I have been having blood tests for the last few years, with my TSH levels fluctuating between 0.03 up to 5.76. I’ve previously been diagnosed with raised antibodies and present with numerous under active symptoms.
My current blood work shows:
TSH 4.4mu/L (0.35 - 5.0)
Vitamin D 70 neologism/L (75-200)
Ferritin 24 ug/L (15-250)
Am sick of feeling exhausted all the time. I have an appointment to discuss my results with the doctor next week but not sure that he will actually do anything to help. Has anyone got any pointers to help?
Written by
katgwyn
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He’s never given me medication! He keeps saying let’s wait and see what the next blood test will show. To be honest I feel like I’m on my knees most days, just want to be able to convince my doctor to at least trial something to help sort my levels out.
A TSH 4.4mu/L is not high, most people would be OK. However, you have symptoms for a long time so it would make sense to have a trial of levothyroxine (50 mcg or more - 25 mcg has no noticable effect). This is cheap and safe. A high TSH indicates the thyroid is failing but there are other causes of hypothyroidism which doctors don't consider, hence a trial of levothyroxine makes sense. Do you have figures for fT3 and fT4? GPs tend not to request these but they are very useful. Often fT3 is not done even if the GP requests it, so they have to cleary insist it is done when filling out the form.
The approach your GP is taking is what they are told to do by the endocrinologists, so I wouldn't blame the GP but I would try and persuade them to prescribe levothyroxine for a few months to see if it helps.
For full Thyroid evaluation you need TSH, FT4, TT4, FT3 plus TPO and TG thyroid antibodies and also very important to test vitamin D, folate, ferritin and B12
Low vitamin levels are extremely common and can lower TSH meaning it's difficult to get diagnosed due to over reliance on blood tests, instead of looking at symptoms
Private tests are available. Thousands on here forced to do this as NHS often refuses to test FT3 or antibodies
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).
With Hashimoto's levels of thyroid hormones fluctuate a lot, especially early on in 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 .
That low ferritin won't be helping. Ask for a full iron panel. GP probably won't treat if TSH is in range, but you need to know Free T4, free T3, and TPO and TG antibodies. Fluctuating TSH is usually autoimmune thyroiditis (Hashimotos) and NHS should treat if high antibodies, TSH over 4 and symptoms, but probably won't.
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