MRI shows nothing but could it still be a possibility that I have Central Hypothyroidism; and do I need to take iron supplements?

[Pipricho]

I recently posted here that my thyroid results were:

TSH 0.79 (0.40-4.00);

FT4 12.9 (11.5-22.7);

FT3 3.4 (2.8-6.5);

RT3 .29 (.14-.54);

TG less than 32 (less than 40);

TPO less than 14 ((less than 34)

I was having an MRI for tinnitus and wondered if it would show up any CH. However it was all normal apparently.

I have never taken thyroid meds. I am currently on Adrenavive 3, ACE -750 mg daily.

I am wondering if CH would be obvious on an MRI. If so, what could my problem be and how to treat it?

I'm having a first Endo appointment in 3 weeks and want to plan what to say to him.

I also posted because my Ferritin is on the low side: 46 (30-400) and I have had recent iron blood testing as advised. I wondered if iron could be an issue:

TIBC: 60.8 (45-81);

Serum iron 18.8 (6.6-26);

Transferritin 30.9 (15-45)

Given these results, should I start taking iron to bring the Ferritin up?

I feel constantly tired with head fog, poor memory, poor cognition, insomnia etc.

Hope you can offer some advice.

[adrienne1972]

Pretty much like my results and symptoms will follow.

[adrienne1972]

Also I got my ferritin up to over 100 but it hadn’t made any difference to my thyroid function. Scanty hair growth it my main problem !

[Ginny52]

I have a very similar problem, and would be interested to know how it turns out for you.

I think the audiologist is not entirely wrong, in that a couple of things that could be responsible for disrupting the function of your hypothalamus or pituitary, like an adenoma or injury, could be big enough to be noticed even if you weren’t looking for them, but my own experience suggests to me that the endocrinologist would have to request a specific pituitary scan, with contrast- the pituitary is only pea-sized even when intact. The nhs endo I went to refused to order this on cost grounds.

Where abouts in the country are you?

[Pipricho in reply to Ginny52]

That’s interesting – thank you. The radiologist told me that it would pick up problems with the pituitary but I guess she could’ve been wrong.

I am in Sheffield.

I suppose I will have to wait and see what the Endo says.

[Pipricho]

I was really surprised to be offered an MRI – I was referred to the audiologist for tinnitus. The hearing test found that I had perfect hearing. The audiologist said they always do an MRI when they can’t find a cause of tinnitus because it could be a tumour. I was shocked but I didn’t argue.

[Pipricho]

Yes, lately I’ve been hearing my pulse clearly in my ears especially during the night.

Hope you get it sorted out. It’s such a shame that doctors sometimes seem like an adversary rather than a partner in health.

[Ginny52]

I asked where you are because I recently asked a London endocrinologist for such a scan and he refused on cost grounds. I then went to a private one, (£275!), and he gave me a form for a private one, and I was too embarrassed to tell him I couldn't afford it. He put on the reason for exam/clinical indication part 'history of severe haemorrhage, concern re presence of Sheehan's syndrome, to exclude empty sella'

Scan required: MRI pituitary, gadolinium contrast.

I didn't know it was the radiologist who said she would be able to see it, and I suppose that means she looked for it. Did you have contrast?

[Pipricho in reply to Ginny52]

Hi Ginny52. Thanks for replying. I'm so sorry you couldn't get the scan done. If it was recent advice, could you not get the endo to put his advice in a letter so that you could give it to your GP to try to get it done on NHS? Please don't be ashamed just because you couldn't afford to have it done privately-most people are in the same boat.

Interesting though what he put on as the reason and type of scan required. I didn't have that on mine so assume it would need to be more specific. The radiologist told me somebody else looks at it and interprets so I am now assuming she doesn't have this kind of specialist knowledge.

So interesting about Sheehan's syndrome too. I've not looked into this before but was prompted to by your message. When I miscarried in hospital 23 years ago, I distinctly remember a nurse saying to me 'your blood pressure is so low, normally people are haemorrhaging when its this low'. It was 30 or 40 over something. I didn't take much notice as my BP is typically low, but it may fit with this syndrome, if by 12 weeks of pregnancy the pituitary has grown. I did have trouble producing milk for my subsequent baby and had to give up breastfeeding as she was losing weight. I will look into this further. Do you have any more info about Sheehan's. Thanks so much for posting this-sometimes things really click with somebody else when posted on here.

