Advice please

[-fudge-]

Good morning ..been ages since posted. Went to g.p Thursday as woke up covered in bruises on legs (has happened before on body and gp not interested) but new gp had bloods done see results. I am feeling so down crying all time have put weight on skin itchy at times and purple bags under eyes awful pain down left side of neck had that a while. gp suggested anti depressants and counselling. I have aortic stenosis fibromyalgia and osteoarthritis. Im feeling pretty Fed up . Any advice. Back at gp tonight. Tried to put another pic of all othet results but no joy. Haemoglobin 150. White cell 9.8. Urea 7.8. Potassium 4.5. Calcium 2.32.

[crimple]

Sorry I can't offer any advice. Doc should be fired for offering anti d's. Is there another doc you can see? If not I think I might just present at A&E!!

[SeasideSusie Remembering]

TSH alone is not enough to ascertain thyroid status, you also need FT4, FT3 and thyroid antibodies. Ask if your GP will do these although ultimately the lab makes the decision and frequently won't do them if TSH is in range, in which case doing a private fingerprick test with Medichecks or Blue Horizon is your best option.

[SlowDragon Administrator]

Are you taking Levothyroxine or trying to get diagnosed.

If on Levothyroxine then TSH is too high

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 and don't take Levo in the 24 hours prior to test, delay and take straight after. 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...

List of hypothyroid symptoms

thyroiduk.org/tuk/about_the...

[-fudge- in reply to SlowDragon]

Thank you. Yes on levothyroxine 100mcg. Have been for years. Had radio active iodine 1991. Just waiting to see gp now.

[SlowDragon Administrator in reply to -fudge-]

Then TSH of over 2 is much too high

You need 25mcg dose increase

TSH should be around one (or slightly less) FT4 towards top of range and FT3 at least half way in range

Essential to test FT4 and FT3 when on Levothyroxine. Just a TSH is largely irrelevant

Likely to have low vitamin levels too if under medicated

Ask GP to test vitamin D, folate, ferritin and B12

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 articles from Thyroid UK email print it and highlight question 6 to show your doctor

please email Dionne:
[e-mail]

Prof Toft - article just published now saying T3 is likely essential for many. Note especially husband comments about current inadequate treatment following RAI

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

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 and don't take Levo in the 24 hours prior to test, delay and take straight after. This gives highest TSH, lowest FT4 and most consistent results

Email Thyroid UK for list of recommended thyroid specialists

please email Dionne:
[e-mail]