Help with blood tests, please?

[lily82]

I had a bunch of blood tests done recently as I've been having frequent periods (gone from 3 weeks apart, then 2weeks, then 6 days). Also insomnia, headaches, fatigue, emotional changes, hot flashes weakness, memory loss, generally feeling awful. Symptoms been going on for years.

Could someone help me interpret these tests, please? (none of these tests were fasting) Taken at 9am.

I also have a history of a brain injury. (I'm female, 35 years old)

Ferritin 45 ug/L (15-300)

Prolactin 465 mu/L (71- 566)

TSH 3.41 mu/L (0.30- 4.40)

T4 level 10.9 pmol/L (9.0-19.1)

Serum sodium 136/ mol/L (133-146)

Serum potassium 4.7 mol/L (3.5-5.3)

FSH 3.2 iu/l

Serum LH 4.7

Growth hormone 0.23 ug/L

Glucose 4.1 mol/L (3.0- 7.7)

Many thanks.

[SlowDragon Administrator]

Obviously a brain injury can affect Pituitary and this can affect thyroid

Your TSH is on high side

FT4 very low

But standard assessment will very unlikely say you have a thyroid issue

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

See if you can get full thyroid and vitamin testing from GP. Unlikely to get FT3

Private tests are available

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. This gives highest TSH, lowest FT4 and most consistent results

Link about antibodies

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

Link about thyroid blood tests

thyroiduk.org/tuk/testing/t...

Print this list of symptoms off, tick all that apply and take to GP

thyroiduk.org/tuk/about_the...

[lily82 in reply to SlowDragon]

Thanks for your reply!

My GP said that the labs would't do a T3? Too expensive?

Oh, my folate is 20. 7 ug/ L

She didn't say my tests should be fasting. Hmm.

[Clutter in reply to lily82]

Lily82,

Tests don't have to be fasting. It is a patient-to-patient tip to show TSH at its highest which will usually help to get a diagnosis or dose increase and perhaps to avoid a dose reduction.

I agree with SlowDragon, a brain injury may have affected pituitary which would mean TSH shouldn't be relied upon. If your GP won't order FT3 you can order a private TSH, FT4, FT3 test via thyroiduk.org.uk/tuk/testin... Medichecks are offering 20% discount until Monday and offer #ThyroidThursday discounts.

[lily82 in reply to Clutter]

Ahh, that's interesting- I had no idea a BI would affect TSH. Thanks for the info.

My growth hormone levels seem to be quite low, from the results I've seen. But my GP wasn't sure what it meant.

She said she wasn't sure what all the results meant in terms of what I'm experiencing.

I hadn't even made the connection between my BI and my periods etc until I began to understand how BIs affect hormones.

Thanks again!

[Clutter in reply to lily82]

Lily82,

It might not have done, but unless your pituitary has been investigated it may have done. Pituitary can affect thyroid, sex and growth hormones.

If your GP doesn't understand the results she needs to consult with an endocrinologist or refer you to endocrinology.

[lily82 in reply to Clutter]

I'm going to speak to a nurse in the Pituitary Foundation on Monday, as she's the one who gave me a list of tests to ask for. Then I'll phone my GP.

It's really frustrating, because I don't feel right at all, and I have quite a complex history with my BI and I'm only now putting it all together.

And my GP isn't an expert on BIs so she didn't really know how to interpret all the results.

Thanks again!

[lily82 in reply to Clutter]

I've done some research, here it says that growth hormone for an adult woman should be

Women: < 10 ng/mL or < 452 pmol/L

emedicine.medscape.com/arti...

Mine is 0.23 ng/mL (I converted it using a medical conversion chart)

That just seems low?

[Clutter in reply to lily82]

Lily82,

If your conversion is correct it does seem low. I'm sorry I can't help you with this. The Pituitary Foundation may have a forum which can help you.

[lily82 in reply to Clutter]

Just been Googling.

Having a low T4 and a normal range TSH indicates 'central hypothyroidism' i.e coming from damage to the pituitary. Not primary hypothyroidism.

The nurse from the Pituitary Foundation recommended I get tested as all my symptoms suggested pituitary damage.

[Clutter in reply to lily82]

Lily82,

Your GP should consider secondary/central hypothyroidism and refer you to endocrinology for further investigation.

See cks.nice.org.uk/hypothyroid...

[lily82 in reply to Clutter]

I'm definitely going to ask for it. Thanks for the link!

My GP did admit that she didn't know what it all meant. So I'll speak to the Pituitary Foundation nurse on Monday, and also I'm seeing my brain injury neurologist next week so I can take all this to her.

