Help- Medichecks Results- Unhelpful GP

[U02ejp6]

Hi

I recently had a thyroid check with medichecks. The doctor suggested it is showing signs of under active thyroid. My reasoning for having my blood tested was because I had been having reflexology prior to getting pregnant and she commented on where the pituitary gland is on your foot. She said it was “crunchy”. I had my female hormones tested while I was on the pill a few years ago and it was suggested there could be something wrong with my pituitary gland.

My symptoms are- tiredness, long cycles (35- 40 days), low breastmilk supply, brain fogginess (sometimes I can’t think of words... which is very unusual for me), hair falling out, feeling cold (unless have lots of layers on or on holiday), migraine with aura, feeling down before my period and while on my period, puffiness of my face (occasionally this has happened again unusual).

My results are below. However my GP said these results are normal and was not sure about my antibody result so is requesting assistance from an endriconologist.

ENDOCRINOLOGYThyroid Function

THYROID STIMULATING HORMONE *8.23 mIU/L 0.27 - 4.20

FREE THYROXINE *11.7 pmol/L 12.00 - 22.00

TOTAL THYROXINE(T4) 75.4 nmol/L 59.00 - 154.00

FREE T3 4.06 pmol/L 3.10 - 6.80

THYROGLOBULIN ANTIBODY *220.000 IU/mL 0.00 - 115.00

THYROID PEROXIDASE ANTIBODIES 10

I have just started back at the gym- mostly weight work. I haven’t exercised since having my baby last year and being pregnant. Should I notice anything from exercising due to hypothyroidism?

UPDATE

Below are results from blood results I had done in 2014 & 2016 respectively. Ranges TSH0.2- 4.5 free t4 9-21

TSH 2.8

Free t4 13

TSH 1.4

Free t4 12

I was told this was normal.

Further UPDATE

I emailed Dr Toft my results and he said they are not normal. Just need to find out whether my insurance will cover a consultation with him and I will fight with my GP to refer me to him!!!

[greygoose]

Well, you haven't put the ranges for those tests, but your TSH is most definitely not normal! Despite the rediculous TSH range, most people have a TSH of between 0.8 and 1.25. You are hypo when your TSH hits three.

And, even without the range, those antibodies have got to be positive for Hashi's. I don't need an endo to tell me that. You really should be on thyroid hormone replacement.

As for exercising, you will probably have long recovery times, afterwards. You really shouldn't be doing anything too strenuous at the moment. Just gentle walking or swimming.

[U02ejp6 in reply to greygoose]

The GP told me 8 is normal!! She didn’t know what the antibody Test meant because apparently it’s not one carried out on the NHS.

Why shouldn’t I be doing anything too strenuous at the moment? What damage can it do if I did?

[Marz in reply to U02ejp6]

Time to seek a GP who has a basic understanding of the Thyroid and Auto-immunity. Correct - yes the NHS rarely, if ever test Anti-Tg - just the TPO. That is how so many people get missed and continue to suffer as BOTH need testing - as you have done.

Strenuous exercise uses up valuable T3 in the body - which is the ACTIVE thyroid hormone needed in every cell of your body. So a more gentle approach until you have good levels of everything is suggested on the Forum in an effort to help people find wellness.

As you now realise Docs love to use the word Normal - we all want to feel normal - however they mean in range - but where you are in the range is key when Hypo.

There are many things you can do to help yourself - and healing the gut by being gluten free could be a help for you. Also have the following tested - B12 - Folate - Ferritin - VitD - all need to be good - B12 near the top of the range - Folate and Ferritin - mid range - and VitD around 100. There are 1000.s of posts about Hashimotos - so have a read and then come back with questions. Under the heading TOPICS to the right of your post if you are on a PC - or scroll down and down if on a phone or tablet .... Also detailed in the link I have posted for you below

Breastfeeding difficulties can indicate low thyroid - it happened to me - but I didn't know at the time I had a thyroid issue.

thyroiduk.org

The above link takes you to the main website of this Forum where you can read everything Thyroid .....