[Ginny52 in reply to Pipricho]

Yes! Absolutely! I think my motivation to find out about it came from here too, and it absolutely fell into place.

In particular, inability to lactate is a strong indicator. I didn’t have this because I never managed to carry a pregnancy to term after this. Your bloods look very like mine too. I have so much stuff for you. Can you pm me?

Also the drop in bp at the time- that is what actually causes the damage, and the pituitary (which has definitely swollen by the end of the first trimester, because I’ve found several other cases), has an infarction like a heart attack, and ischaemic damage is caused.

Pm me xxxxx

[Pipricho in reply to Ginny52]

Wow thanks Ginny. I'm not sure how to pm you but I'll find out!

[judburke]

From my personal experience - it seems that your ferritin is very very low. It is right at the bottom of quite a wide range. When my ferritin was so low I had many symptoms of tiredness, hair loss and muscle aches. I took iron to get levels up as mine needs to be higher to improve my health. FYI It takes a while to get ferritin levels up and then a bit longer for the symptoms to improve.

I would also be asking your GP and/or endo to investigate/explain why your ferritin is so low. It is possible that there might be a gut absorption problem. Coeliac is a common one but there are other reasons too. Have you had other key vitamins tested too? Such as B12, folate and D3. We all need decent levels of these to feel well too i.e. not just at the bottom of the range

[Pipricho in reply to judburke]

Hi and thanks for your reply. The GP has told me that the Ferritin levels alone don't matter as the other levels are within normal. Would you disagree with that? My Mean Cell Haemoglobin Concentration (MCHC) has consistently been below normal but GP doesn't even know what that is! My reading about it has shown that it is an important measure of iron concentration. Do you know about this?

It would be helpful to me if you could tell me what type of supplements you took and at what dose? I've had further iron tests as above and so am happy I won't be overdosing on iron now if I take some supplements. I think I just need to start taking iron for now. I just can't get anywhere with GPs. Just changed to new surgery but same old lack of concern.

I've had B12 and D3 testing a few months back and they were both above the normal range. Cant remember folate specifically so think it was within normal, but not sure where. I recently had endoscopy etc. and biopsy for coeliac which was negative.

[judburke]

I would disagree with the GPS comment but please note that I am not medically trained. I recommend that you do some research on ferritin. As I understand it ferritin is the iron that is stored in your body for use. Have a look on here at comments about ferritin levels. I don't know much about the MCHC so I can't help you sorry.

I take any iron tablet but I take it with Vitamin C as this improves absorption and makes it more gentle on the gut. I don't take it within a few hours of thyroid meds as it interferes with them. For blood tests it is recommended to be off iron tablets for 5 days in order to get a true storage reading.

I would ask for copies of your blood tests for the D3 and the B12 and make sure they give you the ranges too. Many Drs/labs will say they are ok as long as they are some where within the range. Thats great that they have tested you for Coeliac and rules that out

[adrienne1972]

I had an enormous miscarriage becoming unconscious from blood loss and NHS -(with count similar to your own) refused a scan on recommendation from private endo on account that other hormones were still being produced - prolactin and I did the test where they pumped you with Adrenalin and I apparently responded. Cortisol was borderline till then. Couldn’t afford private scan like you. Since then thyroid has dropped again t4 is 8 ( with the range at my GP starting at 7.5 !). I’ve been reading a lot about iodine therapy and going to try that- as well as get rid of Candida that can attach or something and prevent hormones attaching. I don’t want to just patch over the problem with thyroid supplements.

[AmandaK]

Hello, I'm coming very late to this message - I was doing a search on Central Hypothyroidism as it's been suggested that I might have this. I also have many of the symptoms.

As I read your post I began to think that I had written it as your TFTs and experience is almost identical to mine! I also have low in-range FT3 and FT4 with normal TSH. I had a blow to the head in 2016 and in 2002 experienced an incomplete miscarriage resulting in very low BP (though due to massive blood loss) and the need for emergency surgery.

I have had pulsatile tinnitus for a number of years, greatly worsened by the head trauma and had an MRI head scan, but nothing showed up. However, they did the wrong one as I was supposed to have the contrast. I couldn't face having it done again (it made the tinnitus even worse) but I'm now thinking that this might reveal problems with the pituitary.

Can I ask how things are with you now and if you received a CH diagnosis? I hope you were able to find a way forward. Please feel free to PM. With thanks, A