Looking for advice

[wmarcella]

Looking for some help, I have PCOS and have problems like digestive issues, anxiety, tiredness and aches and pains. Just wondering what below results indicate? Thank you!

TSH 5.6 (0.2 - 4.2)

FT4 15.7 (12 - 22)

[shaws Administrator]

Those results indicate you are hypothyroid because your TSH is above range but, if you're in the uk, doctors have been told not to diagnose until the TSH is 10, which is ridiculous if you take account of patients clinical symptoms (they know none).

I'd advise you to get a thyroid antibodies blood test - your GP may not do it but we have two private labs that will do so. If you have antibodies you will have an Autoimmune Thyroid Disease called Hashimoto's and the antibodies attack the thyroid gland until the person is hypo but one doctor advises that if antibodies are present we should be given levothyroxine.

Blood tests for thyroid hormones have to be at the very earliest, fasting (you can drink water) and allow a gap of 24hours between last dose of levo and test and take afterwards.

Ask GP to test B12, Vit D, iron, ferritin and folate. Going gluten-free can help the antibodies attack but get a diagnosis first.

thyroiduk.org.uk/tuk/testin...

[wmarcella in reply to shaws]

Hi thank you, I had a thyroid test done in November which showed a TSH of 60.7 (0.2 - 4.2) and Free T4 10.2 (12 - 22) ?

Thyroid antibodies came back at 1200 (<34)

[shaws Administrator in reply to wmarcella]

You have an autoimmune Thyroid Disease, also called hashimotos due to you having antibodies.

Your TSH at your Nov test was very over range at 60.7

Treatment is the same i.e. levothyroxine but going gluten-free can help reduce antibodies.

If your doctor has prescribed levo it isn't an optimal amount as TSH it should be 1 or lower when on replacement hormones. Not somewhere in the range.

Your FT4 is not optimal so I suspect your FT3 will be also. T3 is the only active thyroid hormone and T4 is inactive and has to convert to T3.

PCOS can also be caused by hypothyroidism and I doubt few doctors know the reason but this is a copy I took a while ago and may be helpful. May even be helpful for the GP:-

Multiple Ovarian Cysts as

a Major Symptom of Hypothyroidism

The case I describe below is of importance to women with polycystic ovaries. If

they have evidence, such as a high TSH, that conventional clinicians accept as evidence

of hypothyroidism, they may fair well. But the TSH is not a valid gauge of a woman's

tissue thyroid status. Because of this, she may fair best by adopting self-directed

care. At any rate, for women with ovarian cysts, this case is one of extreme importance.

In 2008, doctors at the gynecology department in Gunma, Japan reported the case

of a 21-year-old women with primary hypothyroidism. Her doctor referred her to the

gynecology department because she had abdominal pain and her abdomen was distended

up to the level of her navel.

At the gynecology clinic she underwent an abdominal ultrasound and CT scan. These

imaging procedures showed multiple cysts on both her right and her left ovary.

The woman's cholesterol level and liver function were increased. She also had a

high level of the muscle enzyme (creatine phosphokinase) that's often high in hypothyroidism.

Blood testing also showed that the woman had primary hypothyroidism from autoimmune

thyroiditis.

It is noteworthy that the young woman's ovarian cysts completely disappeared soon

after she began thyroid hormone therapy. Other researchers have reported girls with

primary hypothyroidism whose main health problems were ovarian cysts or precocious

puberty. But this appears to be the first case in which a young adult female had

ovarian cysts that resulted from autoimmune-induced hypothyroidism.

The researchers cautioned clinicians: "To avoid inadvertent surgery to remove an

ovarian tumor, it is essential that a patient with multiple ovarian cysts and hypothyroidism

be properly managed, as the simple replacement of a thyroid hormone could resolve

the ovarian cysts."[1]

Reference:

1. Kubota, K., Itho, M., Kishi, H., et al.: Primary hypothyroidism presenting as

multiple ovarian cysts in an adult woman: a case report. Gynecol. Endocrinol.,

24(10):586-589, 2008

[wmarcella in reply to shaws]

Hi no levothyroxine prescribed will go back and ask

[shaws Administrator in reply to wmarcella]

You cannot be diagnosed as hypothyroid and not be given levothyroxine. Once we are diagnosed it is a lifetime prescription. If we don't have replacement hormones our body starts to get very symptomatic and especially our heart and brain needs thyroid hormones as does every single one of the T3 receptor cells in our body.

[Greybeard]

Those results indicate that your thyroid is struggling to produce enough hormone. You could ask your doctor to prescribe you levothyroxine, unfortunately most doctors are reluctant to prescribe till your levels of tsh go higher or t4 goes lower.

[wmarcella in reply to Greybeard]

Hi thank you, I had a thyroid test done in November which showed a TSH of 60.7 (0.2 - 4.2) and Free T4 10.2 (12 - 22) ?

Thyroid antibodies came back at 1200 (<34)

[Greybeard in reply to wmarcella]

What did doctor say about those bad results?

[wmarcella in reply to Greybeard]

Hi I wasn't told about them, I only asked for them at reception and the receptionist gave them to me. I was surprised I received no phone call despite comments saying abnormal contact patient!

[Greybeard in reply to wmarcella]

If your doctor was a toaster you would bin it and get a new one. Your health would benifit from a doctor who follows the guidelines. Others will advise your next action but if it were me I couldn't trust that doctor.

[Clutter in reply to wmarcella]

Wmarcella,

Has TSH gone from 60.7 to 5.6 without Levothyroxine?

[wmarcella in reply to Clutter]

Apologies, results round the wrong way. My TSH has gone up and not down

[Clutter in reply to wmarcella]

Wmarcella,

TSH 60.7 with FT4 10.2 below range means you have overt primary hypothyroidism and need Levothyroxine replacement. If your practice hasn't contacted you to see a GP or collect a prescription you should make a formal complaint to the practice manager.

Make an appointment to see your GP as soon as possible. Ask your GP receptionist or pharmacist for a medical exemption form to complete as you will be exempt from prescription charges. You will have to pay until the medex card arrives but your pharmacist can give you recepts so you can reclaim any prescription costs you pay in the meantime.

The goal of Levothyroxine is to restore the patient to euthyroid status. For most patients that will be when TSH is 0.3 - 1.0 with FT4 in the upper range. FT4 needs to be in the upper range in order that sufficient T3 is converted.

Thyroid peroxidase antibodies are positive for autoimmune thyroid disease (Hashimoto's). There is no cure for Hashimoto's which causes 90% of hypothyroidism. Levothyroxine treatment is for the low thyroid levels it 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_...

For maximum absorption Levothyroxine should be taken with water 1 hour before, or 2 hours after, food and drink, 2 hours away from other medication and supplements, and 4 hours away from calcium, iron, vitamin D supplements, magnesium and oestrogen.

It takes 7-10 days for Levothyroxine to be absorbed before it starts working and it will take up to six weeks to feel the full impact of the dose. Symptoms may lag behind good biochemistry by several months.

You should have a follow up thyroid test 6-8 weeks after starting Levothyroxine. Arrange an early morning and fasting (water only) blood draw when TSH is highest, and take Levothyroxine after your blood draw.

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

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