Thyroid UK

TSH 4.5 Doctor refused to discuss my thyroid function as a possible cause for my symptoms

Hi, has anyone in the UK successfully received a prescription for levothyroxine with a TSH of 4.5? My doctor has had me in tears today. I am exhausted all the time as well as a very long list of other symptoms. I don't think she is listening to my symptoms and I left with her telling me she could prescribe slimming world and counselling. Apparently I am just fat and depressed. I also have a ferritin level of 9 as well as high cholesterol, low vitamin D and PCOS. I feel desperate and not sure what to do next.

Here are my results taken 22 Sep 2017- The normal ranges are apparently in the brackets. I have been given iron (liquid) and vitamin D (Tablets) supplements but I really struggle with the effect of the Iron on my stomach.

I am not receiving any treatment for my PCOS.

Serum TSH level - 4.49 mu/L ( 0.35 - 5mu/L )

Serum vitamin D - 40 nmol/L ( 30 - 300nmol/L )

Serum vitamin B12 - 318 ng/L ( 130 - 800ng/L )

Serum folate - 6.1 ug/L ( 4 - 20ug/L)

Serum ferritin - 9 ug/L ( 12 - 250ug/L )

Serum cholesterol 6.86 mmol/L

Haemoglobin estimation - 138 g/L (120 - 160g/L

)

Total white cell count - 7.5 10*9/L (4 - 1110*9/L )

Platelet count - 301 10*9/L (150 - 40010*9/L )

Red blood cell (RBC) count - 4.73 10*12/L (3.8 - 5.810*12/L )

Haematocrit - 0.41 L/L (0.35 - .45L/L )

Mean corpuscular volume (MCV) - 85.9 fL (80 - 100fL )

Mean corpusc. haemoglobin(MCH) - 29.3 pg (27 - 32pg )

Mean corpusc. Hb. conc. (MCHC) - 341 g/L (300 - 358g/L)

Red blood cell distribut width - 14.4 (11 - 14.5 )

Mean platelet volume -9 fL (6.5 - 20fL )

Neutrophil count - 5.2 10*9/L (2 - 7.510*9/L

)

Lymphocyte count -1.4 10*9/L (1.5 - 410*9/L )

Monocyte count - 0.6 10*9/L (0.2 - .810*9/L

Basophil count - 0.1 10*9/L (0 - .110*9/L )

Eosinophil count - 0.1 10*9/L (0 - .410*9/L )

20 Replies
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It would help people to comment if you can obtain a copy of your blood test results* and publish them here with the reference ranges as the machines and the assays they use in labs are different and it isn't possible to interpret numbers/results without the ranges (typically in brackets to the right of the number).

Please get all of your results including the vitamin D etc. as it's all relevant and there's a lot of advice here about how to remedy any deficiencies because it's so much harder for thyroid hormones to do their job properly when vitamins and minerals aren't in a healthy range (not necessarily including those who scrape in at the bottom of a normal range :) ).

Please mention any supplements or medications that you're currently taking. Are you receiving care for the PCOS?

*In lots of surgeries, you can look at the results online. If you're not registered to do this as yet, then request a print out of the results from the receptionist - as long as the results were within the last 20 days or so they should provide them for you free of charge or for no more than the cost of printing them.

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You mean she didn't prescribe anti-depressants and statins? I guess she saved that for your next appt. 🙄

As far as I know, doctors are financially rewarded for handing out anti-depressants, statins, and all kinds of other crap. But are they interested in getting to the root of the problem and rectifying that? No, of course not.

Come back Hippocrates, all is forgiven. 🤕

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I think if I had asked she would have prescribed anti depressants! I actually shouted at her I AM NOT DEPRESSED!!!!!

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I am proscribed prozac. I don't take it. I have been offered no support. But because I don't feel well I must just be depressed.

Don't think I could get my Dr to prescribe Smarties with as much ease.

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Daize,

When doctors are inept or just too damn lazy to bother to identify and rectify the cause of your pain and fatigue, etc... they simply write a prescription for anti-depressants and collect their financial bonus.

What they're practicing isn't 'medicine'. 🤕

We should all be vocal about this.

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Can you edit these into your main post - just to make it easier to see for people like SeasideSusie ? Can you see an arrow that gives you an edit option on your main post?

SS has some excellent suggestions as to what strategies might be helpful for iron supplementation when other products are too harsh, and how best to take them for the greatest effect. Likewise, SS can suggest useful ways of addressing the vitamin D levels etc.

