ESR: Hi there, 7 months later and still not seen... - Thyroid UK

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ESR

Runbuddy profile image
9 Replies

Hi there, 7 months later and still not seen a consultant. I had a large thyroid nodule confirmation last Oct. After yet another trip to the doctors for feeling generally unwell with low mood and another bloodtest it would seem my tsh is still in the normal range :

207mu/l (0.27-4.5)

Again no t3-4 or Ft's probably due to being in range. But could someone please explain about ESR because I notice that in Feb I measured 6mm and this time it's lower

4mm/h (9.0-19.0)

I have been taking ferrous fumarate for 11 weeks.

Many thanks.

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Runbuddy
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SlowDragon profile image
SlowDragonAdministrator

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

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

Recommended on here that all thyroid blood tests should ideally be done as early as possible in morning and fasting. This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip, best not mentioned to GP or phlebotomist)

Ask GP to test vitamin D, folate, B12 and thyroid antibodies plus TSH FT3 and FT4

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

Runbuddy profile image
Runbuddy in reply to SlowDragon

Thank you, I have / do consider this often but I mistakenly thought that surely the gp would arrange it as they keep saying its a 'complete' bloodtest. My consultation was cancelled after waiting 6 months and now my gp has referred me to another hospital, feeling very let down.

MaisieGray profile image
MaisieGray in reply to Runbuddy

If you wished, you could find out which hospital has a shorter wait time, and have your referral moved to that one.

Mary-intussuception profile image
Mary-intussuception in reply to Runbuddy

It would help if you had all your blood tests results in full.

If in UK you can apply to the hospital by email or letter for copies of all your medical records. They have to supply them free of charge now (since new rules 25 May 2018 ). Then you can see exactly what has been tested and where in the range your 'normal ' results are. I would phone the hospital to enquire the email address of the person who deals with applications for copy records. It could be Medical Records Department or Legal Services.

You can ask for all records or just blood test and scan reports if you prefer.

Ask your GP /Practice Manager /Receptionist for print outs of your blood tests results.

With Autoimmune Thyroiditis (Hashimoto's ) the regular Thyroid Function blood tests results can fluctuate and fall within the normal range, so are not always reliable. Was there anything else shown up in the scan? Any Thyroiditis? You really need Antibodies tested too. Given that your Endocrinologist appointment has been cancelled, I would ask your GP to test TPO and TgAb ( Thyroid Peroxidase and Thyroglobulin Antibodies ). Say you would like to eliminate Autoimmune Thyroiditis. Ask for the Vitamin D, B12 etc too?

You could also phone the Secretary of the Endocrinologist you are now being referred to and ask how long you might wait to be seen. Explain your situation - the cancelled appoinment and the finding 7 months ago and how unwell you are.

When you get your records post results on here with dates & ranges in brackets and scan reports for comment.

SlowDragon profile image
SlowDragonAdministrator in reply to Runbuddy

Laboratory tests are often set up not to test FT4 or FT3 if TSH is within range

It's completely unacceptable to only test TSH once on Levothyroxine

Get hold of copies of previous testing and see exactly what has been tested and equally important what hasn't been tested yet

See GP and request both TPO and TG antibodies are tested if not been done before

Essential to regularly test vitamin levels at least 2 times per year

Make sure all Thyroid tests are as early as possible in morning and fasting. Last Levothyroxine 24 hours prior to blood test

Current NHS testing and treatment is not satisfactory

Hence almost 100,000 members on here

Many of us only made progress by getting FULL Thyroid and vitamin testing

Runbuddy profile image
Runbuddy in reply to SlowDragon

I'm not on any meds except amitriptyline because of the increased migraine and 2 x 12 week courses of ferrous fumarate over the past 15 months, even my levels for that were in range at 26 but I was dizzy so gp prescribed it. I'm hoping that the new gp I have just seen will help me more than the last 2!

SlowDragon profile image
SlowDragonAdministrator in reply to Runbuddy

Migraine is often a hypothyroid symptom

Getting vitamins and antibodies tested is next step

Looking for cause of low ferritin....

Persistent low vitamins with supplements suggests coeliac disease or gluten intolerance

gluten.org/resources/health...

MaisieGray profile image
MaisieGray

I'm assuming the TSH result is a typo and that you meant to write 2.07? If not, 207 would mean you are very hypothyroid.

ESR - Erythrocyte Sedimentation Rate - is an indirect/non-specific measure of the degree of inflammation present in the body, so an elevated result doesn't tell you what the problem is, only that there is some degree of inflammation for some reason. Conversely there can be inflammation present and the result show normal. As the name implies, the test measures the rate of fall (sedimentation) of erythrocytes (red blood cells) in a tall, thin tube of blood. Results are reported as how many millimetres of clear plasma are present at the top of the column after one hour. Normally, red cells fall slowly, leaving little clear plasma. Increased blood levels of certain proteins (such as fibrinogen or immunoglobulins, which are increased in inflammation) cause the red blood cells to fall more rapidly, increasing the ESR. Any abnormal ESR test results need to be considered together with other more specific test outcomes.

Runbuddy profile image
Runbuddy in reply to MaisieGray

Thank you, yes was a typo

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