Latest Medichecks results - advice please - Thyroid UK

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Latest Medichecks results - advice please

Hi all,

I wonder if you lovely people could take a look at my latest results.

I haven't been feeling great so got bloods done by Medichecks again so I can go back to my Dr and try to get help. These are my latest results - all previous results are in my bio. TSH has risen again to highest it has been but FT4 and FT3 seem to be very slightly higher too....

I still haven't tried going gluten / dairy free and I don't want to supplement too much in case it affects other results.

Dr told me to stop taking Ferrous Fumarate when I asked for a blood test to check levels (pharmacist didn't want to sell me more until I got checked). Still taking Vit D but not every day (with K2)

***I am not taking any Thyroid medication, not yet prescribed***

Fasting blood taken 1st thing AM (as usual)

ENDOCRINOLOGY

Thyroid Function

THYROID STIMULATING HORMONE *7.18 mIU/L 0.27 - 4.20

FREE THYROXINE 14.900 pmol/L 12.00 - 22.00

FREE T3 4.81 pmol/L 3.10 - 6.80

THYROGLOBULIN ANTIBODY *248.000 IU/mL 0.00 - 115.00

THYROID PEROXIDASE ANTIBODIES *70.2 IU/mL 0.00 - 34.00

HAEMATOLOGY

Vitamins

ACTIVE B12 63.100 pmol/L 37.50 - 188.00

FOLATE (SERUM) 19.98 ug/L 3.89 - 26.80

25 OH VITAMIN D 65.9 nmol/L 50.00 - 200.00

BIOCHEMISTRY

Inflammation Marker

CRP - HIGH SENSITIVITY 2.56 mg/l 0.00 - 5.00

Iron Status

FERRITIN 84.3 ug/L 13.00 - 150.00

I am off to the USA for 2 weeks so plan to book an appointment for when I am back. I might see if I can get Dr to agree to another blood test as I haven't had an NHS one for 4 months and I know sh won't accept the Medichecks results.

I want to go in with the right advice from you guys to get something done.

Thankyou :)

22 Replies
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If my TSH was that high I'd probably be on the floor. Most people seem to need it around 1.0 to feel ok. Your vitamin D is low in range too. It they were my results I'd be wanting to increase levo by 25mcg and retest in 6 weeks time and so on until my TSH was around 1 or even a little lower suits me.

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thanks Nanaedake,

I'm not currently on medication as my GP is saying TSH isn't high enough. It's an ongoing saga....

I have been taking VitD 3200, was daily but I haven't been taking them every day for last couple of weeks. I think I will start taking them daily again.

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Can you see a different GP? And ask for a trial of Levothyroxine? You are very hypo with a TSH up in the 7's but so many GP's refuse to understand that.

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Hi FancyPants54, I’m onto 2nd gp and she asked for advice from an endo last time. She said she could refer me to endo but I said no as I’ve not heard good things about him. Maybe I’ll say yes this time.

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And I asked for a trial of Levo but was refused

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Just shows how useless the GP's are being for you. They won't give you a trial but they will refer you to an endo! They should start with the trial. But yes, if you get that offer again, take it. If you can choose who to see - even better. Your other option is to buy your own meds and trial it yourself.

I've been to the GP today because I have a bad chest/cough giving me a bit of asthma back and I needed an inhaler after years without. But at the same time I took her one set of blood test results for my thyroid and one menopause doctor's letter for my file explaining my HRT protocol. I practically had to type the results and notes into the system. She was so flummoxed by it all. I explained my blood test was done on 100mcg of Levo and as a result of my TSH still being 6.6, I had moved on up by 25mcg to 125mcg a day and she looked confused and troubled. It's so obvious to me, but not to them. I have an endo appointment in 2 weeks, my first. I'm hoping that they will agree with me and we can work out a program that the GP's can cope with following. If not, I'm on my own. I'm not letting them keep me sick.

