Advice needed - please - TSH of 2.1 (so no action by GP) yet I am feeling so very ill - what can I do? Is it possible to be hypothyroid?

[Yogaga]

Hello I'm new here. Female 32, mother of one. I had one year post partum of having severe anxiety, severe insomnia, etc which I put down to post natal anxiety and did not seek help for (I regret this now!)

However, a year later and I've been having the following symptoms for 3 months - chronic headaches (tension type) with occasional migraine and aura. General feeling of exhaustion and brain fog, memory is worse than the proverbial goldfish. Restless sleep; dizziness palpitations; pins and needles in arms, broken nails, mouth sores, irritability with everyone (I feel like there's nothing left in my reserve ). Muscle weakness and fatigue i.e. putting washing out on line makes my arms scream, going to yoga I spend half of it in childs pose, my arms and legs burning with effort.

I was sure I was anaemic so requested they test for that. My haemoglobin levels are good but ferritin 16. TSH 2.1. I would like to try to conceive a baby this year but I feel so exhausted I don't see how my body could survive a pregnancy when I feel like I'm running on empty.

It's been a hell of a year with a cancer diagnosis in April but that was removed with surgery and no chemo required (I feel so incredibly lucky!

Has anyone else had normal TSH levels and still been suffering hypothyroidism ? No weight gain issues tho.

I am really at a blank as GP just says your fine, it's stress. I have been much much more stressed in my life, things are going well (aside from feeling like death warmed up!) Any advice would be so gratefully received (even if its just to say this doesnt sound like a thyroid issue) thanks xoxo

[issyisabelle2]

TSH tends to be highest if tested AM and fasting so you could retest in the morning fasting if you haven't already. Low ferritin can also make you feel bad even if you aren't anaemic.

[Yogaga in reply to issyisabelle2]

It was tested in the AM and I'd only had a bite of fruit so I'd say it was probably fairly accurate. Thanks for your help

[greygoose]

Well, it does sound like thyroid. But, the problem is, the symptoms are non-specific, and could be caused by a lot of things - although, not depression or anxiety! Those are symptoms themselves, not diseases. But, doctors know so very little about thyroid.

Yes, you could be hypo with a TSH of 2.1, because there are quite a few causes of hypo. And, a TSH on its own won't tell you much. You need FT3, FT4 and antibodies tested, as well. And B12 would be a good idea, too. The chances of your doctor doing all of them, and understanding the results, are pretty slim, so could you do private labs? If you get

TSH

FT4

FT3

TPO antibodies

Tg antibodies

vit d

vit B12

folate

ferritin

that will give you a much clearer picture of what's going on.

[Yogaga in reply to greygoose]

My doc offered firstly sleeping tablets and then beta blockers both of which I have turned down because I dont feel like that is the crux of my problem.

So instead she offered to test for folate and b12 levels and prolactin. Golate appears to have a few of my symptoms so will be good to check. I suppose I'll have to pay for a private test for FT4 FT3 and antibodies. Anyone have a discount code? Not rolling in cash right now but desperate to find some answers.

I have been supplementing with Vit D and B12 off my own back so I doubt they will be low? Folate maybe tho.

Thanks so much for taking the time to answer xxx

[greygoose in reply to Yogaga]

You're welcome.

[FancyPants54]

That ferritin level is a real problem. It will be getting in the way of your body being able to use your thyroid hormone properly. You must work to raise that. Have you got the results of a full iron panel? If so, post them up here, with the lab reference ranges, and ask for help with them. Just because you GP says you are fine doesn't mean you are fine. Your ferritin should be at least halfway in the reference range.

[Yogaga in reply to FancyPants54]

I will post it up tomorrow.

Yes, I specifically pointed it out to her that it seemed low and that previously my ferritin has been around 100 (feeling very fit and well). Her response 'its in the range of normal'. She wasn't being obstructive I guess just has hands tied? Since the 1.3l haemorrhage during my cancer surgery (bearing in mind I'm barely 5 foot and 120lbs it was a lot to lose!) I felt awful. That was April. They took my iron fingerprick test in the hospital and said it was fine and discharged me. Three weeks later I could still barely climb 3 steps without stopping; and dragged myself to surgery carrying my toddler, my ferritin level was 6!!! Ferrous fumarate for 3 months and that ended July, they retested and levels were normal although i didn't check them in detail. I felt okay though. However Sept -Oct started downhill. So perhaps its all linked to that ferritin level! What a stream of consciousness (sorry) but you've helped a lot, thanks x

[FancyPants54 in reply to Yogaga]

I just can't understand why a GP looks at a reference range and if it's one point inside it they declare "Fine!" and if it's one point out of it they panic and roll in to action. They don't seem able to see any shades of grey, only black and white.