[U02ejp6 in reply to Marz]

What concerns me is after I went to the gym I felt pressure in my upper back and chest...

[Marz in reply to U02ejp6]

As you have only just started going to the gym after a break - I would expect it is just muscular. Take a look at the muscles of the upper body on a good internet site - and you will see what I mean. We have more muscles than bones ! I teach yoga so always have my nose in a book or website - to learn more !

You didn't comment on my post - was it helpful ?

[U02ejp6 in reply to Marz]

Sent you a PM

[Marz in reply to U02ejp6]

As mentioned above - you really need the B12 - Folate - Ferritin ( stored Iron ) and VitD tested as they are often LOW with Hashimotos - I would do it with the same company you used before as the NHS seem to be refusing VitD of late.

[shaws in reply to U02ejp6]

This supposed to be 'doctor' is so very ignorant about hypothyroid. He/she is sticking to the awful guidelines we have in the UK, in that they have not to diagnose patients until the TSH is 10. 10 is definitely far higher than the top of the range which is usually about 5.

In other countries they prescribe for the patient when the TSH goes above 3.

We need the Active Thyroid Hormone T3 in all of our T3 receptor cells and we have millions. Exercising before we are on an optimum dose of thyroid hormones depletes the T3 and makes us not feel very well.

Thyroid hormones run our whole metabolism from head to toe and heart and brain needs the most. T4 (levothyroxoine when prescribed) is T4 only and is an inactive hormone and it has to convert to T3 (liothyronine) which is the only active thyroid hormone and heart and brain need the most. If T3 is too low we don't feel well. When you post results always put the ranges as labs differ in their machines and so the ranges can be different. Knowing the ranges makes it easier for members to comment.

[U02ejp6 in reply to shaws]

I know very clueless. I posted the ranges after. I didn’t know about ranges and labs having differing ranges.

Based on my results are you advising I should be prescribed t3 as well as t4?

[shaws in reply to U02ejp6]

In an ideal life, we shouldn't really need to be on a forum to try to find out the 'whys and wherefores' of hypthyroidism.

Levothyroxine is T4. T4 is inactive but it converts to T3. T3 is the only Active thyroid hormone which is needed in our millions of T3 receptor cells. It runs our whole metabolism and brain and heart contain the most receptor cells.

As levothyroxine is increased it should also convert to T3. Some people may be poor converters but hopefully you will be fine.

At the next test ask for B12, Vit D,iron, ferritin and folate. Everything has to be optimal.

All tests have to be at the very earliest, (make date quite a number of weeks before) fasting (you can drink water) and allow a gap of 24 hours between last dose and test and take afterwards. This helps keep the TSH at its highest and prevents the doctor reducing dose.

Always get a print-out for your own records of the results, etc and post if you have a query.

[meyow12345]

Please do post the lab values for the tests. Also, pituitary crunch in your foot? Change doctors. My mom was very symptomatic at TSH 3.5. Your antibodies show that you have Hashimotos, where you thyroid is seen as a foreign body and the body tries to eliminate it. I was on the fun up and down train for 10 years before it finally burnt out. Miserable. Please don't let them tell you it is postpartum or depression and everything is fine with your thyroid because is not fine.

[silverfox7]

I wonder what your doctor thought about the two results starred? She hasn't thought about the range and that it's saying TSH is over range and FT4 is under. But she has picked up on raised antibodies! So not even consistent! Make she that you get to see the endocrinologist and it's not a letter she is sending as if that is the case she may not send all your results. Is there another doctor in the practise you can see in the future?

[U02ejp6 in reply to silverfox7]

She said my result being 8 is normal. Didn’t mention FT4! I asked her about the antibody!! Which she didn’t know the answer to!!! It is a letter, she said she is questioning the antibody result as she doesn’t know what that means. I’m not sure what to say if I do see another doctor I feel i’ll Get the same response.