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We seem to know a lot more than they do, thanks to this site and the great advice. Good luck with your treatment.

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What reason did the GP give for not offering a trial of levothyroxine?

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I think she’s just taking a wait and see approach, she didn’t really give a reason, in fact she actually said to me that of course I’d feel better on Levo, anyone would. I was stunned and didn’t know what else to say.

But her approach is not working for me. My TSH is steadily rising and my symptoms are getting worse which makes it harder for me to know what to do as my brain is already very foggy.

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Shows how much she knows! If you feel better on Levo then you needed it because your own body wasn't keeping up! And anyway, many of us suffer when put on it, at least at first. It seems to take a long time to stabilise and have good effects for some of us. I'm certainly not there yet. I was started on it with a TSH of 4.3 or similar, I forget now, and taking the Levo made my TSH rise up to over 10 in December last year! I'm still struggling to get it down and as I said above my last test was 6.6. I'm worse now than I was before I started taking it. Your GP doesn't have a clue.

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It would be nice to be given a trial so we can see what affect it has but being left in limbo is worse :(

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If someone doesn't need levothyroxine they will not feel well on it. I knew someone who was prescribed it accidentally and it made the person very unwell. Ask your doctor if she has tried taking it? If not, then how does she know how it would make someone feel who didn't need it?

I would ask for a solid reason for not prescribing a trial, for example, does your doctor think you have another condition that is causing your symptoms? If so, then you need a full evaluation. Ask for full blood tests to be run for all possible autoimmune conditions and check out all other vital functions such as liver, kidneys, heart, lungs. Also ask for a full vitamins and minerals test. It's just possible your symptoms are due to something else but without a thorough evaluation how would you or your doctor know? Ask your doctor to rule out all possible other conditions. Also, ask for a bone density scan and calcium levels while you're at it.

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She is sure it’s menopause but won’t test hormones. I can’t win

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Well, you can point out you have raised thyroid antibodies so that is not caused by menopause. It's caused by autoimmune thyroid disease. Autoimmune thyroid disease is not caused by menopause. The antibodies will slowly destroy thyroid tissue so the condition is progressive and will not improve although it can fluctuate. Taking Levothyroxine may not make you feel totally well but it might slow the disease progression and prevent other complications. If doc thinks menopause is implicated then has she tested calcium and sent you for a DEXA scan to check bone density?

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As you have raised Thyroid antibodies and symptoms and TSH is above range your GP is completely WRONG

Guidelines say treatment should be started

SeasideSusie has a link you can print out to take to GP

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Thanks SlowDragon

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MelonJ

SeasideSusie has a link you can print out to take to GP

Yes, it's to with subclinical hypothyroidism and antibodies.

Your results are

THYROID STIMULATING HORMONE *7.18 mIU/L 0.27 - 4.20

FREE THYROXINE 14.900 pmol/L 12.00 - 22.00

FREE T3 4.81 pmol/L 3.10 - 6.80

and a TSH between 4 and 10 is classed as subclinical hypothyroidism - see

cks.nice.org.uk/hypothyroid...

Scenario: Subclinical hypothyroidism (non-pregnant)

If TSH is between 4 and 10 mU/L and FT4 is within the normal range

◾In people aged less than 65 years with symptoms suggestive of hypothyroidism, consider a trial of LT4 and assess response to treatment 3–4 months after TSH stabilises within the reference range — see the section on Prescribing information for further information on initiation and titration of LT4. If there is no improvement in symptoms, stop LT4.

And fromhttp://www.thyroiduk.org/tuk/about_the_thyroid/hypothyroidism.html

The 'UK Guidelines for the Use of Thyroid Function Tests' state that, "There is no evidence to support the benefit of routine early treatment with thyroxine in non-pregnant patients with a serum TSH above the reference range but <10mU/L (II,B). Physicians may wish to consider the suitability of a therapeutic trial of thyroxine on an individual patient basis." If your TSH is above the range but less than 10, discuss a therapeutic trial of thyroxine with your doctor.

