Need help with test interpretations and next steps

[Pipricho]

This is my first post here as I'm relatively new.

I resigned from my job two years ago thinking a break from a very stressful job would make me feel better. Since then I have been feeling just as bad as I did when I was working.

Since it dawned on me that this is something more than work stress, I have been trying to get to the root of the symptoms I’ve had for years:

Constant fatigue, head fog, poor sleep, memory problems, very low energy levels, constant ringing in the ears, sensitivity to heat and cold, irritability, depression and generally feeling unwell and exhausted.

Since December I have been monitoring my temperature which is consistently below normal as is my pulse rate. My blood pressure has always been low. My GP says all of this is just normal for me!

I’ve had private tests gradually over the period and have been learning as I go.

Firstly I thought it was adrenal problems and had a saliva test in January:

Cortisol:

Sample 1; 3.23 (2.68-9.30);

Sample 2: 2.37 (0.75-2.93);

Sample 3: 1.21 (0.36-1.88);

Sample 4: 1.21. (Less than 0.94)

DHEA am: 0.16 (0.25-2.22)

After advice at that time from Dr Peatfield, I started to take Adrenavive (adrenal cortex extract) at low doses but have now increased it to 500 mg in the morning and 250 mg at lunchtime. It is early days on this dose yet but I think there may be some improvement with my sleep on this.

In April I still felt unwell and had thyroid blood tests:

Total T4: 57 (58-161)

TSH: 0.79 (0.40-4.00)

FT4: 12.9 (11.5-22.7)

FT3: 3.4. (2.8-6.5)

rT3: 0.29 (0.14-).54)

Thyroglobulin: Less than 32 (Less than 40)

Peroxidase: Less than 14 (Less than 32)

I have had several blood tests over the past few years. These are the most recent ones taken in April:

Haemoglobin concentration 123 g/L [110.0 - 147.0]

Total white blood count 3.9 10*9/L [3.5 - 9.5]

Platelet count - observation 232 10*9/L [150.0 - 400.0]

Red blood cell count 4.18 10*12/L [3.75 - 5.0]

Mean cell volume 91.1 fL [80.0 - 98.1]

Haematocrit 0.381 L/L [0.32 - 0.43]

Mean cell haemoglobin level 29.4 pg [27.0 - 33.0]

Mean cell haemoglobin concentration 323 g/L [335.0 - 370.0]

Outside reference range

Neutrophil count 1.78 10*9/L [1.7 - 6.5]

Lymphocyte count 1.46 10*9/L [1.0 - 3.0]

Monocyte count - observation 0.47 10*9/L [0.25 - 1.0]

Eosinophil count - observation 0.11 10*9/L [0.04 - 0.5]

Basophil count 0.04 10*9/L [< 0.25]

Blood haematinic levels

Serum folate level 15.2 ug/L

Folate deficient if < 3.9 ug/L.

Serum ferritin level 46 ug/L [30.0 - 400.0]

Ferritin may be elevated due to inflammatory response

and therefore not reflect iron stores.

Serum vitamin B12 level 806 ng/L [197.0 - 771.0]

Outside reference range

I was concerned at the low ferritin and the MCHC level below the range. Having looked back at test results since 2015, the MCHC has been consistently below normal, and ferritin has been around the same mark as the latest one. I have asked my GP if I have problems with iron but she says Ferritin is ok and MCHC ‘is not something that we look at’.

From my research on this forum and other places, I am concerned that my FT4 & FT3 levels are low, that TSH is on the low side, and that low levels of cortisol and iron may be impacting on all of that. I have also read that a higher level of a RT3 is a problem. But I don’t know if I’m on the right track and I would really appreciate some advice with interpreting all of these results and any suggestions about how I could improve my health or if I should have any other appropriate tests.

My GP has consistently said my test results are all normal and that I must be suffering from chronic fatigue syndrome which she thinks would explain my symptoms. I do not agree with her and am really frustrated with her unwillingness to hear what I have to say. She has referred me to an Endo so that ‘we can settle this for once and for all’.

I would really appreciate some guidance in interpreting all of this, especially before my appointment which I’ve not yet been given. Many thanks in advance!

[Marz]

There is Central Hypo which Docs seem unable to pick up - when all results are low. It usually indicates a Pituitary problem. From reading this forum for years I understand it is more common than the Medics think. Testing sex hormones may reveal more.

Also VitD was missing 😊

What supplements are you taking ? Any other meds ?

[Pipricho in reply to Marz]

Hi Marz.

I’m not taking any other mads or supplements at the moment.

It’s really difficult to find my way round my GP website, but the last time I had D3 tested I believe it was above normal. Possibly about a year ago.

I asked my GP for sex hormone testing but she said they don’t do it. Do you know if it is possible to have this done privately?

From my reading I have thought that it could be central or secondary hypothyroidism and I told my doctor that it could be a problem with my pituitary gland. She was very dismissive of that and said that only affects one in every three or 4 million people.

Anyway, I was referred to the hearing clinic because of my tinnitus and they want to do an MRI scan on me which by coincidence is booked in this week. The consultant in the hearing clinic said that that would pick up any pituitary problems. I am going to check with them when I go in.

[Marz in reply to Pipricho]

Private Testing available on Thyroid UK website - click onto About Testing - in the link below ...

thyroiduk.org

Hope the scan goes well for you ...

GP's are dismissive when they don't know what they are talking about 😎