I'm sorry if this post is long but I have been having a fight with my GP for a long time.
I was diagnosed with hypo around 15 years ago as I was feeling extremely tired and weak. I suspected hypo as my mother had it. I had also been diagnosed 5 years earlier with severe depression and advised after seeing psychologist to take anti-D's. I am still on them and dose has increased. GP did test my thyroid as asked and I was borderline so prescribed 50mcg to start with a follow up in 12 weeks. results were ok to stay on 50mcg but as I was still feeling tired, GP kindly increased the dose to 75mcg and I have been on this dose up until Jan 2017. unfortunately I do not have test results for this period as I wasn't clued up then. I've never felt wonderful but thought I felt better than I did before taking levo.
I lost my mother very suddenly in May 2016 and having been a very tense and stressed out person all my life due to a dysfunctional upbringing, I started to feel very strange after the initial shock had subsided. I was forgetting everything, couldn't recall names, words or would stop mid sentence and ask myself what I was talking about. I would get very cold mid afternoon and would have to go back to bed. I felt as if my cortisol was raised as the symptoms seemed to fit so GP did a serum cortisol test 6/12/16 which showed 499nmol/l (Range is 133 -537 for serum cortisol). I was concerned but my GP wasn't so I had a salivary test done privately which included Cortisol and DHEA. Basically cortisol was high(off the chart) throughout the 4 readings of the day and DHEA Low. DHEA : Cortisol ratio 0.010 (Range 0.015-0.150) low
What I have only just discovered are the RESULTS of a THYROID TEST taken at the same time as my serum cortisol. This was taken while fasting WATER ONLY
Results 8/12/16 were as follows . TSH 9.03 mU/L ( 0.27-4.20). FT4 18.4 pmol/l (11.00-25)
Surgery rang me to say there was a new prescription for me and I was to increase levo to 100mcg and re-test in 8 weeks.
Results 1/3/17 TSH 0.17 . FT4 21.1 (Range as before)
Results 4/5/17 TSH 0.57 . FT4 18.5 ( " " )
Results 24/8/17 ( I managed to get FT3 tested this time as well)
TSH 1.15. FT4 18.6 FT3 4.2pmol/l ( last time tested 2011 when it was 4.3) (Range 3.10-6.80pmol/l)
Also showing in full blood count were Red Blood cell distribution width which was 16.7% (Range 11.00- 14.80%) This had an asterix by it. B12 deficiency=enlarged red blood cells?
Because of this I asked for folate, ferritin, B12, TG ab and B12 to be tested. I already know TPO is ok. Only some tests were done and the results for these are from
5/9/17 B12 is 311 ng/L (180- 900) Labs commented that B12 deficiency was unlikely but for GP to seek further advice is suggestive features present!!!! She didn't, she said it was fine. i feel this is borderline B12 deficiency from what I can gather from internet.
Serum folate 4.4ug/l (range is >3.8) I take 5mg folic acid a week as I am on 10mg of methatrexate per week for R.A. I also have osteoporosis and take Adcal D3 twice a day (600mg Calcium and 400 IU Colecalciferol which is equivalent to 10 mcg D3(taken from side of box)
Now if you notice the FT4 has around my usual spot when TSH was raised in Dec. 16 and increased slightly when first tested on increased dose of levo in March 2017. I thought Clutter has mentioned that it didn't matter what TSH was doing as long as FT4 was ok, so this is why I am wondering if GP is doing the right thing based on results. She doesn't seem to know much about Thyroid but has referred me to endo in local area who speciality is Diabetes. I have asked to be referred to out of area Endo but he only works with NHS and GP says if we have an endo on our health board I cannot refer you outside of that. Meanwhile I wait for the local one to see me and then if he refers me to the one out of the area(he is allowed) then there will be another waiting list.
I feel awful a lot of the time, constantly tired, cannot get up in the morning, muscle/joint pain which is not from RA, hair thinned out, no pubic/underarm hair left, etc etc. I think I may need RT3 tested to check if this is causing T3 to be low. I know cortisol being high can stop converting of FT4 to FT3. my serum cortisol has since come down to 329n/mol/l as of 5.9.17
The good news is I have managed to source some good T3 50 tables at 20 mg, this was the smallest dose I could get but I am afraid to start taking it because I understand you need to drop around 25% of levo when you do this and my levo tablets are very small 100mcg each. I don't want to ask GP to supply them in 75/25mcg as she has advised me not to dabble with T3 although she did say she can't stop me.
So sorry once again for the essay but I don't know where to turn and feel as if I am getting nowhere with GP who says wait to see local endo..........AND THEN WHAT?!?!
Does anyone think T3 tabs is the right way to proceed. I am so very, very tired and confused.
Thank you all for reading