New to site - hello!

[Elle_c]

Hi I am worried about my symptoms which I think might be thyroid? Doctor says I am borderline hypo. Symptoms are tiredness, weight gain, constant throat clearing, throat feeling tight, swelling in front of neck, constipation, heavy periods, hair loss, eyebrow loss, cramps, pins and needles.

Thank you for any input!

November 2011

TSH 5.4 (0.2 - 4.2 mIU/L)

Free T4 16.7 (12 - 22 pmol/L)

January 2012

TSH 2.2 (0.2 - 4.2 mIU/L)

January 2013

TSH 0.97 (0.2 - 4.2 mIU/L)

June 2013

TSH 44.1 (0.2 - 4.2 mIU/L)

Free T4 10.1 (12 - 22 pmol/L)

August 2017

TSH 5.6 (0.2 - 4.2 mIU/L)

Free T4 13.1 (12 - 22 pmol/L)

Free T3 3.2 (3.1 - 6.8 pmol/L)

[SeasideSusie Remembering]

Elle_c If you post your test results, with reference ranges, members can comment. Not much to say without seeing results.

If you've had vitamins and minerals tested post those also.

Ideally we need to see

TSH

FT4

FT3

Thyroid antibodies

Vit D

B12

Folate

Ferritin

[Elle_c in reply to SeasideSusie]

Thyroid ones included. Thanks!

[SeasideSusie Remembering in reply to Elle_c]

Elle -

June 2013

TSH 44.1 (0.2 - 4.2)

Free T4 10.1 (12 - 22)

Well this one stands out a mile. Extremely high TSH and below range FT4. You should have had a diagnosis of hypothyroidism back then and started on Levo. There's no way that one is borderline.

I think you should go back and discuss all these results with your GP. Ask why you weren't diagnosed and prescribed Levo back in 2013 and the fact that your TSH has varied so much suggests autoimmune thyroiditis - that is autoimmune thyroid disease caused by either Thyroid Peroxidase or Thyroglobulin antibodies, patients call it Hashimoto's.

If he says antibodies aren't important, they definitely are. They attack and gradually destroy the thyroid and eventually cause full blown hypothyroidism.

Your results currently show an over range TSH with low FT4 and FT3 and you have symptoms. Print this list of symptoms thyroiduk.org.uk/tuk/about_... tick any that apply to you, show it to your doctor and say you should be diagnosed with subclinical hypothyroidism according to bestpractice.bmj.com/best-p... > click on High TSH - associated with a normal FT4 and/or FT3 which says

"High TSH - associated with a normal FT4 and/or FT3

•Subclinical (or mild) hypothyroidism occurs when TSH is above reference range with a normal FT4 and FT3. The risk of progression to overt hypothyroidism is 2% to 5% per year. [42] The risk is higher in patients with positive TPOAb. [43] The decision to treat these patients is controversial. Generally, thyroxine replacement is not recommended when TSH is below 10 mIU/L. [44] TSH and FT4 should be repeated at 6- to 12-month intervals to monitor for improvement or worsening in thyroid status in untreated patients. [42] "

The fact that you have had numerous tests already with 3 over range TSH results will hopefully be enough to persuade him to start you on Levo.

You still need antibodies testing (and the vitamins and minerals).

[Elle_c in reply to SeasideSusie]

Thanks well the thyroid test done which showed the sky high TSH was done privately, the GP kept dismissing my concerns of my symptoms. I tested positive for antibodies.

[SeasideSusie Remembering in reply to Elle_c]

So positive antibodies, over range TSH, symptoms. Currently that should give you a diagnosis of subclinical hypothyroidsm as suggested in the link to the BMJ site I gave.

More evidence for you to take thyroiduk.org.uk/tuk/about_...

The 'UK Guidelines for the Use of Thyroid Function Tests' state that, "There is no evidence to support the benefit of routine early treatment with thyroxine in non-pregnant patients with a serum TSH above the reference range but <10mU/L (II,B). Physicians may wish to consider the suitability of a therapeutic trial of thyroxine on an individual patient basis." If your TSH is above the range but less than 10, discuss a therapeutic trial of thyroxine with your doctor.

