Nails thin and snapping

[Honey-rainbow]

Hi. Can any one advice me on what I need to do, I have just come off the phone to my doctor after telling him I wanted other blood tests taken(although I don't know which ones) I thought he would have known, I told him my nails are constantly splitting vertically and are as thin and bendy as paper and my hair falling out, I am still under the hospital and have bloods taken every 6months but I can't help thinking they are missing something out, since having my thyroid removed almost 3 years ago I haven't really seen any improvement with my health, although hospital says my levels are right I am constantly tired and have muscle aches

[SlowDragon Administrator]

First thing is do you have any actual blood test results? If not you need to get hold of them. You are entitled under data protection laws.

You may be able to view test results online - ring and ask about this. If you can then apply for online access to your account. All GP practices are supposed to offer this, in reality very few have blood test results available online.

If not then ask for print out of recent tests. Pick up in a day or two. They may make a nominal charge for paper.

You need to know results for TSH, FT4 and FT3.

Was your thyroidectomy for cancer or Graves

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

Essential to test vitamin D, folate, ferritin and B12. Always get actual results and ranges. Post results when you have them, members can advise

For full evaluation you ideally need TSH, FT4, FT3, TT4, TPO and TG antibodies, plus vitamin D, folate, ferritin and B12 tested

If you can not 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 and don't take Levo in the 24 hours prior to test, delay and take straight after. This gives highest TSH and most consistent results

Link about antibodies

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

Email Louise at a Thyroid UK for list of recommended thyroid specialists [e-mail]

You are quite likely under medicated and/or need the addition of small amount of T3 (many with no thyroid do).

Dr Toft, past president of the British Thyroid Association and leading endocrinologist, states in Pulse Magazine,

"The appropriate dose of levothyroxine is that which restores euthyroidism and serum TSH to the lower part of the reference range - 0.2-0.5mU/l.

In this case, free thyroxine is likely to be in the upper part of its reference range or even slightly elevated – 18-22pmol/l.

Most patients will feel well in that circumstance. But some need a higher dose of levothyroxine to suppress serum TSH and then the serum-free T4 concentration will be elevated at around 24-28pmol/l.

This 'exogenous subclinical hyperthyroidism' is not dangerous as long as serum T3 is unequivocally normal – that is, serum total around T3 1.7nmol/l (reference range 1.0-2.2nmol/l)."

You can obtain a copy of the article by emailing [e-mail] print it and highlight question 6 to show your doctor.

[Honey-rainbow in reply to SlowDragon]

Ok thank you very much, my thyroid removal was because of cancer, and for the first time I am hearing from you that I shouldn't take my medication before bloods, I have never been told this before, I am not even sure what bloods get taken, I just know that they will come back and the docs will say everything is fine, I will contact the links you have sent me and also get a copy of my bloods for here, thanks very much

[Honey-rainbow in reply to SlowDragon]

Also to add on, I take iron tablets twice a day, 6 calcium tablets a day, but have never been adviced by docs to take anything else but from online support I take B12 and zinc

[SlowDragon Administrator in reply to Honey-rainbow]

6 calcium tablets sounds a lot

Suggest you test your vitamin D via vitamindtest.org.uk if GP won't

But they should, especially as you are on calcium

Ask GP to test ferritin too. You may not be on enough iron. Do you take it with vitamin C, it helps absorption

The "no meds in 24 hours before test" is tip from endocrinologists in the know and the early morning and fasting is patient to patient tip

See graph here showing daily variation in TSH. We want it at its highest due to medics current over reliance on TSH. Really they should look at FT3 and FT4. FT4 should be right at top of range and FT3 at least half way in range.

healthunlocked.com/thyroidu...

Graph showing average TSH of healthy population

healthunlocked.com/thyroidu...

[Honey-rainbow in reply to SlowDragon]

I take one vitamin D tablet per month, vitamin C has never been mentioned to me, I emailed the link you sent me, and I am going to ask docs about doing all the bloods as when I looked at prices to go private, I couldn't afford it,

In total I take around 15 tablets per day but was told when I first had My thyroid removed that I would only have to take one tablet a day 😩

[SlowDragon Administrator in reply to Honey-rainbow]

Many with no thyroid find they need addition of small dose of T3

But you will struggle to get NHS to even test FT3 let alone treat it

But there is battle going on between endocrinologists who realise this and ones that can't admit they have kept 1000's of patients extremely unwell by not acknowledging this

Email Louise at a Thyroid UK for list of recommended thyroid specialists [e-mail]

Some are T3 friendly and a very few are NHS

Read up as much as possible about thyroid treatment

Thyroid UK, home of this support group is good place to start

Few links

dailyrecord.co.uk/news/real...

dailymail.co.uk/health/arti...

[Honey-rainbow in reply to SlowDragon]

Ok thankyou for all your help