Not diagnosed - thyroid issue? Feel like hypochondriac

[Tigerlily17]

Hi, I am new and looking for advice. I am a 21 year old female and have the following symptoms -

* swelling at front of neck (confirmed goitre and enlarged thyroid gland)

* sweating

* depression

* memory loss

* headaches

* dry eyes

* constipation

* weight gain

* pins and needles in legs

* tiredness

* muscle cramps

* feeling breathless

* coming down with all sorts of infections

* heavy periods

* hair falling out

* ovarian cysts

* endometriosis

* hyperpigmentation in skin creases

* IBS type symptoms

* blotchy skin.

Is it possible these are thyroid related? GP says I have general anxiety disorder and sent me away with antidepressants. Please see 2 of my latest bloods. Thank you.

AUG 2017

TSH - 5.6 mIU/L (0.2 - 4.2)

Free T4 - 15.7 pmol/L (12 - 22)

Ferritin - 24 ug/L (30 - 400)

Folate - 2.3 ug/L (4.6 - 18.7)

VItamin B12 - 201 pg/L (190 - 900)

NOV 2017

TSH 2.2 mIU/L (0.2 - 4.2)

Free T4 - 14.4 pmol/L (12 - 22)

Ferritin - 33 ug/L (30 - 400)

Folate - 2.1 ug/L (4.6 - 18.7)

Vitamin B12 - 199 pg/L (190 - 900)

[Tigerlily17]

Hi and thank you, I had a scan of my thyroid which showed it was enlarged, vascular and looked moth eaten, also hypoechoic nodules

[Clutter in reply to Tigerlily17]

Tigerlily17,

Enlarged and moth eaten sounds consistent with autoimmune thyroiditis (Hashimoto's). Did the scan say what size the nodules are?

There is no cure for Hashimoto's which causes 90% of hypothyroidism. Levothyroxine treatment is for the low thyroid levels it eventually causes. Many people have found that 100% gluten-free diet is helpful in reducing Hashi flares, symptoms and eventually antibodies.

chriskresser.com/the-gluten...

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

Your November results are euthyroid (normal) but they were hypothyroid in August. Symptoms can precede abnormal bloods by months and Hashimoto's can also make you symptomatic.

thyroiduk.org.uk/tuk/resear...

NHS won't diagnose hypothyroidism until TSH is over range or FT4 below range. Ideally ask to be retested within the next 6 months and arrange the blood test early in the morning when TSH is highest and fast (water only) as TSH drops after eating and drinking.

Ferritin is low. It would be worth your GP doing a full blood count and iron panel to rule out iron deficiency anaemia.

B12 is very low and folate has been deficient since August. Symptoms of deficiency are in b12deficiency.info/signs-an... healthunlocked.com/pasoc are the experts on B12 and folate deficiency so ask them for advice.

[Tigerlily17 in reply to Clutter]

Hi no size given on the nodules and I had TSH measured at 26 (0.2 - 4.2) and Free T4 10.2 (12 - 22) 3 weeks ago, wouldn't I need treatment?

[Clutter in reply to Tigerlily17]

Tigerlily17,

Yes, you should have been offered Levothyroxine because you are overtly hypothyroid with TSH >10 and FT4 below range.

Who ordered the thyroid tests, your GP or endocrinologist

[Tigerlily17 in reply to Clutter]

GP

[Clutter in reply to Tigerlily17]

Tigerlily17,

Then you need to make an appointment to see a GP at the practice to get a prescription for Levothyroxine. NICE recommends 50-100mcg as a starting dose with 4 weekly dose increases until optimally dosed which is usually when TSH is 0.2 - 1.0 with FT4 in the upper range. cks.nice.org.uk/hypothyroid...

Ask your GP what size the largest nodules are or whether it is a multi nodular goitre.

I would also make a written complaint to the practice manager that no-one from the practice contacted you to make an appointment to discuss your results with your GP or to collect a prescription.

[SlowDragon Administrator]

What supplements has GP prescribed for all you very low vitamin levels

Ask for Vitamin D and thyroid antibodies to be tested

Highly likely to have high thyroid antibodies, this is Hashimoto's also called autoimmune thyroid disease

Extremely likely to have desperately low vitamin D

Ferritin you need full iron panel done. Likely to need iron infusion, certainly ferrous fumerate 3 times daily

B12 - you need testing for Pernicious Anaemia before starting B12 injections

Folic acid supplements should not be started until after first B12 injections

Hyperpigmentation suggests Addison's disease

This can be complication of undiagnosed thyroid disease

You will need full adrenal testing before thyroid hormones are prescribed

Article by Prof Toft just published

rcpe.ac.uk/sites/default/fi...

[Tigerlily17 in reply to SlowDragon]

Hi I had TSH measured as being 26 (0.2 - 4.2) and Free T4 10.2 (12 - 22) surely I would need treatment? Also high antibodies. Thanks

[SlowDragon Administrator in reply to Tigerlily17]

Yes definitely, but also need vitamins testing as well

Make urgent on the day appointment for tomorrow

Also if adrenal issues suspected then adrenals must be tested first and if necessary treated before starting Levothyroxine

Make sure to show hyper pigmentation to GP