Recent Medichecks Results

[Elsa1509]

I have had my thyroid tested this week as I have worsening symptoms. These are:

Profound muscle weakness and pain

Exercise intolerance

Significant palpitations

Mild panic attacks and anxiety

Extreme fatigue

Increased appetite and some weight loss (Strangely!)

TSH 1.34. (0.27 - 4.2)

FT3 3.19 (3.1 - 6.8)

FT4. 13.2. (12 - 22)

For once I did my test mid afternoon after breakfast and lunch and a walk as I wanted to see why I nosedive so badly in the afternoon and have to rest (although anxiety is worse on waking).

My Vit D, folate and B12 are all high in range so I don’t think that is contributing. My ferritin is always low but a few months ago it had reached 17 (11 - 150). I take one Ferrous Fumerate every day (210mg).

I have diagnosed autoimmune thyroid disease and a multinodular normal size thyroid gland. TPO antibodies (248 iu/ml ) and TgAb (1,200 iu/ml).

Should I be asking my GP for thyroxine based on these results ? Feeling a bit desperate really 😕

Thank you so much for any thoughts!

[greygoose]

Yes, you should. Your FT3 is rock bottom. Not surprising you have symptoms. Your FT4 is also low. And, your TSH doesn't reflect this, so rather doubtful he will give you levo, as they only tend to look at the TSH.

Seems to me that there might be a slight pituitary problem, here - Secondary Hypo. It is possible to have both Hashi's and Secondary Hypo. But GPs know nothing about that. So, you would need to do your homework on that one, before mentioning it to him. You need to be referred to an endo.

Secondary Hypo is when the problem lies with the pituitary rather than the thyroid (Primary Hypo). For some reason, the pituitary is unable to make enough Thyroid Stimulating Hormone (TSH) to stimulate the thyroid to make enough thyroid hormone (T4 and T3). So, you have low FT4/3, but also low normal TSH. You need a brain scan and other pituitary hormones tested to confirm Secondary Hypo.

[Elsa1509 in reply to greygoose]

Thank you so much greygoose. I will take my results to my GP who is relatively understanding and kind but has just described me as “complicated”. Sometimes my FT4 is mid range or higher but this has always been on early am tests and fasting. My TSH is about the same on these early tests as well - for once I wanted to see what my thyroid hormones get up to later in the day ! I am feeling really down about it all and now have to face the battle with the GP.... thank you so much for your advice.

[greygoose in reply to Elsa1509]

Your FT4 level shouldn't vary with the time of day. So, maybe that's due to the Hashi's. If your TSH is the same early morning and later in the day, then that could indicate a pituitary problem.

[Elsa1509 in reply to greygoose]

Thank you Greygoose. I blame the rock climbing accident I had years ago when I smashed the back of my head (fortunately with helmet on) into the rock! I don’t think that has helped my pituitary! Thanks for all your advice.

[greygoose in reply to Elsa1509]

Ah, well, that could very well be the problem, then. Don't forget to tell your doctor that.

[Elsa1509 in reply to greygoose]

Thank you Greygoose - if my woolly brain can remember I definitely won’t forget !

[greygoose in reply to Elsa1509]

Write it down. Write everything you want to say on a piece of paper so that you don't forget anything.

[Elsa1509 in reply to greygoose]

Yes I will do ! My GP will probably groan inwardly when I get my piece of paper out 😂. Too bad ! Thank you 😊

[greygoose in reply to Elsa1509]

You're welcome.

[SeasideSusie Remembering]

My ferritin is always low but a few months ago it had reached 17 (11 - 150). I take one Ferrous Fumerate every day (210mg).

This level of ferritin is far too low. It's recommended to be half way through range, and apparently it needs to be at least 70 for thyroid hormone to work (our own as well as replacement hormone).

Is the ferrous fumarate prescribed?

Was an iron panel and full blood count carried out to see if you have anaemia?

If you have iron deficiency anaemia then 1 x FF daily is not the correct treatment.

Do you take your iron tablet with 1000mg Vit C to aid absorption and help prevent constipation?

Symptoms of low ferritin are listed within this article:

restartmed.com/low-ferritin/

[Elsa1509 in reply to SeasideSusie]

Thank you SeasideSusie. My ferritin is always low and a full iron count last year led to an urgent NHS referral for gastroscopy and infusion. I literally had no iron in me ! In 2012 my ferritin dropped to 3 and last year it was 5. I have struggled for years despite being a meat eater and always taking FF tablets with 1000mg Vit C. My physician at the hospital just says I cannot store iron 😣! I am not celiac (biopsy done last year). The ‘iron battle’ will continue till after the menopause (which is round the corner I believe !). Thank you!