Seeing new GP tomorrow. Need advice.

[FeelBlah]

Hello!

Tomorrow I have an appointment with a new GP (my old one having left) I've been going to the GP for years on and off complaining of fatigue, constipation, migraines, brain fog generally feeling unwell (too many things to list), and she has done blood tests-(the last was over a year ago) but never tested more than TSH (2.43miu/L (range of 0.27-4.2) & Serum Free T4 (15.2pmol/L (12-22). As these were in range it was not thought to be Thyroid, and she diagnosed depression. To be honest I was quite low at the time, but am not now (apart from the frustration of this!) I've also done saliva cortisol tests that weren't acknowledged but very low, and spent a couple of years following adrenal fatigue diets/taking glandulars & buckets of supplements/vitamins/pacing etc to no real gain.

I recently did a finger prick Thyroid test (results below- Grey goose has already given me some pointers thanks!) but am nervous about showing this to my GP as they don't ever seem to like self diagnosers. I know they are under pressure, and only following guidelines, so I want to make it as easy for them to help me as possible. I did actually really respect my last GP, and even she thought that there was some merit in the idea of adrenal fatigue, but didn't feel that beyond recommending a mindfulness course, and pacing was much she could do.

Basically because the numbers are all in the reference range I'd like to know if you lot think I have a thyroid problem, and some pointers on how to handle the GP consultation. What to ask for/point out etc, and a clear way of setting out my case that my foggy brain can handle (facts I can use/evidence etc)

Medi-check finger prick results:

TSH 2.82miu/L (0.27-4.20

Free Thyroxine 14.92pmol/L (12-22)

Total Thyroxine (T4) 100.2nmol/L 59-154

Free T3 3.89pmol (3.10-6.80)

Thyroglobulin antibody <10 IU/ml (0-115

Thyroid Peroxidase Antibodies 14.27 IU/ml (0-34)

Vit B12 298pmol/L (140-724)

Folate (serum) 19.98 ug/L 2.91-50.00

CRP 0.5mg/l (0-5)

Ferritin 62.82ug/L (13-150)

[bluebug]

Are you on thyroid medication?

[FeelBlah in reply to bluebug]

No. I'm not taking anything.

[bluebug]

You don't have a vitamin D test result. Low vitamin D can cause similar symptoms to thyroid.

[FeelBlah]

I had a diagnosis of low Vit D about 2 years ago & now supplement. my last bit D result was 135nmol (in January), which is not too bad, and has been higher, so I'm not worried that its Vit D.

[bluebug]

Have you had a full blood count done recently?

The reason I'm saying various things is as your thyroid hormones are all in range you will be told there is nothing wrong with your thyroid.

In addition your ferritin, vitamin B12 and folate are in ranges so the GP will say there is nothing wrong with them. However with these they aren't optimal therefore need to check there is nothing showing on a full blood count that indicates they are worse than this.

[FeelBlah]

This is from January. I think its all normal.

Erythrocyte sedimentation rate 5 mm/h [0.0 - 15.0]

Full blood count

Haemoglobin concentration 141 g/L [115.0 - 165.0]

Total white blood count 7.4 10*9/L [4.0 - 11.0]

Nucleated red blood cell count 0.0 10*9/L [< 0.1]

Platelet count - observation 191 10*9/L [150.0 - 450.0]

Red blood cell count 4.57 10*12/L [3.8 - 5.8]

Haematocrit 0.430 [0.35 - 0.47]

Mean cell volume 94.1 fL [76.0 - 100.0]

Mean cell haemoglobin level 30.9 pg [27.0 - 32.0]

Mean cell haemoglobin concentration 328 g/L [310.0 - 360.0]

Differential white blood cell count

Neutrophil count 4.8 10*9/L [2.0 - 7.5]

Lymphocyte count 1.7 10*9/L [1.3 - 3.5]

Monocyte count - observation 0.5 10*9/L [0.2 - 0.8]

Eosinophil count - observation 0.4 10*9/L [0.0 - 0.4]

Basophil count 0.1 10*9/L [0.0 - 0.3]

Bone profile

Serum calcium level 2.35 mmol/L [2.15 - 2.5]

Serum adjusted calcium concentration 2.21 mmol/L [2.15 - 2.5]

Serum inorganic phosphate level 0.93 mmol/L [0.81 - 1.45]

Serum alkaline phosphatase level 32 iu/L [35.0 - 104.0]

Below low reference limit

Serum total protein level 70 g/L [66.0 - 87.0]

Serum albumin level 47 g/L [35.0 - 52.0]

Serum globulin level 23 g/L [18.0 - 36.0]

Serum urea level 2.9 mmol/L [2.8 - 8.1]

C-REACTIVE PROTEIN (S)

Serum C reactive protein level 0.4 mg/L [0.0 - 5.0]

Urea and electrolytes

Serum sodium level 140 mmol/L [136.0 - 145.0]

Serum potassium level 4.4 mmol/L [3.5 - 5.1]

Serum creatinine level 61 umol/L [44.0 - 80.0]

GFR calculated abbreviated MDRD > 60 mL/min [60.0 - 90.0]

EGFR COMMENT 1 eGFR should not be used in patients with acute

renal impairment.

EGFR COMMENT 2 If patient is of African-Caribbean origin the eGFR

result should be multiplied by a factor of 1.21

EGFR COMMENT 3 eGFR is not validated in pregnant women.

Serum follicle stimulating hormone level 4.0 iu/L [3.5 - 12.5]

LH/FSH ref ranges shown apply to follicular phase

Liver function tests

Serum total bilirubin level 5 umol/L [0.0 - 21.0]

Serum alanine aminotransferase level 12 iu/L [0.0 - 33.0]

Thyroid function test

Serum free T4 level 15.2 pmol/L [12.0 - 22.0]

Serum TSH level 2.43 mu/L [0.27 - 4.2]

VIT D, 25OH, TOTAL, SERUM

Serum total 25-hydroxy vitamin D level 135 nmol/L [50.0 - 120.0]

Above high reference limit

HbA1c level (DCCT aligned)

Haemoglobin A1c level - IFCC standardised 33 mmol/mol [< 42.0]

[bluebug in reply to FeelBlah]

Good news all your results are well within the range.

Bad news it will be up to your to supplement your folate, vitamin B12 and ferritin to get them optimal as you aren't so deficient in them so the NHS won't help you.

Vitamin B12 should be over 500 to avoid symptoms. This website has more info - b12d.org

Folate should be halfway in range and to raise this you just need to take a good vitamin B complex.

Ferritin should be halfway in range to 100. I would take a solgar gentle iron.

You can find all the supplements online via Amazon. Don't bother with the high street as they tend to sell junk plus things you don't need mixed in with them.

[FeelBlah in reply to bluebug]

Thank you Bluebug. You don't think i have any issues thyroid wise?

[bluebug in reply to FeelBlah]

Your thyroid numbers aren't good but in the UK you will not be treated for it as you are in range. If you want to treat your thyroid you have to research yourself and then self-treat.

[FeelBlah]

To be honest, I'm finding that all VERY confusing. Is there a document somewhere that makes it clearer. I even bought a book, which took me through everything but what to do! I feel like I'm in a cotton wool cloud most of the time. I wouldn't have a clue what to take, and where to get it, let alone how much. Also i'm slightly wary of self medicating. Is there such a thing a private GP's or specialists that can help, or am I looking at nutritionists/functional medicine? I'm a bit wary of those too, as they often seem intent on a particular diet.