Central hypo, results?

[AJThyroid]

Hi all

I am a 37 year old male who is hoping you would be able to shed some light on some results I recently obtained from a Complete Thyroid Test (results below). The test was a non-fasting test taken at 12 noon.

The reason I have had the test done is because for years I have been suffering with the following symptoms and I won’t just accept that there’s no good reason. I have tried many elimination diets to see if I can find a food group culprit to no avail:

Vitiligo

Dermatitis

Wildly fluctuating energy levels (to the point that I don’t know how I will feel from one day to the next)

Puffy face

Headaches

Pins and needles

Night sweats

Bags under my eyes

Raynaud’s disease

Various aches and pains

I have some low results and some normal results, although most of the normal results are very borderline low. My TSH for example is right on the cusp of the low yellow marker, my FT3 is in the yellow, my FT4 is low normal and my T4 is low red.

T448(51 - 161)

TSH0.76(0.40 - 4.000

FT414.2(11.5 - 22.7)

FT33.1(2.8 - 6.5)

rT30.24(0.14 - 0.54)

TG<32

TPO<14

Would borderline low TSH, low FT3, low T4 and low normal FT4 suggest that I might benefit from Levothyroxine and does it also suggest that I might have Central Hypothyroidism? I’ve ready online that low TSH, FT4 and FT3 could mean that? Trying to work out why my levels aren’t firmly in the optimum range?

I’m hoping you might be able to shed some light? I’m waiting on some results of a private hormone panel (Dutch urine) test too to see what that says too.

Thanks,

AJ

[SlowDragon Administrator]

Vitiligo is autoimmune, so that makes other autoimmune diseases more likely

Pins and needles and night sweats can be low B12

You need B12, folate, vitamin D and ferritin tested

Have you ever had head trauma or whiplash?

Usually we advise testing as early as possible in morning and fasting to give highest TSH

Your results

TSH shows nothing

Total T4 is very low

FT3 low

Antibodies negative, however not everyone with Hashimoto's has raised antibodies.

Perhaps need ultrasound scan of thyroid

Looking at possibly central or secondary hypothyroidism

Next step is to test vitamins

Come back with results and ranges

If you are in the UK Thyroid UK has list of recommended thyroid specialists

Email Thyroid UK for list of recommended thyroid specialists

please email Dionne


[e-mail]

Possibly need a pituitary and thyroid specialist

Do you have any gut symptoms?

[AJThyroid in reply to SlowDragon]

Hi,

Appreciate the prompt reply, thank you.

I've had two head injuries. When I was 5 years old and when I was around 26 years old. Both hospitalised - first was splitting my forehead on a concrete step (8 stitches). The other, in the same injury spot, was splitting my head on a cabinet after falling down stairs (5 stitches).

My vitamin levels are:

Serum B12 635ng/L (130.0 - 800.0)

Serum folate 23.4ug (4.0 - 20.0)

Serum ferritin 62ug/L (20.0 - 330.0)

Doctor didn't test vitamin D.

NB: I had been supplementing with 1000mg B12 (methylcobalamin) and 1000mg methyl folate for a year before test as I had high homocysteine which is now normal. I am now reducing my intake of both due to high result in folate.

Various gut issues - bloating, loose stools occasionally, cramps.

Thanks for the details.

Should I request a thyroid scan from my doctor, do you think my complete thyroid results warrant that? They were only happy to give me a TSH test which they said was normal (0.98) tested at same time and day 12 noon non fasting - I got the nurse to draw blood for my private test too which is why I have the complete results too.

AJ

[BadHare in reply to AJThyroid]

It might be an idea to have your pituitary (the hormone "master gland") checked out as a potential cause of your hormone issues. My small pituitary adenoma is to blame for a lot of things, though my endos don't seem to understand. A chap I met at a Pituitary Foundation developed an assortment of symptoms including hypothyroidism as a result of a head injury. A relative also had hypo symptoms due to hypogonadism (low testosterone). As the endocrine system is closed, it only takes one thing to go wrong, or a possible micronutrient deficiency to mess up other hormones. Dctors don't always look further than the most obvious, then claim all is ok. As the EDS society states, doctors shouldn't assume the sound of hooves is always horses, when it could be a zebra!

[AJThyroid in reply to BadHare]

Thanks for the reply, BadHare. I am waiting on results for my hormones so will see what comes up there and see if there's any correlation.

[SlowDragon Administrator in reply to AJThyroid]

So before supplementing B12 and folate you presumably had low levels, plus high homocysteine

Were you tested for Pernicious Anaemia before starting?

B12 isn't very high considering your supplementing. You may need to continue at this level or even higher

Suggest you get vitamin D tested

vitamindtest.org.uk

The fact you have gut issues could be directly due to thyroid or causing thyroid issues

Look at gluten intolerance as possible issue. Getting coeliac blood test first.

Other aspect is that Head injuries can cause pituitary damage and secondary hypothyroidism

[AJThyroid in reply to SlowDragon]

Not sure whether I had low levels of B12 and folate. Through genetic testing I discovered I have a heterozygous MTHFR mutation and so tested my homocysteine levels and found out it was very high. I therefore started supplementing with methylcobalamin and methylfolate to bring it down to the safe range.

Will keep supplementing with the B12 and methylfolate at a lower level.

Thanks re vit D test, have ordered.

Have been tested for coeliac but that came back negative. I have raised igE levels which indicate I am having an allergic reaction to something but have had various testing which all came back negative (dairy, pollen, dust, gluten, animals, MSG etc. all the standard things). I've read that autoimmune diseases can cause raised igE so may be linked?

[SlowDragon Administrator in reply to AJThyroid]

Many many people are not coeliac, but gluten intolerant

So next step is to try strictly gluten free diet. Try it for 3-6 months. If no noticeable improvement then reintroduce gluten and see if symptoms get worse

[AJThyroid in reply to SlowDragon]

Thanks SlowDragon, I avoid gluten anyway. I have tried various diets strictly for many months and reintroduced with no difference. Have tried Paleo, GAPS, low histamine, salicylate etc. Am sure something else is going on.

[SlowDragon Administrator in reply to AJThyroid]

Here's links about MTHFR and hypothyroidism. You may have already seen these

thyroidpharmacist.com/artic...

holtorfmed.com/mthfr-gene-t...

verywellhealth.com/the-link...

[AJThyroid in reply to SlowDragon]

Thank you for these

[BadHare in reply to AJThyroid]

Some folks have an issue with phytates in grains, rather than gluten. I eat sourdough as the phytates, & also gluten, are degraded by the slower fermentation. It also enhances rather than inhibits mineral absorption.

[AJThyroid in reply to BadHare]

Many thanks

[HLAB35]

Although I'm pretty much certain that your head injury is responsible for the problems, there is an outside chance that you could have low zinc levels. Zinc is also vital for testosterone and serotonin.

Low zinc has been linked to the failure of TRH to increase in the absence of low circulating thyroid hormone - which can present itself with blood results like yours.

ncbi.nlm.nih.gov/pmc/articl...

However, that said, your symptoms are not screaming zinc deficiency as a single cause. If you are taking B12 and folate it's important that you realise that these are 'mineral hungry' vitamins (especially Magnesium) and they also 'use up' other b vitamins as well. B2 (riboflavin) is very good for keeping the mucous membranes working and is effective at preventing headaches - especially migraines. For poor circulation, Ginkgo is good; Cinnamon and Ginger are also recommended.

[AJThyroid in reply to HLAB35]

Many thanks