Advice needed on blood results for when I see consultant please

[vicks05]

Hi I'm due to see an endocrinologist on Monday for the first time, referred from my gp, due to fatigue, weakness, pains, pins and needles, tingling in feet, hair loss etc. I have vit D deficiency +on medication. My Vit b12 levels continued to fall but still in range but dropped on 3 separate occasions lowest been 243. I saw a locum doctor who prescribed Vit b12 injections +after 2weeks started to feel a little better but my normal gp, I feel wasn't happy that I had injection+so has now referred me to see consultant. I got some bloods done private again so I have some results to take to my appointment

TSH 4.52 mIu/L (0.27-4.20)

Free thyroxine 13.5 pmol/L (12-22)

Total thyroxide( T4) 68.6 nmol/L ( 59-154)

Free T3 4.38 pmol/L (3.10-6.80)

Thyroglobulin antibody 136 IU/ml (0-115)

Thyroid peroxidase antibodies 42.2 IU/ml (0-34).

Foliate 6.82 ug/L (2.91- 50)

I had a vit b12 but this was taken a few weeks after my injection 121 pmol/L (25.10-165)

I know my TSH and antibodies are slightly above range, do you think the consultant would/should do something+will they acknowledge these results. Also is there any advice if he won't do anything.

Thank you for reading

[greygoose]

He certainly should do something - you have Hashi's - although he will probably call it Autoimmune Thyroiditis - or maybe deny everything! - and you are hypo with a TSH over 4. But whether he will have the correct knowledge or the right attitude is anybody's guess! Nor will he recognise your low B12, because it was 'in-range'. Personally, I wouldn't recommend any hypo see an endo, because they seem to be less and less knowledgeable and have worse and worse attitudes. But, who knows! You might hit the jackpot with this one!

If he won't do anything, come back here and let's think again. But, I would say that it was a no-brainer that your fatigue is due to your low thyroid and pins and needles due to your low B12. But, then, I'm not a doctor!

[vicks05 in reply to greygoose]

Thank you for your reply. Yeah I'm not feeling too confident especially as he is a diabetic specialist, could be a waste of time

[greygoose in reply to vicks05]

They nearly all are. Thyroid just isn't interesting enough for them, for some reason. I would have thought it was far more interesting than diabetes! But, perhaps that's because I'm hypo and don't have diabetes!

[vicks05 in reply to greygoose]

😃😃

[SlowDragon Administrator]

Most endo's never seem to consider at all the importance of vitamins levels or how badly gut can be affected by Hashimoto's

Did you get your vitamin D retested after loading doses? It was extremely low before supplementing Are you still taking a maintenance dose, if so how much, plus recommends magnesium and vitamin K2

Private testing of vitamin D, including free vitamin D supplements

betteryou.com/vitamin-d-tes...

With Hashimoto's then Gluten is pretty likely to be causing you problems.

Changing to a strictly gluten free diet may help reduce symptoms. Very, very many of us here find it really helps and can slowly lower antibodies.

thyroidpharmacist.com/artic...

thyroidpharmacist.com/artic...

amymyersmd.com/2017/02/3-im...

chriskresser.com/the-gluten...

scdlifestyle.com/2014/08/th...

[vicks05 in reply to SlowDragon]

Thank you for the information. Yeah I got it re-tested +it had come up I was on 60,000 a week now I'm on 800iu a day. I started taking the vit k2 mk7 but have stopped as my stomach bloated badly+was extremely hard, not sure if it was related, I might try again +if it does happen then stop

[bluebug in reply to vicks05]

800IU per day is too low. You want to keep your level around 100nmol/L and this level of supplementation won't do it especially in winter simply because you have been severely deficient before.

You will very likely find at the end of next year you are severely deficient again.

Unfortunately the NHS rations vitamin D tests so you are going to have to pay for your own. The cheapest sole vitamin D tests are City Assays. They cost £28 and are finger prick tests you do by post.

Personally I would up your dose to the equivalent of 2000-2,5000IU per day then concentrate on sorting out your B12 and folate problems. You can test your vitamin D next year.

Btw you don't need to talk to your doctor about your vitamin D again unless you have symptoms as many CCGs are not giving out prescriptions for maintenance doses.

[SlowDragon Administrator in reply to vicks05]

Stomach issues are very likely gluten intolerance. With Hashimoto's a very high percentage of us find it essential to be strictly gluten free

Don't expect your GP to know anything about this or the importance of good vitamin levels

[bluebug]

Your folate is low in range. I suggest you go over to the pernious anaemia society on healthunlocked. Ask them questions on B12 and folate stating your results, the symptoms you have and the treatment you have been given.

Once you have seen the endo come back here and start a new thread with an update. Posters here will give you advice on what worked for them as it is extremely unlikely the endo will help you. It is more likely they will upset you and/or p*ss you off.

[Marz in reply to bluebug]

There are two previous posts on PAS Forum. 😊

[vicks05 in reply to bluebug]

Thank you. Yes more than likely. I was in tears during one consultation with a doctor, more through frustration as he wasn't listening or taking on board anything I was saying +constantly saying I had chronic fatigue syndrome

[Marz]

In your threads on the PAS forum it was suggested you show your GP various bits of info re B12 and treatment how did that go ?

[vicks05 in reply to Marz]

It was a locum doctor a saw, he didn't want to know regarding my thyroid and wasn't too keen on b12 but I spoke through the guidelines + showed him stuff I had printed off. He agreed to vit b12 injections +ordered some bloods but my normal gp said they wouldn't do bloods+therefore has now referred me to see an endo

[Marz in reply to vicks05]

Have you researched your Endo ? Is he Thyroid friendly ? - so many only know about Diabetes

[vicks05 in reply to Marz]

Unfortunately I just got a letter from the hospital with his name+stating diabetes specialist. So probably be a waste of time but we shall see

[Marz in reply to vicks05]

Sadly it is often the case. What a shame they do not realise there is a connection between the two endocrine conditions. Bet they do not test their diabetic patients for thyroid issues correctly. An untreated or under-treated thyroid can lead to diabetes I have read ....

[bluebug in reply to vicks05]

The PAS is recognised and provides information to health professionals so don't be scared to tell him that you only consulted your GP after contacting them. If he puts PAS down then you know he's not worth bothering with.

[Marz in reply to bluebug]

.... and Thyroid UK

[bluebug in reply to Marz]

@Marz Best to see how the doctor responds to one before adding in another, and it appears she went to PAS first.

[SlowDragon Administrator]

If your supplementing or injecting B12 then also taking good vitamin B complex will improve folate and keep all the other B vitamins in balance

But when taking vitamin B complex, or any supplements containing biotin, remember to stop these 3-5 days before any blood tests, as biotin can falsely affect test results

endo.confex.com/endo/2016en...

endocrinenews.endocrine.org...