Thyroid with normal tests?

I have hashimoto symptoms including weight loss, had folate deficiency and bottom low range B12. I'm not on any medication, my thyroid results:TSH: 2.75, 0.35-5.50 mu/L and FT4: 12, 7.00-17.00 pmol/L. FT3: 5.6, 3.50-6.50pmol/L. In tests 3 years ago they only tested FT4 and it was 16. Last week had Tpo ab test done and it was 0.5 u/ml, so I take I can't be suffering with hypothyroidism?

Thanks in advance for any replies

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21 Replies

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  • Gwenroberts,

    TSH >2.0 indicates your thyroid is beginning to struggle but FT4 12 is halfway through range and FT3 5.6 is high in range so your thyroid hormones are currently good. NHS doesn't diagnose hypothyroidism until either TSH is over 5.50 or FT4 below 7.00.

    TPOab is thyroid peroxidase antibodies which is the test to determine whether autoimmune thyroiditis (Hashimoto's) has caused hypothyroidism. If 0.5 is below range then it is negative. Negative TPOab doesn't conclusively rule out Hashimoto's because some people are TPOab negative but have positive thyroglobulin (Tg) antibodies. TgAb aren't usually tested in primary care but you can order private tests via thyroiduk.org.uk/tuk/testin...

    Is your folate deficiency and low b12 being treated?

  • Thank you for your helpful reply, so my tsh wouldn't cause the hair thinning? Yes was treated just for the folate with folic acid which raised it from 2 to 21, in the meantime my b12 dropped from 249 down to 225 so I begged for a trial of loading doses, which finished 3 weeks ago, they've just said no more you're good.

  • But I can't gain any of the weight back that I desperately need

  • Gwenroberts,

    Problem is that hypothyroid symptoms can precede abnormal bloods by years so your hair thinning could well be due to you 'becoming' hypothyroid although you are not yet diagnosed hypothyroid because your blood levels are not abnormal.

    If B12 deficiency was dietary the loading injections may be sufficient but if deficiency was due to malabsorption or pernicious anaemia you may need continuing injections. Ask for advice about B12 and folate deficiency on healthunlocked.com/pasoc

  • Ah right I see, if my hair thinning is due to the thyroid I'm buggered then due to my numbers. Well not sure what was the reason for low b12 and folate because I've since at least 2014, the doctor hadn't picked up on it. But last year I got worse I has gastro symptoms lost weight, this is what made me go to the doctor for tests, my cealiac came back negative.

  • Gwenroberts,

    There are several things which can cause hair to thin - low zinc, low iron, menopause so as your GP will say your thyroid bloods are normal it may be worth asking whether s/he can do zinc, ferritin/iron and menopause blood tests.

    I would still advise you to discuss B12 and folate on the PAS forum.

  • You might consider trying a gluten free diet to see if it improves symptoms

    Also good idea to check ferritin is at least mid-range

    Vitamin D is important and very commonly low these days in most of population, but especially if we have any gut issues going on

    Private testing available vitamindtest.org.uk - £28 postal test kit

  • Thanks for reply my ferritin was 48 but they didn't do iron etc tests.

    Gluten free diet I could try it.

  • Gwenroberts,

    It's frequently said that having ferritin <70 causes hair loss. You can raise ferritin by supplementing iron (prescription not required) with 1,000mg vitamin C to aid absorption and minimise constipation.

  • Thank you I'd heard about it but my level was lower:18 when i was 15 yo (over two an half years ago) mind you it has been thinning for about 10+ months, could that frame time coincide with the low ferritin level from over 2 years ago though?

  • Gwenroberts,

    Unlikely if your ferritin has been rising in the last 10 months.

  • That's what I thought, I haven't a clue then unless lack of B12 and folate can cause hair thinning, and maybe my weight loss of 17lbs. It's been a struggle to get the doctor's to test them so I know he'd never check zinc. He did 9am cortisol though: 317. I'll check the link you posted earlier too thanks.

  • Gwenroberts,

    Check this link for signs of B12 deficiency b12deficiency.info/signs-an...

    You can buy 15mg zinc and supplement without testing. Probaby best to take it with 350-400mg magnesium as they are synergistic.

  • You can buy either ferrous fumerate, ferrous sulphate, ferrous gluconate or ferrous bisglycinate off prescription.

    Easiest place to buy it is online from Amazon - make sure the supplier is a pharmacy. Or you can buy it from a behind the pharmacy counter but it is up to the individual pharmacist whether they sell it to you once you have told them you are low in iron and have been advised to purchase some as it is cheaper than on prescription.

    Ferrous fumerate and ferrous sulphate are the cheaper iron salts at <£5 per box/tub and those are what the NHS prescribes people. Ferrous gluconate and ferrous bisgycinate (Solgar gentle iron) are more expensive at >£10 per box/tub. Just make sure you don't buy Ferrograd or Floradix as they don't contain enough iron in them to raise someone's levels if they are sub-optimal and they are also expensive for what they are.

    This link is worth having a read - patient.info/doctor/non-ana...

    Under management it states the treatment is 1 x ferrous sulphate twice a day or ferrous fumerate, ferrous gluconate as they are better tolerated. Like @Clutter states take each tablet with vitamin C.

    What is missing from the advice is:

    1. Ferritin levels can take a long time to increase

    2. You should take iron tablets on an empty stomach with only vitamin C and water. So take it two hours away from other food,drink and supplements to avoid interaction. If you are on any medication it should state on the medication how far away to take it.

    3. You must test your ferritin level regularly e.g. once every 3 months as too much iron is poisonous. Unfortunately you are going to do this privately. Private testing information thyroiduk.org.uk/tuk/testin...

    4. Once you do get your ferritin level up above 70 you need to go onto a maintenance dose to maintain it. Some people find a couple of iron tablets a week is enough to keep their level up while others find eating liver once a week does this, while others have to do a combination of both.

  • Thanks for the detailed reply :) I can't swallow tablets I'm hopeless so I bought Galfer liquid chocolate mint flavouring it's 45g elemental iron, took 10ml a day and gave me the runs so I stopped it :(

  • I'd heard about the iron patches, they seem to get good reviews.

  • I've been suffered with hypothroidism and hashimotos for several years and much of this time has been spent struggling to keep weight on (not the general rule for hypothroidism I know as most struggle to lose it!)..also hair loss as been a problem 1000mg of biotin daily and Nioxin 3 step treatment for thinning hair literally saved it!!

  • Yes weight gain is the usual symptom but like yourself I've come across some who loses weight. Biotin and nioxin, I'll have to try these and see if I can have the same success as you have.Thanks

  • if you have low b12,low folate,hair loss and weight loss and gastro symptoms could you discuss with your gp seeing a gastroenterologist? or have you seen one?.

  • Not once have they suggested a stool sample or to refer me to a gastroenterologist, thank you for your advice, I'm unable to gain any weight back that I lost (without trying) and under my healthy bmi. I will do the sample tomorrow and press on to be referred. In the UK is it possible to have any bacterial germs or worms, h.pylori etc ? Or could gastritis cause it? I'm trying to think of other causes apart from ibd, like chrons, colitis.

    Thank you

  • Hi,

    "my cealiac came back negative"

    I have read that it is still possible to have Coeliac disease even if Coeliac antibody test result is negative.

    A person who has IgA deficiency (IgA is an immunoglobulin) will not produce Coeliac antibodies and may need alternative tests for Coeliac disease.

    See links below for more details

    coeliac.org.uk/coeliac-dise...

    If you're in UK, the next link is to NICE guidelines on Coeliac disease

    nice.org.uk/guidance/ng20/c...

    I am not medically trained.

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