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Instead of you being "in tears", your doctor should be... for being so lousy at her job. 🤕

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Every single one of your results screams HYPOTHYROID as do all your symptoms

Low ferritin and high cholestrol are absolutely indicative of hypothyroid never mind all the other results

Its absolutely vital to sort out low ferritin before your body has a hope of utilsing levothyroxine

Email louise.roberts@thyroiduk.org.uk for a copy of the PULSE article by Dr Toft

Also do a google scholar search on

Ferritin+hypothyroid

Cholesterol+hypothyroid

Folate+hypothyroid

Vit D +hypothyroid

Print them all off and take them back to her and insist Thyroid Antibodies are done

Your stomach acid is likely low and why you have problems with iron

Pepsin+betaine for a while before meals is needed to correct this

At least 2000mg Vit C in divided doses every single day from herein

You need a referral for the PCOS although this may settle once your thyroid is treated

Do other members of your family have thyroid,diabetes,endometriosis ,RA,Lupus

You should immediately be started on 25mcg of levothyroxine and be retested after 6 weeks then dosage should be increased by 25mcg every 4 weeks till your TSH is 1.0 or below

Cholesterol will fall and your symptoms will ease

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Thank you so much for your reply, its helped me feel a little less like I am just being a crazy fat depressed woman. I think I may go see a private GP next, I can't face my GP again.

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Make sure the private GP is more enlightened than your NHS GP. Otherwise, you're wasting time and money on being told the same nonsense again. 🙄

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Armed with the info i have told you to get take an assertive person who has read these forums to go with you to your GP ...she needs educating on thyroid tell her you will make another appt in a week when she has read and absorbed the info plus you have been advised by an NHS choices website

You could also take info from the actual thyroiduk.org website too

Jus t stand your ground but make it a very informed one

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Keep at them! Make them look at your symptoms, not just superficial TSH reading. I was prescribed anti-depressants an and off for 20 years. Then about 12 years ago I had complications, due to hypothyroidism, got properly diagnosed and prescribed levothyroxine. Lost four stone in a year, never taken an antidepressant since

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Medichecks are doing tsh, t3, t4 today £10 off (Thyroid Thursday offer) at £29. It might be worth seeing what your levels actually are.

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susancotterill29677 - beh1 has made a good suggestion about the Medichecks test, it would be good to see where your FT4 and FT3 lie medichecks.com/thyroid-func... (you need to order today for that price) or it might be an idea to also test thyroid antibodies and that has £10 off today as well medichecks.com/thyroid-func... , then you have the whole thyroid picture.

**

Serum vitamin D - 40 nmol/L ( 30 - 300nmol/L )

The recommended level, according to the Vit D council, is 100-150nmol/L.

I doubt whether your GP would prescribe anything, if so the most would be 800iu and you need more than that. I suggest you buy some D3 softgels like these bodykind.com/product/2463-b... and take 5000iu for 3 months then retest. When you've reached the recommended level then you'll need a maintenance dose which may be 2000iu daily (or try 5000iu alternate days or a few days a week), it's trial and error so it's recommended to retest once or twice a year to keep within the recommended range. You can do this with a private fingerprick blood spot test with City Assays vitamindtest.org.uk/

There are important cofactors needed when taking D3

vitamindcouncil.org/about-v...

D3 aids absorption of calcium from food and K2-MK7 directs the calcium to bones and teeth where it is needed and away from arteries and soft tissues where it can be deposited and cause problems.

D3 and K2 are fat soluble so should be taken with the fattiest meal of the day, D3 four hours away from thyroid meds.

Magnesium comes in different forms, check to see which would suit you best and as it's calming it's best taken in the evening, four hours away from thyroid meds

naturalnews.com/046401_magn...

Check out the other cofactors too.

**

Serum ferritin - 9 ug/L ( 12 - 250ug/L )

This is absolutely dire and your GP is being extremely negligent ignoring this. You need to go back, see a different GP, and ask for treatment. As your level is below range, ideally you need an iron infusion so ask for one, but you may only be prescribed tablets which will take months to raise your level whereas an infusion will raise your level within 24-48 hours.

Take each iron tablet with 1000mg Vitamin C to aid absorption and help prevent constipaton. Always take iron 4 hours away from thyroid meds and two hours away from other medication and supplements as it will affect absorption.

You can help raise your level by eating liver regularly, maximum 200g per week due to it's high Vit A content, and including lots of iron rich foods in your diet apjcn.nhri.org.tw/server/in...

Ferritin needs to be at least 70 for thyroid hormone to work - and that is our own or replacement hormone. It's recommended to be half way through it's range.

