Dec but is now only 1/3 of the way through range so you might want to take a maintenance dose of iron to maintan level.

B12 360 is probably okay but it is possible to be deficient <500 so it won't hurt to resume supplementing 1,000mcg methylcoblamin if you felt better with higher levels.

[littlepotofjelly in reply to Clutter]

Thanks Clutter. Arg, this wait and see game is so frustrating - just want to feel better...

Is it okay to ask a few more questions? (I appreciate you might not know the answers to them all, but I really respect your advice).

1. Other than selenium - is there ways to help improve thyroid function or is it really just wait and see if it gets worse or not?

2. If my TSH is 3.1 now - is there a chance this will get better or is eventual hypothyroidism just inevitable?

3. If i'm thinking of getting pregnant, is it dangerous to do so with a TSH at this level? I know that the recommendation when pregnant is lower but not sure if that applies when trying to conceive (we've not starting trying yet so don't know if it will be a struggle or not).

Thanks again.

[Clutter in reply to littlepotofjelly]

Littlepotofjelly,

1. Other than selenium - is there ways to help improve thyroid function or is it really just wait and see if it gets worse or not?

200mcg selenium may improve thyroid function for a while but it won't improve the thyroid gland. It's unlikely your thyroid will get better.

2. If my TSH is 3.1 now - is there a chance this will get better or is eventual hypothyroidism just inevitable?

It's likely your TSH will get worse. If you have autoimmune thyroiditis (Hashimoto's) it is almost certain to progress to hypothyroidism. You could ask your GP to test thyroid peroxidase antibodies but some won't test until TSH is abnormal. You can order a private thyroid test including antibodies via thyroiduk.org.uk/tuk/testin...

3. If i'm thinking of getting pregnant, is it dangerous to do so with a TSH at this level? I know that the recommendation when pregnant is lower but not sure if that applies when trying to conceive (we've not starting trying yet so don't know if it will be a struggle or not).

It can be difficult to conceive when TSH is >3.0 and it increases the risks of miscarriage. You should tell your GP you are planning to conceive and ask to be started on Levothyroxine to bring down your TSH. It is recommended that TSH of women planning conception should be in the low-normal range 0.4-2.5. Levothyroxine dose is usually increased by 25-50mcg when pregnancy is confirmed to ensure good foetal development and to avoid post partum psychosis. Many GPs are unaware of the above so you may want to refer your GP to the links below.

cks.nice.org.uk/hypothyroid...

onlinelibrary.wiley.com/doi...

[littlepotofjelly in reply to Clutter]

Thank you. That's all useful information. Thanks again for your time.

[littlepotofjelly]

Clutter and shaws - please may I ask one more question? If my FT3 and FT4 levels are okay and kind of average for someone not on medication, would a TSH of 3.1 really be able to cause so many symptoms? Sorry to keep asking questions, but i'm finding all of this quite confusing and feeling a bit low and I'm trying to work out whether i've found my answer in thyroid issues or whether it's likely there's something other going on. Thanks again.

[Elainemawby in reply to littlepotofjelly]

Hi littlepotofjelly,

I had all your symptoms and very similar test results for two years and was continually told by my gp there was nothing wrong. I knew things weren't right though and eventually had to pay to see a private functional doctor who immediately confirmed hypothyroidism and put me on ndt. If you are planning on ttc then it's important you get your levels optimal. Do you have hypothyroidism in your family at all?

Elaine

[littlepotofjelly in reply to Elainemawby]

That's interesting to hear Elaine - thanks for sharing. So did they diagnose hypothyroidism even though your TSH and FT3/4 were in range? Did they do any further tests to make the diagnosis? How did you go about finding a good functional doctor? I've yet to find one...

My mum has never been tested for thyroid function but now, knowing what I know, I suspect it's likely she is hypo. She's had a long history of ill health - cold often, dry skin, weight gain on her stomach, bad digestion, cramps in her legs etc. - and never found a root cause or recovered from it and has had years of doctors saying "all normal" - I'm going to encourage her to get a full thyroid panel done to check it out now I have all this research. Might not be hypo but if she was it would provide a long awaited answer to an array of health issues. Not sure about my grandparents - will need to ask my mum. Does it tend to run in families?

Thanks again for your reply.

[Elainemawby in reply to littlepotofjelly]

Yes it does tend to run in families, both my mother and grandmother have/had it. My mum, I think, is still poorly medicated on levothyroxin as she still suffers many symptoms, I'm in the process of trying to get her to see the functional doctor I'm seeing. Thyroid UK have a list of doctors you can search through.

It's not so much about being within ranges but where you fall in them. The difference between many gps and functional doctors is that gps seem to have forgotten how to listen to a patient's symptoms, relying on blood tests and ranges. A good doctor will listen to your symptoms and mainly use blood tests to monitor your levels once you're on medication. There are also many supplements you may need, which again a good functional will advise you on. Good luck, it's a long road but definitely one worth travelling!

Elaine

[littlepotofjelly in reply to Elainemawby]

Thanks so much - that's really encouraging. I'll check out the list on Thyroid UK and hopefully find someone who is able to help work with me to get to the bottom of all of this. I'm so glad you've found your way back towards good health. Thank you again for your time - i'm so grateful for all the advice on this forum - being advocates for our own health is a daunting and overwhelming task sometimes and this space makes it a bit easier and lighter.