Advice on results and what to do next?

[HappySam]

Hi everyone, I posted here months ago about some private medichecks results and symptoms of hypothyroidism I had and a few of you kindly advised me regarding vitamins to be tested and exploring secondary/central hypo. I've done several tests both privately and through my GP over the last few months and would love any advice or information if possible please?

Firstly let me give you a few details about me. 35yo female, 2 kids age 7 and 4. Always struggled with weight but never had an issue losing it before now. Things have got progressively worse since having kids where I had an emergency c section with my first and lost a huge amount of blood (was told I nearly died) and only had a transfusion 3 days later. So sheehans has crossed mine and my GPs minds. I have been doing intense excersise 4 times a week for a year now, tried low calories, cutting out fat, carbs, sugar etc and only managed to lose 7kg in that time (I have around 50kg to lose) I take sertraline for panic attacks for around 9 years. Inhalers for asthma all my life. I have carpal tunnel/numbness and tingling in both hands plus feet also. I'm tired and cold. No libido. Headaches. Brain fog (I can barely remember holidays we have taken since kids, important events etc) I nearly fall over with poor balance and dizziness, constantly shoulder bumping into doorways etc, get dizzy if i stand too quickly, my (ahem!) nipples leak drops of milk occasionally even though it never properly came in as I was so ill after both births with blood loss and paralytic illeus, I eat a good varied diet, cook from scratch etc. My BP and pulse are both fine.

So here are relevant tests you may be interested in:

5/11/17

TSH 1.35 mIU/L (0.27-4.20)

FT4 12.2 pmol/L (12-22)

FT3 4.45 pmol/L (3.10-6.80)

Diabetes testing done and results normal.

Jan 2018: FT4 10.8 pmol/L (12-22)

May 2018: (using same thresholds as above)

TSH 1.81

FT4 11.2

FT3 3.98

cortisol saliva test also done and came back normal. As did thyroglobulin antibody and thyroid peroxidase antibodies.

5.7.18:

Doc advised mean cell haemoglobin level was low again as had been previously too 27.9 pg (28.0-33.0) but didn't explain why etc. Diabetes test again all normal. Doc ran hormone tests also:

Serum LH level 6.8 u/L

Serum follicle stimulating hormone level 8.3 u/L

Serum prolactin level 335 mu/L (60-620)

Serum testosterone level 0.7 nmol/L (0-2.1)

Serum TSH 2.0 mu/L (0.5-4.4)

1/08/18: FT4 10.8 pmol/L done by GP who's reference range begins at 10.0 which differs from medichecks 12.00

3/09/18:

TSH 1.83 mIU/L (0.27-4.20)

FT4 11 pmol/L (12-22)

FT3 3.77 pmol/L (3.10-6.80)

Thyroglobulin antibody 16.700 IU/mL (0-115.00

Thyroid peroxidase antibodies 20 IU/mL (0-34.00)

CRP high sensitivity 5.03 mg/I (0-5.00)

Active B12 49.700 pmol/L (25.10-165.00)

Folate serum 6.47 ug/L (2.91-50.00)

Ferritin 39.4 ug/L (13.00-150.00)

Doctor today has also advised I have gastritis which I had around 3 years ago too I have also tested positive for h.pylori previously last year and had treatment.

My GP agrees there is a possibility something could be going on but our local endo team says my ft4 doesn't meet there threshold and I basically have to wait to see if it keeps going down. My GP has agreed to refer me privately to speed up if I wish, I could afford initial consultation etc but after that it's probably going to be very expensive!

Can any one offer any advice on my results and/or what my next options could be. I'm so tired of all the waiting!

Thanks so much in advance and sorry for such a long post!

Sam xxx

[SlowDragon Administrator]

Yes your results strongly suggest central hypothyroidism, possibly due to Sheehan's syndrome

Your B12 is very low and folate low

b12deficiency.info/signs-an...

Ask GP for full B12 testing before starting on any B vitamin supplements

Active B12 under 70 is considered suspicious

viapath.co.uk/our-tests/act...

Alternatively you can do futher private testing of MMA and homocysteine (NHS rarely test these )

nutris.viapath.co.uk/pages/...

Have you had vitamin D tested?

Ask GP to do so

Or test via vitamindtest.org.uk

Getting vitamins optimal is first step. This is likely to raise TSH so that endocrinologist might actually look at blood tests!

You need a pituitary and thyroid expert endo (not an average Diabetes specialist)

Email Thyroid UK for list of recommended thyroid specialists

please email Dionne


[e-mail]

[HappySam in reply to SlowDragon]

SlowDragon thank you very much for your response and advice, I really appreciate it. I will get vit D tested and look at doing the others related to b12 privately. My GP only seems to take notice when I present him with the hard evidence such as blood tests! I've already advised him of my b12 levels and he didn't even comment..... surely with a normal health diet consisting of dairy, red meat etc the b12 shouldn't be low? So probably an absorption issue, likely related to gastritis/h.pylori history?

Anyway thank you and I will report back with more results!

Sam x

[SlowDragon Administrator in reply to HappySam]

Getting vitamins optimal is first step

Roughly where in UK are you?

You need pituitary and thyroid expert

[HappySam in reply to SlowDragon]

Nottingham SlowDragon