New member with Medichecks thyroid results that I need help with.

[BluesPlayer]

Hi all, new member here looking for advice. I want to try and keep this short and relevant...

Have been suffering depression and anxiety for many years but last summer after losing 5 stone (deliberately) in 6 months and quitting smoking my health - mental and physical took a nose dive.

Rosacea (diagnosis of 20+ years recently questioned by dermatologist) flared badly after being under control for many years (with no treatment). Depression and anxiety which had been a background problem took over my life. Experiencing mental fog, fatigue, loss of libido, erection problems, cognitive decline, etc.. Currently on my 4th antidepressant after the others didn’t work and / or gave me side effects I couldn’t endure. Currently having CBT for anxiety.

Believing there was a physical issue exacerbating these issues I asked for blood tests by the doctor as well as taking private ones with Medichecks.

NHS tests revealed Vit D at 75nmol, healthy magnesium levels, normal TSH and total testosterone in the normal range, however I had high parathyroid levels. Doctor thought it must be low Vit D but a test showed otherwise. No follow up on that!

Due to my symptoms I went for a private male hormone check with Medichecks. That showed my total testosterone to be in the normal range again but my sex hormone binding globulin (SHBG) was very high, indeed, off the chart at 71.5nmol.

The result of the high SHBG was low free testosterone just under the ‘normal’ range at 0.198 nmol (0.2 - 0.62)

Oestradiol was 102pmol/L and within the normal range.

All other checks where well within normal ranges.

Trying to find out why my SHBG was high led me onto my thyroid.

Had a Medichecks thyroid ultravit test and got these results:

CRP High Sensitivity 5.4mg/l (<5) Had cold when done!

Ferritin 138ug/l (30-400)

Folate 4.4ug/l (>3.89)

B12 94.8pmol/l (37.5 - 188)

Vit D 66nmol (50-175)

TSH 2.66miU/L (0.27-4.2)

Free T3 5.75pmol/l (3.1-6.8)

Free Thyroxine 14.8pmol/l (12-22)

Thyroglobulin Antibody <10ku/l (<115)

Thyroid Peroxidase Antibodies 14.5 kIu/l (<34)

What do you make of these results. Medichecks doc is toeing the line and saying everything is normal except CRP and that my raised SHGB is likely down to exercise. Errr... No.

Am I barking up the wrong tree looking at thyroid issues.

Anything else I should consider?

Should also add that prior to summer I was experienced huge rises in my heart beat for no apparent reason. Dangerously high and confirmed by 2 devices. Not happened for a while though and doc didn’t seem concerned.

Ok, I lied about the short part!

Edited for accuracy.

[greygoose]

Are you sure about that Free Thyroxine result? That is very weird.

[BluesPlayer in reply to greygoose]

Good spot..

14.8pmol/L

Anything else standing out as unusual?

[greygoose in reply to BluesPlayer]

That's better! But, it's low compared to your FT3. Which is also strange. And, your TSH says your thyroid is struggling.

Your B12, folate and vit D are a bit low. But ferritin ok.

I don't think you're barking up the wrong tree by looking at thyroid problems, because there's something not quite right, there, but I'm not sure what… Have you ever had your iodine tested? That might tell you something.

[BluesPlayer in reply to greygoose]

Thanks for your reply Greygoose! Never had iodine tested. I'll look into that. Seeing the doctor on Friday so i'll discuss these results. Pretty sure i'll be fobbed off. He had no idea what SHBG was.

Lots of clues pointing at something but the picture is unclear.

[greygoose in reply to BluesPlayer]

I don't know much about SHBG, it apparently it can be high with hypothyroidism. Why did he test it if he didn't know what it was?

[BluesPlayer in reply to greygoose]

Ah, apologies, I wasn’t quite clear with the SHBG thing.

I was tested by the NHS for my total testosterone levels which came back in the normal range, albeit towards the lower end. They said it’s “normal, fine, don’t worry about it.” I wasn’t satisfied with that so had a private test with Medichecks that did a full hormone check. That revealed I had low free testosterone (not bound to proteins in the blood) but high SHBG, hence the low free testosterone. Was aware that a thyroid issue could cause high SHBG, as well as other things, so that prompted me to have a thyroid check with Medichecks. When I pointed out the Medichecks results he confessed he didn’t know what SHBG was and would look into it. To be fair they can’t know everything but was hoping he would understand the importance of low testosterone on a man and he didn’t.

[greygoose in reply to BluesPlayer]

Not just on a man! Women need good levels of testosterone, too, or no sex drive!

They can't know everything, no. But it's the willingness to find out that counts. He gets full marks on that one!

[BluesPlayer in reply to greygoose]

Absolutely! Just as oestrogen is still important to a man despite it being the ‘female hormone’. Just different ratios but doctors focus more on females when it comes to hormone issues, which I can understand, but the effect of hormone issues on men seems less understood by the NHS.

Yep, at least he didn’t completely dismiss it.

[greygoose in reply to BluesPlayer]

Is that what you think? I can assure you it's not true - apart from stuffing women with HRT and birth control pills, which can be potentially dangerous, but Big Pharma gets its cut from those!