Subclinical hypothyroidism (where there are elevated TSH levels, but normal FT4 levels, possibly with symptoms) has been found in approximately 4% to 8% of the general population but in approximately 15% to 18% of women over 60 years of age.

Subclinical hypothyroidism can progress to overt hypothyroidism (full hypothyroidism with symptoms) especially if there are thyroid antibodies present.

If thyroid antibodies are found, then you may have Hashimoto's disease. If there are thyroid antibodies but the other thyroid tests are normal, there is evidence that treatment will stop full blown hypothyroidism from occurring.

Dr A Toft, consultant physician and endocrinologist at the Royal Infirmary of Edinburgh, has recently written in Pulse Magazine, "The combination of a normal serum T4 and raised serum TSH is known as subclinical hypothyroidism. If measured, serum T3 will also be normal. Repeat the thyroid function tests in two or three months in case the abnormality represents a resolving thyroiditis.2 But if it persists then antibodies to thyroid peroxidase should be measured.

If these are positive – indicative of underlying autoimmune thyroid disease – the patient should be considered to have the mildest form of hypothyroidism.

In the absence of symptoms some would simply recommend annual thyroid function tests until serum TSH is over 10mU/l or symptoms such as tiredness and weight gain develop. But a more pragmatic approach is to recognise that the thyroid failure is likely to become worse and try to nip things in the bud rather than risk loss to follow-up."

You can obtain a copy of Dr Toft's article in Pulse magazine by emailing Dionne at ThyroidUK

tukadmin@thyroiduk.org

and the information is in response to Question 2.

Also

ACTIVE B12 63.100 pmol/L 37.50 - 188.00

This needs investigating. According to this article, Active B12 below 70 may suggest B12 deficiency viapath.co.uk/our-tests/act...

Do you have any signs/symptoms of B12 deficiency - see b12deficiency.info/signs-an... If so list them and ask your GP to test for B12 deficiency/pernicious anaemia. Don't supplement any B12 or B Complex or folic acid/folate supplement before being tested for B12 deficiency.

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Thankyou SeasideSusie. I tried explaining a lot of this to my GP before but got the wait and see response. I’m going to insist on a trial. Thanks for the helpful info.

I do have symptoms of b12 deficiency but thought if I started saying that too she would just think I’m hypochondriac.

In fact I made my daughter who was definitely deficient in b12 go back to her dr who said her levels were ok(I went with her). I managed to get her dr to give her loading doses and 8 weekly injections. Her dr learned a lot about b12 and nice guidelines 😊. Unfortunately she’s in a different area so at a different surgery to me. If only I could convince my dr!

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You probably need to lower your inflammation. Get on lots of turmeric. Your T3 is also not high enough if you are on T4/T3 or T3 medication alone. You should get on T3 solely. What is your Reverse T3? If you add T3, your TSH should come down and T3 will go up. T4 should stay in that range but will lower a bit as it does when you take T3. This will give your thyroid some rest because its obviously getting a signal to produce more. Are you hashimoto?

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I just read you are not on medication. If I were you, I would visit an integrative doctor as I did and get on t3 only. I am currently on compounded extended release t3. My TSH was only at 2.8 and I felt miserable. T3 and T4 in low middle range. This brought my TSH around 1 and my T3 is in the top 1/4 of the range and T4 is in mid. A general practitioner will not give you t3 solely but it is very beneficial in this case. If Reverse T3 is in the higher range, this will be more evidence you need T3 dose.

Get on antiinflammatory regimen to fix this long term since it's technically primary hypothyroidism. Turmeric, no dairy, no gluten, ashwagandha, vitamin D, Dulse Flakes (Iodine), Brazil nuts (selenium), etc.

Medical Medium's advice on Thyroid problems is very good.

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Thankyou

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Thanks douse. I am not on any thyroid meds yet.

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