My blood results and am I hypothyroid?

[KT77]

Hi,

I joined yesterday and need advice. My story in short:

When I was 20 I was diagnosed with goiter. Back in my home country I was sent to endocrinologist and she put me on synthetic T4. I took it for 2 years, had no side effects and after that my goiter was gone and I had smooth neck again. Fast forward 10 years, living in UK goiter was back this time with nodules. My GP sent me to see a consultant, they did needle biopsy,then another one after few months and then ultrasound biopsy just to be sure. They all came back as not cancer. I asked if I can be put back on T4 just like the first time but Dr said it would not help and the only solution was to have the surgery to remove the whole thyroid. I said no. It has been 10 years, I'm 40 now and the goiter is still there. My GP runs the standard TSH every time I see her and it always comes back normal. So I had thyroid test done privately and here goes:

TSH: 1.26

T4 Total: 88.1 (64.5-142.0)

Free T4: 14.21 (12-22)

Free T3: 4.37 (3.1 - 6.8)

Anti TPO : 16.8 (<34)

Anti-thyroglobulin : 23 (<115)

Ferritin: 18.4 (20-150) - low

Vitamin D: 42nmol/L - low

B12 and serum folate were in the range

So my question is: Does having goiter automatically means being hypothyroid? I would assume swollen thyroid can't be working properly .Would taking NDT (self medicating) work to shrink the goiter? I'm thinking if T4 worked 20 years ago. I would not mind taking it again but nobody is going to prescribe it for me when my TSH is normal.

Thank you to anyone who can offer any advice on this.

[Clutter]

Welcome to the forum, KT77.

Having a goitre doesn't mean you are hypothyroid. Goitre can be due to hypothyroidism, hyperthyroidism and just plain idiopathic (no known cause). If T4 worked to shrink the goitre 20 years ago it, or NDT, may work again. You would have to try it and see.

Your thyroid levels are euthyroid (normal) for someone not taking thyroid replacement. TSh is low-normal, FT4 is is low in range and FT3 is good. NHS doesn't usually diagnose hypothyroidism or prescribe Levothyroxine until TSH or FT4 are abnormal.

Thyroid antibodies are negative so you don't have autoimmune thyroiditis (Hashimoto's).

Ferritin is below range which may indicate iron deficiency anaemia. Your GP should do a full iron panel and full blood count to check.

Vitamin D 42 is insufficient. Vitamin D is replete 75-200 and most people are comfortable around 100. I would supplement 5,000iu D3 daily x 3-4 months and retest.

What were B12 and folate results and ranges?

[KT77 in reply to Clutter]

Hi Clutter,

Thank you so much for replying.

B12 - 305 (Deficient <140, Insufficient 140-250, consider reducing dose>725)

Folate - 19.48 (8.83 - -60.8)

I take B complex which has both but only 2x per week as it is high dose. maybe I should take it every day.

My GP gave me iron tablets and it made a big difference. I only recently learn about the importance if iron levels for thyroid. Is it true that for optimal thyroid function I need to have ferritin levels around 90? If that is it the case I a have a way to go : ) I will ask for the full iron panel next time I see my GP.

Vitamin D - I have been taking 5000 iu for last 3 weeks and can not believe the difference it makes. I used to get these body aches every day like an old person, especially sole of my feet hurt like hell. Its all gone since vitamin D. Also muscle spasm that were really sharp and took my breath away for few seconds - they are gone too. And no more blood sugar swings. Reduced appetite and no cravings. I'm almost embarrassed I never looked into vitamin D before. I have been taking zinc, selenium, b complex, iodine (on and off) for years but never vitamin D or iron for that matter ( i eat meat so I assumed I must have plenty)

Looking back I have had low ferritin and low vitamin D symptoms for decades. Is it possible that I have goiter simply because of these deficiencies?

many thanks for taking time to reply