Subclinical hypothyroidism (where there are elevated TSH levels, but normal FT4 levels, possibly with symptoms) has been found in approximately 4% to 8% of the general population but in approximately 15% to 18% of women over 60 years of age.

Subclinical hypothyroidism can progress to overt hypothyroidism (full hypothyroidism with symptoms) especially if there are thyroid antibodies present.

If thyroid antibodies are found, then you may have Hashimoto's disease. If there are thyroid antibodies but the other thyroid tests are normal, there is evidence that treatment will stop full blown hypothyroidism from occurring.

And

Dr A Toft, consultant physician and endocrinologist at the Royal Infirmary of Edinburgh, has recently written in Pulse Magazine, "The combination of a normal serum T4 and raised serum TSH is known as subclinical hypothyroidism. If measured, serum T3 will also be normal. Repeat the thyroid function tests in two or three months in case the abnormality represents a resolving thyroiditis.2 But if it persists then antibodies to thyroid peroxidase should be measured.

If these are positive – indicative of underlying autoimmune thyroid disease – the patient should be considered to have the mildest form of hypothyroidism.

In the absence of symptoms some would simply recommend annual thyroid function tests until serum TSH is over 10mU/l or symptoms such as tiredness and weight gain develop. But a more pragmatic approach is to recognise that the thyroid failure is likely to become worse and try to nip things in the bud rather than risk loss to follow-up."

You've now got to fight for your diagnosis and a prescription for Levo. See another doctor if necessary.

[Elle_c in reply to SeasideSusie]

Just logged on to my patient access profile, another thyroid blood test has been done showing TSH 50.3 (0.2 - 4.2 mIU/L) and Free T4 11.2 (12 - 22 pmol/L) and GP comments say abnormal - book appointment to discuss. So surely they can't dismiss my symptoms now?

[SeasideSusie Remembering in reply to Elle_c]

No of course they can't. Take all the information you've been given and get it sorted now. Also, if you didn't have an appointment to discuss those results at the time, ask why not, why didn't they contact you, and make it known that you consider they have been negligent (and may have to think about whether you want to take that any further- that should shake them up!)

[Elle_c in reply to SeasideSusie]

Thyroid peroxidase antibody 376 (<34 IU/mL)

Thyroglobulin antibody 458.3 (<115 IU/mL)

[SeasideSusie Remembering in reply to Elle_c]

Elle

Your high antibodies mean that you are positive for autoimmune thyroid disease aka Hashimoto's which is where antibodies attack the thyroid and gradually destroy it. The antibody attacks cause fluctuations in symptoms and test results.

You can help reduce the antibodies by adopting a strict gluten free diet which has helped many members here. Gluten contains gliadin (a protein) which is thought to trigger autoimmune attacks so eliminating gluten can help reduce these attacks. You don't need to be gluten sensitive or have Coeliac disease for a gluten free diet to help.

Supplementing with selenium l-selenomethionine 200mcg daily can also help reduce the antibodies, as can keeping TSH suppressed.

Gluten/thyroid connection: chriskresser.com/the-gluten...

stopthethyroidmadness.com/h...

stopthethyroidmadness.com/h...

hypothyroidmom.com/hashimot...

thyroiduk.org.uk/tuk/about_...

[Hebeblue]

Hi Elle, welcome to the site- lots of support and help here. If you've had blood tests done publish them on the site and you'll get lots of help. If you're borderline you'll probably be started on a low dose of Levothyroxine.

Do some research on foods to avoid like gluten. It's something we can do to help ourselves. And don't worry!

[Elle_c in reply to Hebeblue]

Thanks

[Elle_c]

Also had vitamins and minerals done recently, supplementing hasn't really helped my levels much.

[ITYFIALMCTT in reply to Elle_c]

If you can post the vitamin and mineral results (together with their reference ranges) that would be very helpful - include the supplements that you're taking with any dosage information. SeasideSusie has lots of helpful suggestions (as you've seen) about how deficiencies might be rectified.

[Elle_c in reply to ITYFIALMCTT]

Thanks will do

[SeasideSusie Remembering in reply to Elle_c]

Elle

Post the results (include ranges), say what supplements you are using, the dose, and how long you've been supplementing. If you have results from before starting supplements, and more results since using them, post them all.