Low SHBG? Blood Test Result Help Please!

[rebeccasophie]

Hello! Looking for help understanding my blood test results please I was tested after symptoms like sudden weight gain, hot flashes, fatigue, constant stomach problems, fast heart rate... I’ve listed out below what looks a bit off:

18/04/2018

SHBG: 31 (40-140nmol/L range)

TSH: 2.8 (0.30-5.50mIU/L range)

T4: 19.9 (9-25pmol/L range)

MCHC: 307 (320-370g/L range)

Previous Thyroid results as an FYI:

20/07/2017

TSH: 2.36 (0.27-4.20 range)

T4: 19.1 (12-22 range)

25/07/2016

TSH: 2.7 (0.35-4.0 range)

T4: 12.8 (9-19 range)

17/06/2015

TSH: 3.082 (0.35-4.0 range)

T4: 15 (9-19 range)

[diogenes Remembering]

Low SHBG can be an indication of tissue hypothyroidism, but you need an FT3 result to find out more. If FT3 is low in range ot below range then this definitely indicates tissue hypothyroidism. Are you on T4 therapy?

[rebeccasophie in reply to diogenes]

Thank you! Hoping to get FT3 tested next week - not on any medication apart from iodine supplement, docs think something is off but not enough to start any treatment

[SlowDragon Administrator in reply to rebeccasophie]

Have you had iodine tested by a recognised iodine specialist? (Not just a GP)

24hour urine test or similar

Who said to supplement iodine

Iodine is really not recommended unless definitely deficient and may be causing you more problems. It use to be used to treat hyperthyroidism. If there is any suggestion that you have Hashimoto's it's best completely avoided

thyroidpharmacist.com/artic...

thyroidpharmacist.com/artic...

[SlowDragon Administrator]

See from your previous post there's family link with thyroid issues

Important to test for autoimmune thyroid disease by testing TPO and TG thyroid antibodies

For full Thyroid evaluation you need TSH, FT4, TT4, FT3 plus TPO and TG thyroid antibodies. Plus vitamin D, folate, ferritin and B12.

Essential to test thyroid antibodies, FT3 and FT4, plus vitamins

Private tests are available. Thousands on here forced to do this as NHS often refuses to test FT3 or antibodies

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 ideally be done as early as possible in morning and fasting. This gives highest TSH and most consistent results. (Patient to patient tip, GP will be unaware)

If antibodies are high this is Hashimoto's, (also known by medics here in UK more commonly as autoimmune thyroid disease).

About 90% of all hypothyroidism in Uk is due to Hashimoto's. Low vitamins are especially common with Hashimoto's. Food intolerances too, especially gluten. So it's important to get tested.

[rebeccasophie in reply to SlowDragon]

Thank you! Been trying to get these tests for ages! I've got another GP appointment next week but I will look into the private ones you mentioned. I was tested for Hashimoto's about 3 years ago and was negative, is this something that could have developed since then?

[SlowDragon Administrator in reply to rebeccasophie]

You need both TG and TPO antibodies tested. NHS usually only test TG antibodies if TPO are positive.

Also it is possible to have Hashimoto's with negative antibodies, just to complicate things

A scan of thyroid may reveal more, if antibodies are negative. Thyroid may be granular in appearance if Hashimoto's.

thyroidpharmacist.com/artic...

thyroidpharmacist.com/artic...

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...

TG antibodies can be high for other reasons too, which I guess is why NHS won't diagnose Hashimoto's on just high TG antibodies

healthline.com/health/antit...

[rebeccasophie in reply to SlowDragon]

This is really great thank you!

[rebeccasophie in reply to SlowDragon]

Hi SlowDragon hoping to get some advice please, doctor tested my TPO after noticing goitre (I asked for the list of tests you mention above but no luck yet) - result was 49 (0-60) so negative. Getting a bit stressed because family and colleagues are noticing the goitre and hoarse voice. Also found a thyroid test from 2014 (blood tests because of recurring cystitis) where TSH was 4.63 (0.27-4.2) and T4 was 18.8 (12-22) but TSH is now 2.8 so 'no action required'. Is it just a matter of waiting until things get worse or should I try to see another doctor/specialist? Would really appreciate your advice on next steps!

[SlowDragon Administrator in reply to rebeccasophie]

Suggest you get full private tests.

You can have just high TG antibodies or about 20% with Hashimoto's have no raised antibodies

As you have visible goitre GP should send you for ultra sound scan to check it out

For full Thyroid evaluation you need TSH, FT4, TT4, FT3 plus TPO and TG thyroid antibodies. Plus vitamin D, folate, ferritin and B12.

Essential to test BOTH TPO and TG thyroid antibodies, FT3 and FT4, plus vitamins

Private tests are available. Thousands on here forced to do this as NHS often refuses to test FT3 or antibodies

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.

Thyroid Thursdaysat Medichecks, often have money off offers

All thyroid tests should ideally be done as early as possible in morning and fasting. This gives highest TSH and most consistent results. (Patient to patient tip, GP will be unaware)

[rebeccasophie in reply to SlowDragon]

Thanks so much for your fast reply! Doc also tested a couple things that I’ve copied below, but I will go through Medichecks/Blue Horizon now. Will also call doctor tomorrow about ultrasound.

Ferritin: 178 (20-200)

Vitamin D: 102 (50-150) I take supplements

Thanks again!

[SlowDragon Administrator in reply to rebeccasophie]

Both at good levels

[SlowDragon Administrator in reply to rebeccasophie]

Recurring cystitis or uti is a hypothyroid symptom

List of hypothyroid symptoms

thyroiduk.org/tuk/about_the...

[janveron1]

What is SHBG?? janveron1

[helvella in reply to janveron1]

Sex hormone-binding globulin

Just added to my Abbreviations and Acronyms document:

dropbox.com/s/og3lmxa1dqadb...

[rebeccasophie in reply to helvella]

Thank you

[greygoose]

Did you get your iodine tested before supplementing? That could be one of your problems. Iodine supplementation is not recommended unless over-seen by a specialist in iodine supplementation.

[rebeccasophie in reply to greygoose]

Yeah I'm not sure what the results were but the supplements were given to me by my doctor, he said it was because he could see that my thyroid was a bit lazy but he didn't want to put me on medication unless it got worse

[greygoose in reply to rebeccasophie]

Yes, but doctors don't understand that taking iodine can make your thyroid even 'lazier'. Iodine is anti-thyroid if taken just like that. I bet he didn't set up the protocols for taking iodine, nor test your selenium, did he? Doctors have this false idea that all you need to do to buck up your thyroid is to throw iodine at it, and that's just not true.

Have a look at what our resident researcher, diogenes, says at the end of this thread :

healthunlocked.com/thyroidu...

I'm afraid your doctor doesn't really know what he's doing.

[SlowDragon Administrator]

As greygoose says, supplementing iodine probably really not a good idea.

drknews.com/iodine-and-hash...

thyroidpharmacist.com/artic...

[rebeccasophie]

Thanks all for your comments! Update so far is that all new tests have come back normal but doctor noticed swelling/fullness in my neck so is going to try to refer me to an endocrinologist. If it doesn't work out, I will book my Blue Horizon test asap!

[SlowDragon Administrator in reply to rebeccasophie]

It can take months to see endocrinologist. Only get referral to one of your own choosing. Vast majority are Diabetes specialists

Contact Thyroid UK for list of recommended thyroid specialists

Getting thyroid scan and full blood tests asap