Low in range TSH. HypErthyroidism ?

[lucylocks]

Hi

My son in law has been really depressed and anxious for a few months now.

He has palpitations and is sweating, is irritable, and very self conscious, and not sleeping very well.

For the past year he has had really bad diarrehea but since cutting out lactose this has improved.

His Doctor did some blood tests and all his vitamin levels came back low, especially B12 level 140 bottom of range 115

His TSH is 0.51 range 0.34 - 4.5.

My daughter and I both suffer from hypOthyroidism and know how Doctors stick rigidly to the ranges without taking symptoms in to account, so were wondering if son in low could be in fact hyperthyroid with a low in range TSH.

Any advice would be gratefully received.

Thank you.

[greygoose]

I don't think his TSH is low enough to be hyper. But, a TSH on its own doesn't tell you much. He would need his FT4, FT3 and antibodies tested:

TPO and Tg antibodies for Hashi's,

TSI or TRAB for Grave's.

[lucylocks in reply to greygoose]

Thank you greygoose,

I don't suppose his Doctor will do the tests so will he will have to get them done privately.

[greygoose in reply to lucylocks]

I'm afraid he will.

[Jazzw]

He’s going to feel quite rubbish with a B12 level as low as that. That needs treatment, I would say.

I don’t think it’s hyper either - more likely to be a bowel issue of some kind (the low B12 is a clue). Has he been tested for coeliac disease?

[lucylocks in reply to Jazzw]

Thank you Jazzw,

his coeliac test came back negative.

Doctor has said they could not do anything about his B12 as it was in range,

so my daughter bought and is giving him 10,000mg B12 supplement daily.

He went back to the doctor as he was not feeling any better and he told him he is taking the supplements.

His doctor said to go back in a months time and if the supplements do not raise the level he will then see what he can do. In the meantime he has been offered antidepressants.

[SlowDragon Administrator]

If he's lactose intolerant, is he perhaps also coeliac?

His B12 is seriously low. What is GP doing?

Should be tested for Pernicious Anaemia before starting loading B12 doses

For full Thyroid evaluation he needs TSH, FT4, FT3 plus TPO and TG thyroid antibodies and also very important to test vitamin D, folate, ferritin and B12

Private tests are available. Thousands on here forced to do this as NHS often refuses to test FT3 or antibodies

thyroiduk.org.uk/tuk/testin...

Medichecks Thyroid plus ultra vitamin or Blue Horizon Thyroid plus eleven are the most popular choice. DIY finger prick test or option to pay extra for private blood draw. Both companies often have special offers, Medichecks usually have offers on Thursdays, Blue Horizon its more random

Private testing for suspected Graves - TSI or TRab antibodies

medichecks.com/thyroid-func...

[lucylocks in reply to SlowDragon]

Thank you SlowDragon,

many thanks for the information.

He was tested for coeliac and it came back negative.

I will get my daughter to get him to get the thyroid tests.

She has started him on 10,000mg. daily B12 supplement as Doctor said he could not do anything as his level was in range.

He went back to the doctor as he was not feeling any better and told him he was taking the supplement and he said come back in a month and if the supplements have not increased his level he will see if he can do something.

He has offered him in the meantime antidepressants.

Son in laws Mum and Dad both have B12 injections but I do not know if either have

Pernicious Anaemia.

[SlowDragon Administrator in reply to lucylocks]

Suggest you post about low B12 on Pernicious Anaemia forum

healthunlocked.com/pasoc

But GP sounds useless....like thyroid treatment, PA care seems to be getting worse too.

A GP gets a financial bonus for managing patients on antidepressants......no wonder they push them

He needs his low B12 sorted, not anti depressants

Loading doses of B12

healthunlocked.com/pasoc/po...

Official Guidelines on B12 and folate

hey.nhs.uk/wp/wp-content/up...

Guidelines on low B12 and folate

onlinelibrary.wiley.com/doi...

[lucylocks in reply to SlowDragon]

Many thanks SlowDragon,

From for the link you kindly gave, his doctor is not following the guidelines.

As you say he is useless.

I will print a copy for him and get him to take it to the doctor.

I will put a post on the P.A. forum thank you.

[SlowDragon Administrator]

Strongly recommend he tries strictly gluten free diet. Coeliac blood test is notoriously unreliable, and it doesn't pick up other forms of gluten intolerance

[lucylocks]

Thank you RFU,

I will get him to make an another appointment and ask for the tests.