Results help before appointment

[Bubble89]

Hi all

I’ve been posting and following for a few months now after many years of symptoms (see prior posts) and a family history of autoimmune and thyroid issues.

I saw a new gp last week and explained my concerns. He said I presented as hypo and wanted to do further tests which seemed positive. My results from those bloods are below, I’ve also include the historic results I’ve gathered from my records.

Feb 2014

TSH 2.65 (0.6-4.2)

T4 16.4 (12.5-20.5)

December 2014

TSH 3.03 (0.6-4.2)

December 2017

TSH (H)6.41 (0.27-4.2)

Feb 2018

TSH (H)4.38 (0.27-4.2)

T4 17 (12-22)

Ferritin 33 (13-150)

May 2018

TSH (H)4.56 (0.27-4.2)

FT4 15.8 (12-22)

FT3 5 (3.1-6.8)

TPOAb (H)158.1 (0.0-75.0)

I’m due to go back to see him so wondered if someone could have a look at these and give me some thoughts before I go?

I’m not that hopeful with this gp to be honest. He’s very nice but said T3 wouldn’t be clinically helpful (though agreed to do it), and said he only knew of TPO antibodies. I can see he’s also marked the results as ‘satisfactory, no action’. I also requested an iron panel which he agreed, but doesn’t appear to have been done.

Any thoughts would be gratefully received. I’m undiagnosed and untreated (on Nortryptaline for Fibromyalgia, which was diagnosed in 2015).

Thankyouuuuuuuuuu!!!!

[SeasideSusie Remembering]

Bubble

December 2017

TSH (H)6.41 (0.27-4.2)

Feb 2018

TSH (H)4.38 (0.27-4.2)

T4 17 (12-22)

Ferritin 33 (13-150)

May 2018

TSH (H)4.56 (0.27-4.2)

FT4 15.8 (12-22)

FT3 5 (3.1-6.8)

TPOAb (H)158.1 (0.0-75.0)

There you have all you need. Over range TSH and positive TPO antibodies. Confirms autoimmune thyroid disease aka Hashimoto's and according to Dr Toft, in his article in Pulse magazine, where antibodies are present then Levo should be started to "nip things in the bud"

thyroiduk.org/tuk/about_the... > Diagnosis

The 'UK Guidelines for the Use of Thyroid Function Tests' state that, "There is no evidence to support the benefit of routine early treatment with thyroxine in non-pregnant patients with a serum TSH above the reference range but <10mU/L (II,B). Physicians may wish to consider the suitability of a therapeutic trial of thyroxine on an individual patient basis." If your TSH is above the range but less than 10, discuss a therapeutic trial of thyroxine with your doctor.

Subclinical hypothyroidism (where there are elevated TSH levels, but normal FT4 levels, possibly with symptoms) has been found in approximately 4% to 8% of the general population but in approximately 15% to 18% of women over 60 years of age.

Subclinical hypothyroidism can progress to overt hypothyroidism (full hypothyroidism with symptoms) especially if there are thyroid antibodies present.

If thyroid antibodies are found, then you may have Hashimoto's disease. If there are thyroid antibodies but the other thyroid tests are normal, there is evidence that treatment will stop full blown hypothyroidism from occurring.

Dr A Toft, consultant physician and endocrinologist at the Royal Infirmary of Edinburgh, has recently written in Pulse Magazine, "The combination of a normal serum T4 and raised serum TSH is known as subclinical hypothyroidism. If measured, serum T3 will also be normal. Repeat the thyroid function tests in two or three months in case the abnormality represents a resolving thyroiditis.2 But if it persists then antibodies to thyroid peroxidase should be measured.

If these are positive – indicative of underlying autoimmune thyroid disease – the patient should be considered to have the mildest form of hypothyroidism.

In the absence of symptoms some would simply recommend annual thyroid function tests until serum TSH is over 10mU/l or symptoms such as tiredness and weight gain develop. But a more pragmatic approach is to recognise that the thyroid failure is likely to become worse and try to nip things in the bud rather than risk loss to follow-up."

You can obtain a copy of the article by emailing Dionne at

[e-mail]

Print it and highlight the relevant parts in answer to Question 2 and ask your GP for a presciption for Levo.

[Bubble89 in reply to SeasideSusie]

Thanks SeasideSusue, that’s really useful, I’ll email her. I’ve ordered the info pack as well so will take some bits from that with me.

Should I be pushing for the iron panel? Ferritin if 33 isn’t the lowest I’ve seen people discussing by far, but it seems less than optimal.

Dependant on how the appointmentbgoes I’m hoing to get a full set of tests done by Medichecks (will need GP’s support for this as need to have the blood drawn at the surgery).

Thanks so much for your help. There’s a massive sense of relief from knowing there is actually something wrong rather than me being insane. Just got to get them to do something about it now!

[SeasideSusie Remembering in reply to Bubble89]

Bubble

I was offered iron supplements by the Nurse Practioner at my practice when my ferritin was 39 because it had reduced from 119. I refused, iron panel wasn't offered so he obviously wasn't concerned where my serum iron lay and that's irresponsible I feel. I told him I would raise my ferritin by eating liver.

I do an iron panel from time to time with Medichecks, I buy one when it's on offer at £29 and you have 6 months to use it. I'll do one or two a year when I feel it might need checking.

[Bubble89 in reply to SeasideSusie]

Thankyou, that’s really useful. I had been wondering how long you could ‘sit’ on the medichecks kits, as I may buy one in advance and get it done when I’m next due blood work at the GP.

Going to make the appointment and go in there calm and clear. I shall report back!

Thanks very much for your help ☺️