Unsure if this could be a thyroid issue and I should see an endocrinologist..?

[hummingbird88]

hi all!

I'm new here and wanted to get opinions on my test results. I originally was diagnosed with pernicious anemia after experiencing severe fatigue, shortness of breathe, weight gain, along with some other more minor symptoms. I experienced these symptoms for a year until they grew in severity to where I believed they must be a result of a medical problem, and around 6 weeks ago, I finally saw a doctor. She tested my blood levels and I was deficient in B12, vitamin D, and iron, which was odd because I was taking vitamin B supplements, as I am a vegetarian. She conducted further tests which found that I tested positive for the intrinsic factor antibody, meaning I had pernicious anemia, and needed B12 injections. However, this didn't explain the sudden weight gain of ~15-20lbs in 4-5 months with no change in diet or activity. In fact, in the last 6 months, I have really restricted my calorie intake as I noticed the weight gain, to absolutely no effect. I rarely gain/lose weight and this is extremely abnormal for my body.

I went to see a hematologist who told me my other test results indicated I probably had just gotten a false positive for the intrinsic factor antibody, and I should just continue taking vitamins without injecting B12. I had already injected a loading dose of B12 (a dose every day for seven days), and felt marginally better, but not completely. The hematologist's response was really frustrating and distressing because the likelihood of a false positive intrinsic factor antibody test is low, as fare as I understand. Because of the different opinions I continue to get, in addition to the weight gain, I wanted to see if my thyroid seemed normal, as it had been tested the first time. My family has a history of hypothyroidism, and it would also explain many of my symptoms. My original doctor and hematologist have dismissed the possibility of hypothyroidism, as it is in the "normal" range, but I really feel this could be a possibility, instead of or in addition to the pernicious anemia. Is there anything that could be indicative? Should I see an endocrinologist? I am only skeptical because the doctors so far have acted like my issues are all in my head.

My results are the following: (please ignore if not relevant, I wasn't sure what was)

-Vitamin D, 25-Hydroxy 25.50 ng/mL, range: 30.0-100.0

-Vitamin B12 7/28/2018 221.00 pg/mL, range: 232-1245

-Folate (Folic Acid), Serum, 18.10 ng/mL, range: >3.0

-Iron Bind.Cap. (TIBC) 427.00 ug/dL, range: 250-450

-UIBC 383.00 ug/dL , range: 131-425

-Iron, Serum, 44.00 ug/dL, range: 27-159

-Iron Saturation 10.00 % , range: 15-55

-RBC 4.56 x10E6/uL , range: 3.77-5.28

-Hemoglobin, 12.90 g/dL , range: 11.1-15.9

-TSH 2.52 uIU/mL, range 0.450-4.500

-Triiodothyronine,Free,Serum, 3.30 pg/mL , range: 2.0-4.4

-T4,Free(Direct)1.10 ng/dL, range: 0.82-1.77

-Intrinsic Factor Abs,Serum 13.50 AU/mL, range: 0.0-1.1

-Antiparietal Cell Antibody 17.20 , range: Units 0.0-20.0

-Gastrin,Serum,16.00 pg/mL, range: 0-115

-Methylmalonic Acid, Serum 101.00 nmol/L , range: 0-378

[Marz]

As PA is auto-immune then it would be helpful to have Thyroid anti-bodies tested to rule out auto-immune thyroid - Hashimotos.

Your VitD could be improved - 60 would be better. Are you in the US ?

Docs have very little knowledge regarding B12/PA or thyroid. There is a good Forum on HU - the PAS forum. So posting on both could be helpful.

Nothing is in your head - you are struggling with PA and possible Hashi's.

EDIT- sorry have just spotted your posts on PAS Forum 😊

[Hidden]

Given your history I think this is probably as you say a thyroid issue. A good way to clarify is by taking you pulse and temperature first thing inthe morning for 5 days before you get out of bed.If either or both are low then this is strong evidence to indicate thyroid issues. I would not advise trying to get GP to refer to an endo as they are very blood test led. There is however available via the Thyroid uk website a list of more helpful doctors some of whom work on the NHS. However even if some of them prescibe T3 they do not nessasarily treat with normal blood results. You low B12 and B vitamins are indicative of thyroid disease which reduces the ability to digest vitamins. You might find that you do Ok with some B12 patches or lozenges. A Dr Chandy runs a B12 support organisation that sents out B12 injections to people if they cannot get them prescribed.(google B12 support Dr Chandy to find)

You do need to improve your Vitamin D. There are some good sprays available which also include K2. The vitamin D council advise redoses etc. I would betaking 10,000 iu a day at your level for a month at least then 5000 to maintain over the winter.

Vitamins and minerals all kind of interact with thyroid disease.The thyroid disease reduces your levels but also your thyroid needs various vitamins or minerals to enable the body to make use of the hormones the thyroid produces. It can bea bit of an ongoing battle to keep your vitmain levels up to the right levels. B12 is especially needed for thyroid function, as if ferritin, vitamin D and folate. Vitamin Chelps you to asborb vitamin in the gut and also helps you absorb any orally taken hormones.

[humanbean]

-Iron Bind.Cap. (TIBC) 427.00 ug/dL, range: 250-450

-UIBC 383.00 ug/dL , range: 131-425

-Iron, Serum, 44.00 ug/dL, range: 27-159 Approx 13% of the way through the range

-Iron Saturation 10.00 % , range: 15-55

Do you have a result for ferritin (iron stores)?

It is possible to have low iron and high ferritin together which is a condition called "Anaemia of Chronic Disease (ACD)", and usually this condition should not be treated with iron supplements until the underlying cause of the condition has been fixed. And if you do manage to fix any underlying conditions then the ACD should fix itself anyway.

irondisorders.org/anemia-of...

(See Page 8 in the following link)

irondisorders.org/Websites/...

A doctor would say that your iron is fine because it is in range, but with such low levels I wouldn't expect you to feel well at all.

If your ferritin was low in range or under the range along with the low iron then in your shoes I would want to treat the low iron by taking iron supplements.

Optimal levels for iron related tests are shown on this link :

rt3-adrenals.org/Iron_test_...

Low vitamins and minerals, including low iron, are very common in thyroid disease. In hypothyroidism the cause is low stomach acid reducing the body's ability to extract nutrients from food. Low stomach acid causes indigestion which is often treated with acid-suppressing treatment or antacids which makes the problem even worse. In hyperthyroidism the body uses up nutrients much more quickly than usual.

-TSH 2.52 uIU/mL, range 0.450-4.500

-Triiodothyronine,Free,Serum, 3.30 pg/mL , range: 2.0-4.4 54% of the way through the range

-T4,Free(Direct)1.10 ng/dL, range: 0.82-1.77 29% of the way through the range

Your TSH is still well within the reference range and your Free T4 and Free T3 are still in range. I would agree that both your Free T3 and Free T4 are too low for many people to feel well. But sadly you will have to get a lot worse before a doctor will treat you for hypothyroidism because the diagnosis of hypothyroidism is sadistic and inadequate.

You might find this link of interest. It shows the levels of TSH in healthy people with no known thyroid disease, and your TSH is already higher than that of most healthy people. I think you will become hypothyroid but there is no way of predicting when.

healthunlocked.com/thyroidu...

What you should do in the meantime is maintain your health as best you can by optimising your nutrient levels and keeping them there. Also, maximise your gut health. There is lots of info about gut health on this forum. You could ask for help on this in a new post specifically on the subject.