**

Serum vitamin B12 - 318 ng/L ( 130 - 800ng/L ) Serum folate - 6.1 ug/L ( 4 - 20ug/L)

Just check here to see if you have any signs of B12 deficiency b12deficiency.info/signs-an... If so you need to post on the Pernicious Anaemia Society forum healthunlocked.com/pasoc If not then you can self supplement with that level.

An extract from the book, "Could it be B12?" by Sally M. Pacholok:

"We believe that the 'normal' serum B12 threshold needs to be raised from 200 pg/ml to at least 450 pg/ml because deficiencies begin to appear in the cerebrospinal fluid below 550".

"For brain and nervous system health and prevention of disease in older adults, serum B12 levels should be maintained near or above 1000 pg/ml."

Sublingual methylcobalamin lozenges are what's needed if you wish to self supplement, start with 5000mcg then when the bottle is finished change to 1000mcg as a maintenance dose, along with a good quality B Complex (eg Thorne Basic B) to balance all the B vitamins.

Folate needs to be at least half way through it's range, if you buy the Thorne Basic B it has 400mcg methylfolate which will help raise your folate level.

**

Serum cholesterol 6.86 mmol/L

Raised cholesterol can be part and parcel of hypothyroidism. If you can get diagnosed and prescribed Levo, this should eventually lower.

I think you should see a different GP.

I think you should see a different GP.

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Thank you so much! I have just ordered the test suggested and will let you know the results. I really appreciate your feedback so thank you again for taking the time to reply.

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If you can't get full thyroid and vitamin testing from GP

thyroiduk.org.uk/tuk/testin...

Medichecks Thyroid plus ultra vitamin or Blue Horizon Thyroid plus eleven are the most popular choice. DIY finger prick test or option to pay extra for private blood draw. Both companies often have money off offers.

All thyroid tests should be done as early as possible in morning and fasting

Do you also have high thyroid antibodies? You need to know. Did GP test these? If not ask that they are tested.

TPO antibodies, plus ideally TG antibodies too

If antibodies are high this is Hashimoto's, (also known as autoimmune thyroid disease). About 90% of hypothyroidism in UK is due to Hashimoto's.

Hashimoto's very often affects the gut, leading to low stomach acid, low vitamin levels and leaky gut.

PCOS is strongly linked to Hashimoto's

drhagmeyer.com/women-pcos-o...

pcosnutrition.com/thyroid/

See another GP

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My TSH has been over 5 for 4 years and as high as 6.90 last year without any help from GP or consultants until I recently found out I have family history of hypothyroidism and I saw a GP who is new to the practice. He did a blood test and it came back 6.1 (range 0.38 - 5) and I explained that Ive had increasing symptoms for many years and rising TSH since 2011. He agreed to start me on levothyroxine 50mg trial. It has been a long fight to get someone to listen to me and I couldn't believe my ears when he said a trial of levy to see how I feel. I guess the answer is not to give up the fight even when doctors treat you like a nutcase as they did me. trying all ways to give anti depressants instead of looking at my history. Good luck. Joolz.x

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susancotterill29677 ,

You have been offered an excellent advice by other HU members. There is no point repeating what has already been said but I just want to emphasise that:

1. you need to be put on thyroxine asap.

2. please see a different GP. Either a different GP in your practice, a GP in a different practice or a private one. Find out info about them before you see them - there is no point seeing another incompetent idiot!

3. if you have an assertive friend or a family member who isn't foolish enough to put 100% of their trust in doctors and has a bit of knowledge about thyroid conditions - take them with you.

4. Jarrow B12 sublingual is very efective in increasing B12 levels: amazon.co.uk/Jarrow-Formula...

They also have a great B complex: Jarrow B Right.

P.S. Regarding point 4. - I find that most people trust doctors blindly and without any criticism. There is no point taking somebody like that with you...

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P.S.2 I'm sure it has been already mentioned but thyroid tests always have to be done as early in the morning as possible. TSH is the highest in the morning and lowest in the afternoon so you can be very hypothyroid and still have "normal" TSH in the afternoon.

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Hi

I have not commented or replied before but my GP prescribed 50mg Levo a day for my TSH of 4.5. The reading the previous year had been 2.51. Testing done the first time due to thyroid nodules. I did go in well armed ready to quote the British Thyroid guidelines and those else where. The prescription was as a trial but he said at the next check up he only had to look at me to see it was working. I have always found him very good unlike so many I have seen. I hope this gives you some hope. I don’t see why you should pay privately for something others are getting on the NHS.

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