[Marz in reply to U02ejp6]

Please pop the ranges into your first post - click onto the Edit Key after pressing the downward arrow The T4 is produced by the thyroid and looks to be below range - so your thyroid is struggling. Surely your GP can see this. I would try another GP - read up on everything first so you can ask good questions ! Information is power ! Docs do not understand Hashimotos - sadly !

[U02ejp6 in reply to Marz]

Thanks edited to include ranges!

[Marz in reply to U02ejp6]

FAB

[Angel_of_the_North in reply to U02ejp6]

What a stupid woman! Can't she look it up? I'd try to see a different GP.

[silverfox7 in reply to silverfox7]

I was thinking of seeing another doctor in the surgery next time you go with your thyroid as can't be any worse and hopefully knows more or at least how to read results! Failing that I would ask to see an endocrinologist as if she can't see anything wrong with you tell her of all your problems. Look on the Thyroid UK sitexehobrun this forum and print off and annotate the list of symptoms and say that you are having symptoms so no right so can you see an Endo as I don't think she is going to be any help to you.

[U02ejp6 in reply to silverfox7]

I have an appointment today with the locum doctor...

[Marz in reply to U02ejp6]

Have you made a list of questions ?

[U02ejp6 in reply to Marz]

Not a list of questions but I wrote down information from the thyroid U.K. website. She also didn’t know what TG antibodies were- don’t test this on the NHS! Have to wait to see what the endrconologist says about them which she noted doesn’t know how long that will be.

She was very reluctant to prescribe but in the end gave me 25mg for a month and I have an appointment in two weeks to re-test my TSH, T4 and the vitimins you mentioned!

Will the medicine not interfere with my results?

[Marz in reply to U02ejp6]

Well I would have had questions - in order to ascertain her knowledge without her knowing 25 mcg is for the very old and for people with a weak heart - so setting you up for failure. 50mcg is the usual starting dose - I believe NICE have the Guidelines for treating the Thyroid - SlowDragon usually posts these.

Also it takes 6 weeks for any dose to settle into the body and have an effect. Yes the medicine will affect the next tests - but only time will tell by how much.

I am utterly appalled that two doctors in the same surgery do not know what Thyroid anti-bodies are - I am so glad I look after my own health and would not entrust it to others

Have you seen the Paper on this Forum written by Professor Toft - saying that in the presence of anti-bodies the Thyroid should be treated - or words to that effect. I will try and find it by using the Search Facility above.

healthunlocked.com/thyroidu...

Earlier post in the link above

Cannot find the one about the anti-bodies - sorry ....

[U02ejp6 in reply to Marz]

Thank you!

Well we shall see what the next results state...

I think I saw an article on thyroid uk’s website which I tried to explain to her but she said but is that in the presence of both antibodies or just one. She then went on to state my TPO is within range of the Medichecks lab but contradicted herself by saying my t4 isn’t low because the range is 9-20 which isn’t based on Medichecks!

She didn’t want to give me anything so 25mg seems like a win atm haha!

[shaws in reply to U02ejp6]

50mcg is a starting dose with increments of 25mcg levo every six weeks until our TSH is 1 or lower.

[SlowDragon Administrator in reply to U02ejp6]

Testing should only be 6-8 weeks after any dose increase or change.

[Marz in reply to U02ejp6]

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

Did you read this link ?

[SlowDragon Administrator]

Essential to test vitamins, as outlined by Marz

Suggest you see different GP

High TG antibodies link

healthline.com/health/antit...

[Marz]

RE: UPDATE

Those tests were without the FT3 and the Anti-bodies being tested - so not the full story. Were they done at the same time of day - as that can make a difference !

[U02ejp6 in reply to Marz]

Around the same time- one at 8:13 and the other at 8:38. My medichecks was done at 9:14

[U02ejp6 in reply to Marz]

I had my blood drawn by Professor Toft to confirm results of Medichecks. My Medichecks Test was performed around 9:15 and my test yesterday 10:15- I hadn’t eaten for both. Does that matter and will it change results?

