Advice needed pls: Hi, looking for advice... I am... - Thyroid UK

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Advice needed pls

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Hi, looking for advice... I am a 44yr old male who has previously had an overactive thyroid several years ago. I was gradually taken off the Carbimazole and have been fine until the last 8-10weeks. I’ve been to see a GP a number of times, had a number of tests including a full blood count and had my thyroid checked. GP says my bloods are very encouraging and thyroid is fine. However, I have several symptoms which just don’t add up!

Any advice would be really helpful, getting pretty low and fed up of constantly feeling ill and a GP telling me I need counselling!

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31 Replies
SeasideSusie profile image
SeasideSusieRemembering

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I have several symptoms which just don’t add up!

Symptoms of overactive or underactive thyroid - some symptoms can be indicative of both?

The first thing to do is pop along to your surgery and ask at the reception desk for a print out of your blood test results. We are legally entitled to a copy, make sure it's a print out and don't accept verbal or hand written results (mistakes can happen).

Then post your results, with their reference ranges, on the forum for members to comment.

For a full picture ideally you need the following

TSH

FT4

FT3

Thyroid antibodies

Vit D

B12

Folate

Ferritin

and you can, of course, post your full blood count results as well.

in reply toSeasideSusie

Thank you. I’m not sure but I think the GP did TSH, FT4 and FT3? Can’t remember seeing the other detail, I’ll need to get a print on Monday.

Most my symptoms relate to under active, however, I have lost some weight in about 7weeks that may be due to stress and anxiety of a couple of tests I’ve recently had done (not thyroid related). Previous to this I may have gained weight but I’ve never really monitored my weight as it doesn’t tend to move much, but up until being ill I had definitely added a few lbs

in reply toSeasideSusie

Hi, recently had these tests done... all within range... not really sure what to do next.

Serum ferritin level 280 ug/L [30.0 - 400.0]

Serum vitamin B12 level 398 ng/L [197.0 - 771.0]

Serum folate level 4.7 ug/L [3.89 - 26.8]

in reply to

Previous thyroid function test

Thyroid function test

Serum TSH level 1.56 miu/L [0.3 - 5.5]

Serum free T4 level 17.8 pmol/L [12.0 - 22.0]

Serum free triiodothyronine level 5.4 pmol/L [3.1 - 6.8]

Serum thyroid peroxidase antibody concentration 277 ku/L [< 34.0] Outside reference range

SeasideSusie profile image
SeasideSusieRemembering in reply to

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GP says my bloods are very encouraging and thyroid is fine. However, I have several symptoms which just don’t add up!

Serum TSH level 1.56 miu/L [0.3 - 5.5]

Serum free T4 level 17.8 pmol/L [12.0 - 22.0]

Serum free triiodothyronine level 5.4 pmol/L [3.1 - 6.8]

Serum thyroid peroxidase antibody concentration 277 ku/L [< 34.0] Outside reference range

Your TSH. FT4 and FT3 aren't too bad. Your problem lies with the raised thyroid peroxidase antibodies - this is autoimmune thyroid disease aka Hashimoto's which is where the immune system attacks the thyroid and gradually destroys it. Hashimoto's isn't treated, it's the resulting hypothyroidism that's treated. The antibodies fluctuate and cause fluctuations in symptoms and test results and you can have symptoms of both hypothyroidism and hyperthyroidism.

SlowDragon has mentioned Hashi's in a previous reply further down the thread and has given information and links.

Vitamin D 25nmol/L (55.0-144.0)

I am on vitamin D tablets as prescribed yesterday by GP.

What dose D3? Presumably loading doses totalling 280,000-300,000iu over a period of weeks?

It's essential to retest after the loading doses so that you know what dose to continue with. If GP wont retest then please do a private test with this NHS lab which offers this test to the general public:

vitamindtest.org.uk/ cost is £29. Come back with your new level and I will point you in the direction of how to work out your next dose.

Your GP won't know, because they're not taught much about nutrients, but there are important cofactors needed when taking D3 as recommended by the Vit D Council -

vitamindcouncil.org/about-v...

D3 aids absorption of calcium from food and K2-MK7 directs the calcium to bones and teeth where it is needed and away from arteries and soft tissues where it can be deposited and cause problems such as hardening of the arteries, kidney stones, etc.

D3 and K2 are fat soluble so should be taken with the fattiest meal of the day, D3 four hours away from thyroid meds if taking tablets/capsules/softgels, no necessity if using an oral spray

Magnesium helps D3 to work. We need Magnesium so that the body utilises D3, it's required to convert Vit D into it's active form. So it's important we ensure we take magnesium when supplementing with D3.

Magnesium comes in different forms, check to see which would suit you best and as it's calming it's best taken in the evening, four hours away from thyroid meds if taking tablets/capsules, no necessity if using topical forms of magnesium.

naturalnews.com/046401_magn...

Check out the other cofactors too (some of which can be obtained from food).

in reply toSeasideSusie

Loading dose of d3 was 300,000iu but over 15days. Now taking maintenance dose of 4000iu daily. Doctor said he’d retest in a couple of months, is it still worth getting a retest privately? I am taking k2 about 400 daily and boron 3mcg daily. Oh and magnesium daily as I’ve been advised these help with the D3.

