Thyroid UK
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Possible thyroid problem?

Hi all, I am 23 years old. A bit of background about me - I had my thyroid function checked due to constipation not resolving on laxatives, joint pain not resolving on painkillers, being given antidepressants. My result in November 2017 came back at TSH 5.2 (0.2 - 4.2) FT4 15.7 (12 - 22) FT3 4.2 (3.1 - 6.8)

3 months later my thyroid was tested again and my TSH was 2.2 (0.2 - 4.2) FT4 14.6 (12 - 22) FT3 4.0 (3.1 - 6.8)

The front of my neck has swelled up too, been feeling spaced out, dizzy, feeling cold, unable to focus. Any help would be appreciated x

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You may have autoimmune thyroid disease, but you need both TPO and TG thyroid antibodies tested

Plus very important to test vitamin D, folate, ferritin and B12. Low vitamins are extremely common as result.

Joint pain is often low vitamin D

Ask GP to test vitamins and antibodies

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, lowest FT4 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 are very common too, especially gluten. So it's important to get TPO and TG thyroid antibodies tested at least once .

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...

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Thanks very much, I did a private blood test through Blue Horizon back in 2015 and I do believe my antibodies may be elevated. I would really like interpretation of them if possible.

TOTAL THYROXINE 91 (53 - 154)

THYROID STIMULATING HORMONE 6.7 (0. 2 - 4.2)

FREE THYROXINE 13.8 (12 - 22)

FREE T3 4.0 (3.1 - 6.8)

THYROGLOBULIN ANTIBODY 808.5 (0 - 115 NEGATIVE)

THYROID PEROXIDASE ANTIBODY 487 (0 - 34)

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Vitamins tested by GP back in April 2018

FERRITIN 22 (15 - 150) confirmed iron deficient

VITAMIN D 33.8

FOLATE 2.2 (2.5 - 19.5)

VITAMIN B12 216 (190 - 900)

I take 800iu vitamin D too.

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Did GP prescribe the Vitamin D tablets for the VitD insufficiency?

B12 and Folate need attention also. Ask to be tested for Pernicious Anemia.

Yes, you have Hashimoto's Autoimmune Thyroiditis.

Is your GP aware of these private test results ?

You could ask GP to send you for an Ultrasound scan of your Thyroid and/or ask for urgent referal to an Endocrinologist.

Have you had blood test for Calcium?

Have you had any tests to check your Adrenals?

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Thanks, yes my GP prescribed me 800iu for vit D deficiency.

The GP and endo I see for male pattern hair growth do not know about the private results, I just kept them to myself.

I had a scan last done in 2015 which showed thyroid gland enlarged.

Calcium when last tested was low in range. Has always been mid range.

I had cortisol checked in 2014 it was 332 (140 - 700) and DHEA 2.3 (2.8 - 7.5) endo made no comment on this.

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It's most likely you have autoimmunte hypothyroidism as your antibodis were high. Your TSH is not going as high as would be expected with your combined low normal fT3 and fT4. It will be difficult but I would persuade your doctor to treat what looks very much like hypothyroidism. There's no point relying on the TSH for diagnosis or treatment as it seems to be under-performing, better to go by your symptoms and fT4.

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Thanks very much, my TSH was above 30 back in 2013 and GP just wrote unknown

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You probably had an autoimmune thyroid attack at that time, or possibly spontaneous thyroiditis, it doesn't matter which. Your GP should have requested an fT4 assay at the very least at the time, did they not do this?

It is possible for patients to have a period of hyperthyrodism (with very low TSH) which they do not notice. This could have happened sometime after 2013 and if the TSH is suppressed for sometime it can cause the thyrotrope (the bit of the pituitary that secretes TSH) to become down-regulated. If this happens your TSH fails to respond adequately from then on making it more difficult to diagnose and treat hypothyroidism.

The best way forward is a trial of levothyroxine to see if you recover. I would push very hard for this and make sure it is for 50 mcg or more, 25 mcg is too little to notice any difference. If you should show signs of too much thyroid hormone (unlikely) you can simply stop the levothyroxine.

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FT4 10.7 (12 - 22)

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meilee,

TSH > 30, fT4 10.7 confirms 'primary hypothyroidism', especially if you have symptoms and your doctor should have started you on levothyroxine. Occasionally you can get transient results like this, such as after the birth of a baby but in most cases it is permanent and the patient should be treated.

Doctors can have a negative attitude to young women so if possible I would visit your doctor with a relative or friend for support and politely but firmly insist on being treated for hypothyroidism. (If you are in the UK and diagnosed hypothyroid you are entitled to free prescriptions, your doctor should give you a form to fill in. It might be a better tactic to just get the first prescription for levothyroxine and then ask the receptionist about a form in a few weeks time).

Once you are taking levothyroxine, after a few weeks you should notice your constipation, joint pain and depression (do you have depression?) improving. You can then slowly wean yourself off the laxatives, painkillers and antidepressants as you feel able to.

If your doctor is unco-operative I suggest you ask for a refferral to an endocrinologist on the basis your case is outside their knowledge. It would be much better to get the GP to prescribe as it will save a lot of time.

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Thanks yes I have depression. I was given antidepressants but I don't really take them all the time.

I am under an endocrinologust for male pattern hair growth, I plan to see a different one

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Some antidepressants are 'refractory' in hypothyroid patients, refractory is a posh way of saying they don't work until the patient is given thyroid hormone.

meilee is a girl's name? They say you have 'male pattern hair growth (extra hair or hair loss?). Hair loss is a sign of hypothryoidism.

If you want to see a different endocrinologist it would be worthwhile writing a new post asking for recommendations in your area. You should ask for replies by 'pm' (private message) as we are not allowed to put doctors' names on the forum.

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Hi meilee

Looks like Hashi's to me. It'd be worthwhile reading today's other posts to get a feel for what you're up against. Magnesium is deficient in Hashi's sufferers and as they won't test for it, it wouldn't hurt to try some now - it should help a bit with the goiter (swelling), constipation, chronic pain and anxiety/depression.

thyroidadvisor.com/benefits...

psychologytoday.com/us/blog...

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