The truth is that doctors know very little about hormones in general, and thyroid hormones in particular, and are actually quite scared of them. I once asked a GP about DHEA. He practically crossed himself! 'Oooo, you don't want anything to do with that!' he said. 'I had two patients that took DHEA and one had blood pressure through the roof and the other one grew a beard!'. And, of course, it had to be the fault of the DHEA, not that they were taking it because they already had those problems! It's pathetic!

[BluesPlayer in reply to greygoose]

That’s what worries me about getting any answers regarding my issues. I think i’m Just going to hit a brick wall.

[greygoose in reply to BluesPlayer]

Quite possibly, to be honest. But, on the bright side, if you can raise your thyroid hormone levels, your testosterone could possibly follow.

Don't give up on your thyroid, keep testing. Especially the TPO antibodies. Antibodies fluctuate, and they could rise over the top of the range, meaning that you have Hashi's - which would explain a lot. And, if you do have Hashi's, your thyroid numbers will eventually become worse. See if you can do that iodine test. If iodine is in short supply, the thyroid sometimes makes more T3 than T4 to economise on iodine (T4 contains four atoms and T3 only three atoms). So, if iodine is low, that would explain the high FT3 and low FT4. There has to be a solutions, somewhere, but you might be the only one looking for it, in the end.

Could you afford an Anti-Aging doctor? Stupid name, I know, but they really know their hormones - all of them! Might be worth consulting one. I did, and he helped enormously - didn't make me much better, but I did learn an awful lot from him, enough to self-treat with confidence.

[BluesPlayer in reply to greygoose]

Not sure about Hashi’s as I don’t match many of the symptoms. Quite the opposite in some cases.

Will look into the anti-aging doctor. Thank you.

[greygoose in reply to BluesPlayer]

What do you consider the symptoms of Hashi's to be? I'm pretty certain that it doesn't have any symptoms, the symptoms come from the resulting low thyroid hormones.

[BluesPlayer in reply to greygoose]

I see your point.

Without symptoms and my levels being in the “normal” range how would I go about getting a diagnosis of Hashis given the chance the doctor will just fob me off. I’ve had some of these issues for a long while though, it’s just recently they’ve taken a turn for the worse. Wouldn’t I be showing symptoms by now including low thyroid hormones or is this something that just creeps up over many years?

[greygoose in reply to BluesPlayer]

It creeps up insidiously. And, at the moment, your thyroid hormone levels aren't cause for concern. But, you need to know if your TSH is going to continue to rise and your FT3 fall. No point in even asking the doctor at the moment, just ask for another test is six months or so.

And, if your TSH rises, and your Frees fall, but your antibodies stay low, ask for an ultrasound, because that would show if any Hashi's-type damage has been done. You can have Hashi's without ever having high antibodies.

[BluesPlayer in reply to greygoose]

Thanks Greygoose, i’ll bear that in mind.

[greygoose in reply to BluesPlayer]

You're welcome.

[BluesPlayer in reply to greygoose]

Well... The doctor didn’t see any cause for concern regarding my results. I’ll re-check with Medichecks in a few months to see if anything changes. Started a trial of testosterone therapy and will be seeing a specialist at some point so we’ll see what happens from that.

[greygoose in reply to BluesPlayer]

Well, of course he didn't! He doesn't know enough about thyroid to spot anything except the very obvious - like a TSH of about 20, say! And, even then, some GPs would argue. He has no idea of the subtlities of thyroid because he hasn't learnt that much in med school. So, yes, best thing to do to do another blood test in a few months.

I don't think I asked, but you're not on statins, are you? Forgive me if I've already asked you that.

[BluesPlayer in reply to greygoose]

Nope, not on statins.

[greygoose in reply to BluesPlayer]

OK, just a thought.

[BluesPlayer in reply to greygoose]

The good thing is the doctor seems to have done his homework on SHBG and testosterone and agrees that there is something physical exacerbating my depression / anxiety. So some progress.

[greygoose in reply to BluesPlayer]

Oh, yes, indeed! That is good. Full marks to him for effort.

[Trufflebuggy]

Did you have a calcium done when the PTH was high, if so what was the result?

[BluesPlayer in reply to Trufflebuggy]

Yes. Don’t know the exact result but was told by the doctor that the levels where fine. They said the most likely reason for an elevated parathyroid level was Vitamin D deficiency. They tested that and it came back at 75 which is fine. They offered to retest ‘ in a couple of months’.

Not a bad result considering I avoid the sun like the plague due to Rosacea. But had it tested by Medichecks in the thyroid package and it was still ok, so... Guess I still got enough over the summer as I don’t supplement.

[Trufflebuggy in reply to BluesPlayer]

hopefully just a transient high PTH, my mum had hyperparathyroidism she felt rotten for ages slightly high calcium on initial blood which wasn't followed up, but she fortunately saw a locum on one occasion and he reviewed all results was unhappy with the calcium and got it repeated with a PTH and bingo... She was in and it (1 of the 4) was whipped out and although it was a slow recovery (possibly due to her mum dying at the same time) she's right as rain now. They call it "moans and groans" due to aching bones and low mood/depression and things not being quite right.

[BluesPlayer in reply to Trufflebuggy]

Hope so!

Glad your mum has made a full recovery. It’s a different doctor i’m Seeing this time so i’ll ask him to look at the results and see what he makes of them.