Blood tests just given to me from June not sure if doctor is doing all she can.

[Sharon212]

I've had blood tests done after having to put a formal complaint in as I've been backwards and forwards feeling really unwell and she adv that she didn't think anything was wrong with my thyroid and that I just needed to lose some weight. My results

TSH level 4.56 (0.38-5.33)

Serum free T4 11 (7.8-14.4)

Thyroid peroxidase antibody 552 (<50)

Serum folate 5.4 (3.1-19.9)

Serum vit B12 207 (180-914)

Anti-nuclear factor negative

Microsomes autoantibodies negative

Anti mitochondrial autoantibodies negative

Parietal call antibodies negative

Auto smooth muscle autoantibodies negative

Nuclear staining negative

Serum alkaline phosphatase 136 (130-120)

Serum gamma level 55 (1-55)

Not sure what to think really all I know is I'm suffering struggling everyday and feeling more depressed about my failing body. My GP said just to wait six months and get retested and see where it takes us ?? Is that acceptable ? I may lose my job soon as I'm on my final written warning for time off.

Any advice thanks will be greatly recieved.

[ITYFIALMCTT]

I can't comment on the thyroid and vitamin results etc. but other people here can.

From the list, it seems as if your GP ordered a comprehensive set of tests to investigate for any markers of an auto-immune condition (e.g., the ANA, ASMA etc.).

It looks like she ordered a Parietal cell antibodies test to see if that were contributing to your low in range vitamin B12 (if she already knew your reading is low, or to check for B12 deficiency to be comprehensive). labtestsonline.org/understa...

Do you have a range of symptoms? It's good that she's willing to retest in 6 months to see if anything has changed that might give a better clue to what is amiss - but it's horrible for you in the interim particularly as you're running into problems at work.

[Sharon212 in reply to ITYFIALMCTT]

Hi, I lists the tests I wanted doing as she had previously refused. She states that my vitamin B12 is fine and no action to be taken at all, just to leave for six months and to re test as she said it may change in that time.

Yes I have a range of symptoms, I'm exhausted, palpitations, have wipe out times and can't physically do anything, having anxiety, Nausea, headaches, pain in my joint and muscles, muscle spasms, unexplained flashes of rash on my face and neck, hot flushes, and regular temp that runs just that bit higher than normal usually 37.2-37.4 quite regular. Feeling quite tears at times and no apparent reason apart from feeling generally unwell. Constantly.m

[ITYFIALMCTT]

Just so that someone like SeasideSusie can comment, in addition to your B12, did you have your iron, vitamin D, and ferritin tested?

Was there anything else, like a fasting blood sugar level and cholesterol panel?

[Nanaedake]

Well you can tell your employer you have an autoimmune thyroid condition called Hashimotos. Thyroid peroxidase antibody 552 (<50) Your antibodies are greater than 50 which shows you've got Hashimotos. Has your doctor not told you that? Doctors usually call it autoimmune thyroiditis. This will affect your thyroid blood test results. Even though your TSH is within range, it's on the higher side within range. If you tested in a few months time it could be higher or lower because the Hashimotos antibodies attack your thyroid and slowly destroy some of the cells so that you become increasingly hypothyroid. When the antibodies attack the thyroid, the dying cells release a lot of hormone and your TSH level will reduce. You might feel a bit jittery or overactive. Then when it settles down you will become hypothyroid again. So you experience these swings.

Thyroid imbalance can make people feel very unwell and if you've received no treatment you may have been experiencing these swings without realising what they were.

In addition, your B12 and folate, although in range, are very low and could be giving you symptoms. Vitamin deficiencies are common in thyroid conditions. Post your B12 and folate results on Healthunlocked pernicious Anaemia forum to ask their advice about what you should ask your doctor to check and what supplements are advisable.

I can't see a vitamin D test or ferritin? These too should be checked as vitamin D deficiency is very common with Hashimotos thyroiditis. Insist your GP tests those.

It is advisable to start on levothyroxine as you are feeling unwell with the aim of bringing your TSH down to around l.0 or slightly less. This will help to prevent antibodies attacks. Also, you can supplement with selenium. 200mcg. Many people with thyroid autoimmune conditions find going gluten free helps a great deal.

Thyroid UK have a document you can take to your GP by Dr Toft who is a renowned endocrinologist. The document explains how your thyroid condition needs to be treated I believe. Contact them for advice.

Make an appointment with your GP to discuss the above and ensure you get the blood tests mentioned and at least a trial of levothyroxine to see if it relieves your symptoms. If you start on levothyroxine you need a blood test in 6 weeks time and adjust the dose until your reach 1.0 which is where most people feel well. If you still have symptoms you need to optimise your vitamin levels. All vitamins need to be mid-range and B12 needs to be top of the range for the thyroid or levothyroxine to work well.

Maybe find a new GP?

Good luck, let us know how you get on with the new GP.

[Sharon212 in reply to Nanaedake]

Hi thanks for replying, my GP said just to recheck in 6 months time as she said I may get a thyroid problem not that I have one now. I'm more prone she said with my results to get a problem but to wait another six months and see where we go from there. She knows how poorly I feel but doesn't seem to think it's linked to my thyroid. She said she can't refer me till my TSH level is 10 or over as that's the protocol at there surgery. I am concerned that she wants to leave me for months and in the process my body is going through hell, and it may cause me more damage. I've had no treatment at all and she believes that I can push through she said.

[Nanaedake in reply to Sharon212]

Point your doctor to the new NICE guidelines which all docs must adhere to. She is out of date and needs to read up so make sure you get a trial of levothyroxine as stated here. Make sure you take a list of your symptoms. See the list of symptoms on Thyroid UK website, tick them off then take the list with you.

If TSH is between 4 and 10 mU/L and FT4 is within the normal range...

In people aged less than 65 years with symptoms suggestive of hypothyroidism, consider a trial of LT4 and assess response to treatment 3–4 months after TSH stabilises within the reference range — see the section on Prescribing information for further information on initiation and titration of LT4. If there is no improvement in symptoms, stop LT4.

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

[Inaquandary]

Please please PLEASE ensure your Vitamin D levels are ok. This is so important for energy etc. If you haven't got enough you will feel dreadful. Its common in hypo patients.