Private blood tests, your opinions please before seeing GP

[tazbex]

Hi

I was finally referred to an endo recently after many years but sadly was very disappointed that she had nothing to add to the opinion of my GP, that everything is fine. The only suggestion she offered was to try going from 100mg of thyroxine each day to alternating between 100 & 75. I have just had private bloods done and some areas are highlighted as an issue but I'd really like the opinion of you wonderfully knowledgeable people regarding the results. Thanks in advance.

[SeasideSusie Remembering]

Tazbex

How do these results compare to your latest NHS results? Can you post them, with their reference ranges.

These show an over range TSH and the need for a dose increase, not reduction. Why does your endo think you need to reduce your dose?

Are you supplementing iron? If not your high Ferritin level needs investigation, it could be inflammation as your CRP is also high, both can be high when inflammation is present but as they're non-specific it doesn't indicate where the inflammation is.

Discuss your below range folate with your GP. Folate and B12 work together - do you have any signs of B12 deficiency - check here and list any you may have to discuss with your GP

b12deficiency.info/signs-an...

Vit D is too low and needs a decent amount of D3. If your GP only offers 800iu, or nothing at all, come back and I will suggest what to buy and the important cofactors needed when taking D3.

[tazbex in reply to SeasideSusie]

Hi

Thanks so much for your reply, very helpful. So, I had said to my endo that I felt I had some signs of hyper as I am very tense when sleeping and wake with aching hands and tense jaw (thought that may be why I'm so tired, restless sleep). This is why she suggested the lower dose. Results below from last 2 tests, endo's assessment was based on April results.

Feb '18 (100mg) Free T4 - 21.2 (12.0-22.0) Serum TSH - 2.71 (0.27-4.2)

April '18 (75/100mg) Free T4 - 18.4 Serum TSH - 3.67

I meant to ask about B12 actually as I started taking 1000 about 3 weeks ago (out of desperation really) and not sure what impact that would have had on my results. I do have a few of the symptoms shown in your link but not too many.

[SeasideSusie Remembering in reply to tazbex]

Tazbex

Your February results didn't show the need to reduce Levo, your TSH was too high. FT3 should have been tested as well, that is the active hormone that every cell in our body needs.

The aim of a treated hypo patient generally is for TSH to be 1 or lower with FT4 and FT3 in the upper part of their ranges if that is where you feel well.

Your April results tell their own story, your TSH has increased, your FT4 is lower, you are probably more symptomatic than before.

Having any symptoms of B12 deficiency means you should be tested. I would stop the B12 supplmenent now, show your GP the list of symptoms you are experiencing and ask for investigation into B12 deficiency and pernicious anaemia.

If given anything for the low Folate level, don't start it until after those B12 investigations have been carried out.

Tense jaw and tense when sleeping may not be a sign of hyper, I get it, I just find it hard to relax, I'm certainly not hyper.

[tazbex in reply to SeasideSusie]

Thanks Susie, lots to take in here. Will stop the B12 but the results from private bloods indicate I'm within range for this so will GP entertain me asking for investigation? Regarding the tension, this is not my normal state I'm a very chilled person and I do fall asleep easily, nothing in my life (apart from this ill health) to worry about, for which I'm very grateful. I'd come right off meds last year for 3 weeks and felt amazing, although I know that wouldn't have lasted, but one thing which I really noticed was that I slept soundly and had vivid dreams. I'd always had lots of dreams but for the last few years don't remember them at all, the difference in my sleep was amazing, that's what led me to think there was an element of hyper.

[SeasideSusie Remembering in reply to tazbex]

tazbex

There are some people who have had a result in the 300s and they are on B12 injections. It's symptoms, not numbers, they should go by, so make a list of your symptoms, maybe read up on that B12 site, gather some information to back up the need for further testing.

[tazbex in reply to SeasideSusie]

Thanks I will do.

[SlowDragon Administrator]

Being UNDER medicated can cause anxiety

Low vitamin D linked to insomnia

drgominak.com/sleep/vitamin...

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 at

[e-mail]

Official NHS guidelines saying TSH should be between 0.2 and 2.0 when on Levothyroxine

(Many of us need TSH nearer 0.2 than 2.0 to feel well)

See box

Thyroxine replacement in primary hypothyroidism

pathology.leedsth.nhs.uk/pa...

[tazbex in reply to SlowDragon]

Thanks for this SlowDragon, will look at it all. I was going to make an appointment for GP on Thursday but think I'll delay in order to understand all this info and make sure I can put my case forward properly.