Advice needed

[Medicaladvice]

Hi I had a blood test last week at my doctors surgery. I have been feeling extremely lethargic, gaining weight 10lb in 10 months, cold all the time and just not feeling myself. I'm usually very fit 2 x 45 min step aerobics workouts, 20 min swim and 2 hours walking 5 days per week. At the moment I can do 1 workout but have to stop for a break every 15 mins. I eat so well yet I'm gaining weight. My mother has had 2 thyroid ops. We also have a family history of early menopause. I am 43 and noticed signs of the peri menopause 3 years ago. Here are my blood results. Any help would be greatly appreciated;

[Medicaladvice]

DateTest NameTest ResultNormal Range

28-Nov-2018

FULL BLOOD COUNT

Comment: (RN) - Nothing of note

Haemoglobin estimation128.000 g/L115 - 166 g/L

Total white cell count5.300 10*9/L3.7 - 11 10*9/L

Platelet count173.000 10*9/L150 - 450 10*9/L

Neutrophil count2.700 10*9/L1.7 - 7.5 10*9/L

Lymphocyte count1.900 10*9/L1 - 4 10*9/L

Monocyte count0.400 10*9/L0.2 - 0.8 10*9/L

Eosinophil count0.200 10*9/L0.04 - 0.5 10*9/L

Basophil count0.000 10*9/L0 - 0.2 10*9/L

Red blood cell (RBC) count4.290 10*12/L4 - 5.5 10*12/L

Haematocrit0.401 L/L0.36 - 0.441 L/L

Mean corpuscular volume (MCV)93.500 fl80 - 100 fl

Mean corpusc. haemoglobin(MCH)29.800 pg27 - 32 pg

Mean corpusc. Hb. conc. (MCHC)319.000 g/L320 - 359 g/L

Nucleated red blood cell count0.000 10*9/L0 - 0.01 10*9/L

GFR calculated abbreviatd MDRD85.000 mL/m/1.73m- mL/m/1.73m

Comment: (RN) - Normal - No Action Please refer to the DoH website under Publications and Statistics for guidance on eGFR. Please note for Afro-Caribbeans multiply result by 1.212

Urea and electrolytes

Comment: (RN) - Normal - No Action

Serum sodium140.000 mmol/L136 - 145 mmol/L

Serum potassium4.300 mmol/L3.5 - 5.1 mmol/L

Serum urea level5.000 mmol/L2.5 - 6.7 mmol/L

Serum creatinine67.000 umol/L50 - 98 umol/L

THYROID STIMULATING HORM.

Comment: (RN) - Normal - No Action

Serum TSH level1.840 mIU/L0.35 - 4.94 mIU/L

Comment

Comment: Euthyroid or adequate replacement. Rarely, patients with pituitary/hypothalamic hypothyroidism can have a normal TSH.

LIVER FUNCTION TESTS

Comment: (RN) - Normal - No Action

Serum total protein74.000 g/L64 - 83 g/L

Serum albumin43.000 g/L35 - 50 g/L

Serum ALT level12.000 U/L10 - 35 U/L

Serum alkaline phosphatase47.000 U/L40 - 150 U/L

Serum bilirubin level7.000 umol/L0 - 21 umol/L

Serum globulin31.000 g/L20 - 39 g/L

Serum ferritin23.000 ng/mL20 - 204 ng/mL

Comment: (RN) - Normal - No Action

HbA1c levl - IFCC standardised33.000 mmol/mol20 - 41 mmol/mol

Comment: (RN) - Normal - No Action

O/E - pulse rate67.000 beats/min- beats/min

Blood Pressure119 / 59 mmHg- mmHg

[Angel_of_the_North in reply to Medicaladvice]

Your ferritin is way too low - needs to be at least 70. Can't tell anything from TSH test on its own as you might have central hypothyroidism when TSH can't rise. You need a full thyroid and iron panel, plus B12 and folate

[SlowDragon Administrator]

There are no thyroid results in this list

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

Go back to GP and explain your family history and ask for thyroid antibodies to be tested plus vitamins, and thyroid tests if not been done already

Low vitamin levels are extremely common, especially if Thyroid antibodies are raised

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

If antibodies are high this is Hashimoto's, (also known by medics here in UK more commonly as autoimmune thyroid disease).

About 90% of all hypothyroidism in Uk is due to Hashimoto's. Low vitamins are especially common with Hashimoto's. Food intolerances are very common too, especially gluten. So it's important to get TPO and TG thyroid antibodies tested at least once .

Link about thyroid blood tests

thyroiduk.org/tuk/testing/t...

Link about antibodies and Hashimoto's

thyroiduk.org.uk/tuk/about_...

thyroiduk.org.uk/tuk/about_...

List of hypothyroid symptoms

thyroiduk.org.uk/tuk/about_...

[Medicaladvice in reply to SlowDragon]

Thank you so much. I'm going to look at having a test done privately, see if I can afford it.

[SlowDragon Administrator in reply to Medicaladvice]

Often on offer for £79 instead of £99

Plus extra if you want private blood draw. Many on here do DIY finger prick test

[SlowDragon Administrator in reply to Medicaladvice]

TSH is 1.84

You need FT3 and FT4 tested plus thyroid antibodies

However Ferritin is currently very low at 23 (20-204)

Suggesting you may be Anaemic. Ferritin should be at least up around 70.

You may need iron supplements. See GP to discuss

Eating liver or liver pate once a week or other iron rich foods should help improve levels

Not sure about all the Full Blood Count results

SeasideSusie or humanbean may add their opinions.....

[Medicaladvice]

Thank you everyone for your help an advice. I have actually made a doctor's appointment for Thursday morning. Armed with all this info I'm sure I can persuade them to do further test. I'm very grateful for your comments.

[Angel_of_the_North]

No thyroid tests there. You might be slightly anaemic (from MCHC), but there's no iron panel, no B12, no folate. Nothing really useful at all.