Thyroid UK
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Can symptoms appear before test results are too bad?

Trying to help a friend who's been off sick for nearly 2 years. She's always been very heavy, at least 20 stone, but in 2015 she became very ill, could hardly breathe, couldn't stand easily,exhausted, put on lots more weight. She's been given water tablets, steroids to help her breathing, sent to breathing exercises physio, given antidepressants. She's weaned herself off all medication now, except for her usual inhaler. I've tried to get her to push for decent thyroid tests, but her GP said it 'didn't need testing again'. She's discovered that around the time she was first ill, it was tested, and her record said 'abnormal, speak to doctor'. But none of the 3 GPs she's seen has mentioned this to her. Her results then were:

FT4 17 (8-21)

TSH 2.93 (0.35-3.5)

Ferritin 159 (23-300)

These don't look horrendous to me, but not brilliant. Can symptoms be obvious before the tests look too bad? She often feels very low, and finds it hard to go shopping for example, as she can't walk far at all.

Any thoughts would be gratefully received! Thank you!

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For ideal and full Thyroid evaluation she would need TSH, FT4, FT3, TT4, TPO and TG antibodies, plus vitamin D, folate, ferritin and B12 tested

Sounds like unlikely to get all these thyroid and vitamin tests 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.

Cost £99 for all these (sometimes £79 when on offer)

Could start with just vitamin D for £28 via vitamindtest.org.uk

Very large people tend to have very low vitamin D.

Has GP tested this? Can they be persuaded to?

Ideally thyroid tests should be done as early as possible in morning and fasting. This gives highest TSH and most consistent results

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Thanks, yes I'm sure Medichecks would be the best way to go. I've used them for a while now - really good. GPs here can't always get even T3 done. Never mind asking for everything else.

But I'm pretty sure she won't be able to pay for all these. 2 years out of work is hard going, and she struggles.

I just wondered if her symptoms could had started before her test results showed too badly. I thought I may have read that somewhere..?

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Yes symptoms can gradually creep up on someone and you get sort of 'used' to being below par but it doesn't enter your head it could be an autoimmune disease. Especially if she's overweight (hypo) she'd just assume it was due to weight rather than low hormones.

Before blood tests were introduced we were diagnosed upon clinical symptoms alone and given NDT (natural dessicated thyroid hormones)

She will probably be able to tick off more than a couple. When GP did her test was it at the very earliest? TSH is highest early a.m.

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

She can tick off her symptoms and the GP must test for thyroid antibodies because often we have them along with symptoms but these aren't tested. If she has thyroid antibodies she should be prescribed. Remember tests always have to be at the very earliest, and fasting (she can drink water).

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I know her GP and family keep saying it's because of her weight, and that's really got her down as she keeps saying there's something else wrong. I've tried not to keep mentioning the weight issue, but wonder if she's been hypo for years and years. I think she had a chest infection around then, so maybe that could have triggered a change. She gets very down, and 'can't be bothered'. Our CCG has stopped T3, and maybe even T3 testing.

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Maybe this will give her some encouragement.

Her family shouldn't be so insensitive as weight is beyond her control if not optimally medicated.

healthunlocked.com/thyroidu...

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She needs a proper blood test - the very earliest, fasting (this keeps the TSH at its highest.

Ask GP to test TSH, T4, T3, Free T4 and free t3 and thyroid antibodies. (I know he wont do T3 and the frees but he should definitely test antibodies.) if antibodies are present she must be prescribed levo. If the doctor wont we have an article which she can give to him. It is ridiculous that we have to teach doctors.

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I think you will be surprised by the following link:-

Few doctors know anything about hypothyroidism except wait until TSH is 10.

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

She needs a Full Thyroid Function Test as advised by SlowDragon

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Thanks Shaws. I don't remember that page, despite often going onto Thyroid UK. I'll send her that link, and hopefully get her to request more tests from GP.

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Shaws, this is all really helpful thanks! Hard to tell but I guess she's put on at least another 2 stone. I feel so sorry for her. Next week's mission is to get her to the GP!

I'm self medicating with T3 now, as it seems to be the only way now - treat ourselves!

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If we've to get well and means we have to self-medicate we have no option, but some just cannot afford to so probably could develop other more serious problems which could have been avoided.

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