Help with Blood Tests - Hypothyroid? Hypogonad? Pituitary?

[SKnud]

Hi everyone,

I've recently been ordering private tests to investigate issues related to chronic fatigue, sexual dysfunction, decreasing athletic performance, swollen legs and painful feet, and quite severe mood swings that have been impacting on my work life. Many of my problems have persisted since going through puberty (early), but recent bouts of fatigue are new and pretty unlike me. I'm sleeping anywhere up to and beyond 15 hours a day on a day off from work (retail shift manager working nights) and am usually only actually getting out of bed on these days to have a meal, then go straight back to sleep. Typically I'll get around six hours for a night on following a shift. Eating is also making me very tired lately. I'll almost always want to sleep following any sort of regular portion meal and it's usually a losing battle trying to stay awake.

Last year was a difficult one as I was a cancer caregiver and had no respite, so I was effectively on duty 24/7 only getting away to go to work. I lost considerable amounts of sleep during this time and could be awake anywhere up to three days at a time while heavily caffeinated (>300mg/dose). Most of the time, I would only nap here and there just to remain functional until his passing at the end of August. Although months have passed, my sleeping patterns are still wildly erratic, but I've curbed my caffeine use quite a bit.

Overall, I'm weak, sore, usually lost with my head in the clouds and angry when I have the energy and/or focus to be. I'm prone to aggressive outbursts at work and have been for most of my working life, but the tiredness and distracted ways are beginning to concern me as I handle large amounts of cash at work and miscounting anything will come down on me and could quite possibly cost me my job. Working in retail also obviously has some element of customer interaction on nights and my tolerance for dealing with anyone has drastically decreased over the past two months. On my most recent shift, I felt my anger starting to get the better of me while dealing with a difficult regular customer and had to basically hide from the situation before I truly lost it.

I'm seeing a private endocrinologist tomorrow to discuss things, but is there anything I should particularly focus on based on my results below? I have full haemotology and biochemistry numbers available, but these are likely the most pertinent numbers for this post. Other patients have told me I'm hypothyroid with my values and I tend to agree, but my GP dismissed the idea based on my first TSH number alone and "normal values in range mean normal health". I certainly don't feel normal hence why I went private.

TSH: 4.34, 4.19 uU/mL (0.35 - 4.50)

FT4: 14.8 pmol/L (11.0 - 26.0)

FT3: 5.8 pmol/L (3.9 - 6.8)

TPOAb: 10.53 IU/mL (<50 Negative)

Testosterone: 8.2 nmol/L (8.64 - 29.00)

SHBG: 17.83 nmol/L (14.0 - 48.0)

LH: 5.6 IU/L (1.7 - 8.6)

FSH: 2.6 IU/L (1.5 - 12.4)

Ferritin: 299 ug/L (30 - 400)

Uric acid: 431 umol/L (200 - 430)

Thanks.

[Clutter]

SKnud,

I find it difficult to understand how doctors can say symptoms are non-thyroidal when TSH is 4.34 which is just under 4.50 but will accept they are thyroidal when they are over 4.50. Symptoms can precede abnormal bloods by years but NHS will not diagnose until TSH is >4.50. Some private endocrinologists may agree a trial of Levothyroxine when TSH is >3.0 but it is very much up to individual doctors.

thyroiduk.org.uk/tuk/diagno...

Thyroid peroxidase antibodies are within range but autoimmune thyroiditis (Hashimoto's) can't be conclusively ruled out as some people are negative for TPOab but positive for thyroglobulin antibodies (TgAb).

Testosterone is deficient and your endo will hopefully help with that.

The other sex and growth hormones and ferritin are within range.

Uric acid is mildly over range.