SeasideSusie has been a great help to me with my ferritin level. Hopefully she can add some of her wisdom when you post your ranges up.

[Yogaga in reply to FancyPants54]

I've posted my ranges. All officially 'OK' but the ferritin is low. The rest look mid range ish. V grateful if you have any advice, still feel dreadful

[Yogaga]

Cervical x

[Yogaga in reply to Yogaga]

Just the tumour was removed x

[SlowDragon Administrator]

See a different GP and ask for full iron panel

Your ferritin is far too low

Eating liver or liver pate once a week should help improve levels, but you possibly need iron infusion or iron supplements

Definitely test vitamin D, folate and B12

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

All thyroid blood tests should ideally be done as early as possible in morning and fasting. This gives highest TSH and most consistent results. (Patient to patient tip, best not mentioned to GP or phlebotomist)

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

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

[Yogaga]

Thanks, I think that might be a good avenue to go down as I am banging my head against the wall with the GPS. So far they have offered basically anti depressants and beta blockers. They clearly think I'm depressed. I am getting more so the more I feel they aren't listening to me but primarily I feel very physically unwell it's supremely frustrating!

[Yogaga]

Serum ferritin 16 ug/l (15-445)

Serum TSH level 2.16 mIU/L 0.27-4.2

ADVICE NOTE UNDERNEATH SAYING LEVEL NOT IDEAL FOR PREGNANCY

[FancyPants54 in reply to Yogaga]

Oh dear. That ferritin is dreadful. For them to say it's not ideal for pregnancy is ludicrous, it's not ideal for anything down there. Almost certainly this will be making you feel ill. What are you taking for iron at the moment?

My levels were not as dire as yours. But I have used iron rich foods and an iron tablet to increase my scores. Not sure how best to advise you with this as I don't understand the results below and don't really know why your ferritin is so low. Sadly you don't seem to have been given a full iron panel test. I think you need to go back to your GP and ask, very firmly, to have a full iron panel tested and vitamin D and B12 at the same time. That might start to provide some answers to help this along.

SeasideSusie can you have a look at Yogaga's awful ferritin levels and talk to her about her options?

[SeasideSusie Remembering in reply to Yogaga]

Yogaga

Taking this from your post further up the thread

my ferritin level was 6!!! Ferrous fumarate for 3 months and that ended July, they retested and levels were normal although i didn't check them in detail. I felt okay though. However Sept -Oct started downhill. So perhaps its all linked to that ferritin level!

Personally to give ferrous fumarate with such a low level was ridiculous, you should have had an iron infusion. Did you have an iron panel and full blood count to see if you had iron deficiency anaemia?

I imagine that you were told your level became normal because it may have just scraped into range. It can take many, many months to reach a decent level when on ferrous fumarate, I wouldn't have thought 3 months would have brought you up to a good level.

As you are now just 1 point inside the range, I would go back to the surgery, maybe see a different GP, go through your history of ferritin levels. Ask for full blood count and an iron panel, also ask for an iron infusion - you may need referring to a hematologist.

For thyroid hormone to work (that's our own as well as replacement hormone) it's said that ferritin needs to be at least 70, preferably half way through range - but don't expect a doctor to know this. You can help raise your level by eating liver regularly, maximum 200g per week due to it's high Vit A content, also liver pate, black pudding, and including lots of iron rich foods in your diet apjcn.nhri.org.tw/server/in...

but this wont replace the treatment you need for such a poor level, and I wouldn't do this anyway before further testing because you don't want to raise your level to where they will just say that "it's normal" again as you wont get any treatment.

This dire level of ferritin really isn't something you should be trying to sort out yourself, there may be more to it which is why the other tests are important.

PS

Mean corp haemoglobin 30.4 pg (37-32)

I've just seen this from your post further down. Different types of anemia can cause low MCH levels. Low amounts of iron in the blood can also cause low MCH levels so you need serum iron tested, part of the iron panel.

[Yogaga]

FBC

TOTAL WHITE CELL COUNT 5.92 (4.00-11)

Red blood cell RBC count 4.3 (3.8-5.3)

Haemoglobin est 133 g/L (120-150)

Haematocrit 0.39 l/l (0.37-0.45)

Mean corpuscular volume 90.8fl (83-100)

Mean corp haemoglobin 30.4 pg (37-32)

Mean corp haem conc. 335g/l (310-350)

Platelet count 260 (150-450)

Red blood cell dist width 12.7 (11.5-15.5)

Neutrophils count 2.37 (1.5-8)

Lymphocyte count 3.05 (1-4)

Monocyte count 0.38 (0.2-1)

Eosinophil count 0.08 (0-0.5)

Basophil count 0.04 (0-0.2)

All are 10*9/L except RBC which is 10*12/L