I am having my folate, ferritin, b12 & vitamin d checked next week by my GP at 10:40, does this matter? What do I need to look out for? Will I need to start supplementing based on my results? No doubt the GP will state they are normal because they are within their guidelines

[Marz in reply to U02ejp6]

Are you sure your GP and the Lab will test all the above ? When you have the results start a new post so more people see them and can comment. More and more I read that Labs are refusing to do VitD - fingers crossed !

Your B12 needs to be over 500 - Folate and Ferritin mid-range and VitD over 100.

Your fasting results should be fine

[U02ejp6 in reply to Marz]

Well who knows! I requested to have them tested... when you say mid-range what does that mean?

[Marz in reply to U02ejp6]

... middle of the range given with your result .... remember ranges vary !

[Angel_of_the_North]

TSH of 8 is hypothyroid AND your free t4 is under range, so, although the NHS don't treat until your TSH is > 10 (over twice the top of the range!), they often will if your free T4 is under range. At least ask for a trial of levothyroxine - and stay out of the gym (once or twice a week easy workouts *might* be OK) as you'll make yourself worse by using up all your T3

[U02ejp6 in reply to Angel_of_the_North]

She said despite it being 8 it has to be over 10 like you said. She didn’t agree my T4 as being under as their range is 9-22!! But managed to get a trial of the medicine for a month.

[SlowDragon Administrator in reply to U02ejp6]

NICE guidelines saying how to initiate and increase. Note that most patients eventually need somewhere between 100mcg and 200mcg Levothyroxine

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

Link about thyroid blood tests

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

Link about antibodies and Hashimoto's

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

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

List of hypothyroid symptoms

thyroiduk.org/tuk/about_the...

[Angel_of_the_North in reply to U02ejp6]

Well done. But she stil doesn't understand ranges. The range is set by the lab and related to the machines they use. So it doesn't matter what someone else's ranges are, as with a range of 9-22, you might have come out as an 8. Your free T4 was still under range. You really need a better GP.

[U02ejp6 in reply to Angel_of_the_North]

Yes most definitely- a better GP! If I don’t get anywhere with another GP in the surgery there is a private GP who worked in Endriconlogy who I might go see...

I didn’t know about differing labs having different ranges either tbh!

[Angel_of_the_North in reply to U02ejp6]

It's why people here always ask for the ranges when you post your results.

[Canta]

Totally appalilng that a GP doesn't understand about lab ranges. It's fundamental knowledge. People like this have no right to be practising.

Good luck U02ejp6 in getting back to good health.

[whispers]

If I were you and I was having another test in 2 weeks I wouldn't be taking the 25 m g of levo until after the test, in the hopes my tsh had risen again, hopefully you have booked an early appointment, dont eat before the test either. I woild still see amother doctor in the practice if there is one, good luck

[U02ejp6 in reply to whispers]

I have the medication but haven’t started taking it yet. They moved my bloods to Wednesday at 9:15 as I have a GP appointment a week later (apparently it takes them a week to review results).

[silverfox7]

This situation gets worse the more I read. Another doctor is a must. I would now have a quiet word in private with the head of the pharmacy and said how frightened you are about the lack of knowledge your GP has on this condition which is so new to you and that you are seriously thinking of changing to another practise. Can she recommend one in the area who does have Thyroid patients. Tell her the. Oncersation is in strict confidence biu .........

She may well be helpful and suggest someone or say what else you can do.

[U02ejp6 in reply to silverfox7]

Apologies for my ignorance but do you mean the pharmacist at the chemist? I believe this is the only GP practise I can be seen at

[silverfox7]

Yes I did. That's a shame there are not other surgeries you could move to so only choice I suppose is to ask to see Ann endocrinologist or go privately butvits shocking so little options when not well served.