Still unsure

[ZM1980]

Hi everyone, I posted a while back about possible undiagnosed Hypothyroidism and had some really helpful and interesting advice (thanks again). However I am still continuing to have many persistent symptoms, which I suspect could be related to a Hypothyroidism, but then again have my doubts - this is mainly because I tend to lose weight really easily and quickly (but also gain easily).

My main symptoms that have been ongoing for many years are:

Fatigue

Memory problems/poor concentration

Tinnitus

Dry eyes

Acid reflux/slow digestion

Anxiety and depression

Hair thinning

Weak, bendy nails

More recently, ectopics (diagnosed by cardio pulmonary exercise test)

I don't have dry skin or as mentioned before, difficulty losing weight. My B12 is within normal range, but my iron and calcium levels are sometimes low. TSH and T4 always come back as 'normal'.

I would appreciate any advice in relation to Thyroid disorders and what type mine could relate to. Also is it possible to be Hypothyroid and not have difficulty losing weight?

Thanks in advance

These were my last Thyroid blood test results: Serum TSH 1.15 ml (normal range 0.34 - 5.6) and T4 level 9.30 pmol (7.5 - 21.1). As expected, GP said they were 'normal', but to me they look on the low end of normal.

[shaws Administrator]

Being hypothyroid - unexplained weight gain plus heart playing up could very well be hypo. You can also tick off other symptoms you may have:-

thyroiduk.org.uk/tuk/about_...

If you have thyroid antibodies - (you should have a check) then you'd have an Autoimmunr Thyroid Disease called Hashimoto's or hashi's but treatment is the same. Going gluten-free can help reduce the antibodies as they attack the gland and wax and wane until hypothyroid.

Always get a print-out of your blood results with the ranges for your own records and post if you have a query.

It is not enough for B12 or any other vitamin/mineral to be 'in range' - they all have to be at an optimum (near the top).

All blood tests have to be at the earliest, make advance appointments, fasting (you can drink water) and allow a gap of 24 hours between last dose of levo and test and take afterwards.

[ZM1980 in reply to shaws]

Hi Shaws, thank you for all the info. I had been looking into private blood tests for Thyroid - as I understand from many posts on this forum, Medichecks and Blue Horizon are the main choices. My GP (as I'm sure many others do) only test for TSH and T4 and if those are within 'normal' range, then you're fine!

Would the GP take private blood test results into account? Also, is a pinprick test as reliable as venous collection? Not sure whether to opt for the d.i.y one or go to a clinic.

Thanks again!

[greygoose]

There are over 300 known symptoms of hypo. But, you don't have to have them all to qualify. Some hypos put on weight, some lose it, some just stay the same. Weight-gain or loss is not something to base a diagnosis on.

The main reason for being hypo is autoimmune thyroiditis - aka Hashi's. To know if you have that, you test for antibodies - TPO and Tg antibodies. However, antibodies levels are not always reliable. If they are high, then we know you have Hashi's. But, if they are low it doesn't prove anything, because antibodies fluctuate, and could be high at a time when you don't have a blood test. Also, some people with Hashi's never develop high antibodies, and are diagnosed by ultrasound when some damage starts showing.

Another cause, less common, is Central hypo, when the problem lies with the pituitary (Secondary hypo) or the hypothalamus (Tertiary hypo), rather than the thyroid itself (Primary hypo). With CH, your Frees will be low but so will your TSH, because the pituitary cannot secrete enough TSH to stimulate the thyroid to make more hormone. This can be cause by a tumour or a bang to the head of some kind.

But, there are many other causes of hypo - genetics - it runs in families - endocrine disrupters in the air or our water, or cosmetics or cleaning products; whiplash in a car accident… It's often impossible to know what caused your hypo.

And, you cannot count on blood tests to diagnose you, because 'normal' just means 'in-range'. However, the ranges are mostly far too wide, so you could be 'in-range' but still hypo.

[ZM1980 in reply to greygoose]

Hi Greygoose, thanks for all the info. I was surprised to learn there are over 300 Hypo symptoms! Makes you wonder how many of your own could be thyroid related.

With regards to CH, I did have a period of epileptic seizures in my early teens - wonder if it had a lasting effect on my pituitary gland?

I had a full neck ultrasound about 3 years ago (for a suspected swollen lymph node), but all turned out ok.

My question is, is it possible to have had hypo symptoms for many (over 20) years, yet always have a supposedly 'normal' blood result? I'm at that stage where I actually wish my results would come back out of range, then at least my GP would take that into account!

[greygoose in reply to ZM1980]

Yes, it is. It's something that creeps up on us slowly, and hypo symptoms begin long before hypo shows up in the blood test results. Plus, it depends what is meant by 'normal'. When a doctor says 'normal', all he means is 'in-range'. But, most ranges are too wide, so it's not possible for a result at the top and a result at the bottom to both be 'normal'. But, doctors don't know enough about thyroid to understand that.

I'm afraid I don't know about any link between epilepsy and the pituitary, but it's a lead worth pursuing, I would have thought.