The worst symptom for me has been the memory loss and concentration issues and the brain fog, it's made it so hard to speak to doctors and put all this together. It wipes me out!

Thanks again!

[lily82 in reply to Clutter]

I'm just writing this as it may help someone else.

I spoke to the Pituitary Foundation nurse and my growth hormone is extremely low- deficient.

Normal range is 3-20 ug/l and mine is 0.23 ug/l.

I've had problems with thinning skin, inability to tolerate exercise, fatigue, hormone issues, memory and concentration issues.

This shows problems with my pituitary.

Low T4 is also relevant in terms of pituitary function and hypothyroidism.

So I'm going to ask for a referral to an endocrinologist.

She said that the findings on my test tally up with all the problems I've had since my brain injury as a child.

[Clutter in reply to lily82]

Lily82,

I hope you don't have a long wait for referral. Show your GP the NIC CKS I posted about secondary hypothyroidism and referral to endocrinology too.

[lily82 in reply to Clutter]

Thanks so much!

We also discussed the possibility of early onset menopause, because of my history of brain injury which has very likely messed up my hormones.

She said the main worry is the very low growth hormone.

It's so hard to push for all of this, I'm mentally exhausted.

I feel like they'll accuse me of being a hypochondriac, you know?

[Clutter in reply to lily82]

Lily82,

If they do you must counter that they are incompetent not to have considered your symptoms and blood tests indicate thyroid, sex and growth hormone deficiencies post brain injury.

[lily82 in reply to Clutter]

My brain injury neurologist is referring me to a endocrinologist, because she says I'm showing signs of low oestrogen as well as all the other stuff- and I need to find out the underlying cause. And also get me on HRT to help with the symptoms.

It's good, because she's going to refer me and explain my background with a BI and all the symptoms I've had since. Which is more effective than my GP referring me, as they don't have a background in brain injuries.

The Pituitary nurse did say I was showing symptoms of low oestrogen (hot flashes, memory loss, headaches that are worse during certain times in my cycle, skin changes etc) were not normal for my age and could be linked to hypothyroidism or a pituitary dysfunction.

It's been scary for me to have worsening memory loss, because the BI already affected my memory and cognitive function. And it's been getting so much worse.

Again, I'm just writing all this out in case it helps another woman who ends up in my situation, of a history of a brain injury who develops hormonal issues years later.

[Clutter in reply to lily82]

Thanks, Lily82.

I hope the referral won't take too long. The neurologist and pituitary nurse have been helpful.

[lily82 in reply to Clutter]

Yeah, both have been great. I was so preoccupied with getting my brain injury stuff sorted- that I ignored my weird periods. When that was the biggest clue as to why I was getting worse!

Low estrogen levels is really bad for a brain that is already not working properly, because estrogen is important for brain function. So no wonder my brain injury symptoms were worsening.

I've been suffering with really random symptoms for years- headaches, dry eyes, high temperature, dry mouth, dizziness, balance, hyper-pigmintation, hair loss etc and now I'm able to put them all together and it makes sense.

I just cannot wait to go on HRT, anything to try and feel a bit more normal. I feel so weak and my memory and concentration is awful.

[Clutter]

Welcome to the forum, Lily82.

Is your GP investigating the frequency of your periods?

Ferritin 45 is suboptimal. Optimal is >100 through to halfway through range. You can raise ferritin by supplementing iron with 1,000mg vitamin C to aid absorption and minimise constipation.

TSH 3.41 indicates your thyroid is struggling and FT4 10.9 is low in range. NHS won't usually diagnose hypothyroidism until TSH is >4.40 or FT4 is <9.0. Supplementing 100-200mg selenium may give some thyroid support.

Sodium, potassium and glucose are within range (normal).

FSH google.co.uk/search?q=FSH+3...

LH google.co.uk/search?q=Serum...

Growth Hormone google.co.uk/search?q=Growt...

[lily82 in reply to Clutter]

Thanks very much!!

I'm being sent for a scan of my ovaries.

My hormones symptoms have been all over the place. I was seriously thinking I was going into early peri-menopause, as I have so many of the symptoms.

I shall definitely get some selenium!

I really feel awful- the worst has been the fatigue and memory loss. It gets much worse during my period, and I've been fainting and having very low blood pressure.

Thanks for your help, I really appreciate it!

[Clutter in reply to lily82]

Lily82,

Has your GP done an iron panel and full blood count to rule out iron deficiency anaemia?