So, my symptoms come and go on a weekly basis. I can go two or three days feeling okay, then it hits me again and I feel terrible for a few hours, really getting me down at the moment. Endo written back to GP and isn’t concerned by antibodies as he said most people who have had a thyroid disorder (I was over 7yrs ago) will have antibodies present. Refused to retest for another 12 months

SeasideSusie profile image
SeasideSusieRemembering in reply to

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Doctor said he’d retest in a couple of months, is it still worth getting a retest privately?

As long as your GP retests that's fine, no need for a private test at this stage. Make absolutely sure you are retested, one way or another, post result because by then you may only need a maintenance dose and we can work that out.

I am taking k2 about 400 daily

I wouldn't take that much. 90-100mcg K2 is said to be enough for up to 10,000iu D3. K2 is fat soluble, like D3, so too much will get stored rather than be excreted like a water soluble vitamin.

Endo written back to GP and isn’t concerned by antibodies as he said most people who have had a thyroid disorder (I was over 7yrs ago) will have antibodies present. Refused to retest for another 12 months

Most doctors dismiss antibodies as being of no importance and know little or nothing about Hashi's and how it affects the patient, test results and symptoms. You need to read, learn, understand and help yourself where Hashi's is concerned. Are you trialling a gluten free diet for a few months? Taking selenium selenium l-selenomethionine 200mcg daily which is said can help reduce the antibodies, as can keeping TSH suppressed.

Hashi's is the most common cause of hypothyroidism but there are plenty of us who do not have Hashi's but are hypothyroid.

No need to retest antibodies, once they are raised and confirm Hashi's that's it, even if tested and they are low you'll still have Hashi's, because antibodies fluctuate so not really much to be gained from retesting.

in reply toSeasideSusie

Thank you for explaining. So confusing and frustrating. Doctors just seem to look at symptoms individually rather than collectively. I hardly ever go to the doctors and feel like I live there currently.

So is it common that my symptoms come and go frequently?

SeasideSusie profile image
SeasideSusieRemembering in reply to

So is it common that my symptoms come and go frequently?

It's common with Hashi's for symptoms to fluctuate, how frequently is individual. I don't have Hashi's (for which I am eternally thankful) but I imagine it's a pig to live with!

in reply toSeasideSusie

It certainly is a pig. Looking back, I have obviously had symptoms a while, the feeling I’m coming down with something only for it to go, now getting more frequent.

SeasideSusie profile image
SeasideSusieRemembering in reply to

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Serum ferritin level 280 ug/L [30.0 - 400.0]

That's a bit high but probably nothing to worry about, maybe a bit high due to infection or inflammation. Recommended is half way through range but I've seen it said that for males 150 is a good level. But it's within range.

Serum vitamin B12 level 398 ng/L [197.0 - 771.0] (ng/L is the same as pg/ml)

This is on the low side. According to an extract from the book, "Could it be B12?" by Sally M. Pacholok:

"We believe that the 'normal' serum B12 threshold needs to be raised from 200 pg/ml to at least 450 pg/ml because deficiencies begin to appear in the cerebrospinal fluid below 550".

"For brain and nervous system health and prevention of disease in older adults, serum B12 levels should be maintained near or above 1000 pg/ml."

However, an Active B12 test gives a better idea as it shows the amount of B12 that is available to be taken up by the cells. I don't think the NHS normally do Active B12 but Medichecks does a fingerprick test for this. If the result is below 70 then that suggests testing for B12 deficiency.

You can check for signs of B12 deficiency here

b12deficiency.info/signs-an...

Serum folate level 4.7 ug/L [3.89 - 26.8]

This is low, recommended is at least half way through range. Eating folate rich foods will help, and a good B Complex containing methylfolate, not folic acid, will raise your level. Consider Thorne Basic B or Igennus Super B, both are good quality supplements with bioactive ingredients. They also contain methylcobalamin and if you don't have B12 deficiency then either of these would help to raise your B12 level too. Don't start B Complex until after further testing of B12 if this is necessary. Also, for all future blood tests, leave off B Complex for 7 days as it contains Biotin (B7) and if Biotin is used in the testing procedure then it will give false results. Medichecks do use Biotin in their assay and they have advised to leave it off for 7 days before testing.

Monique66 profile image
Monique66

Can you see another GP in the practice, get a second opinion?

in reply toMonique66

I’ve seen a few different ones already. All making me feel like I’m making it up. They take one look at my bloods and tell me I’m good. 🤬

Monique66 profile image
Monique66 in reply to

Would seeing a consultant privately be an option?

in reply toMonique66

Going to see what they say Monday and then look in to this I think. Thank you

Monique66 profile image
Monique66 in reply to

Please let me know how you get on.

in reply toMonique66

Will do thank you

in reply toMonique66

Hi Monique66,

A little update for you... I didn’t give up and badgered my GP to do another blood test!

So!!! I wasn’t going mad or being a hypochondriac! Last blood tests, fine no further action (gp put notes on). This is the reply I got when phoning up for recent test results.

Thyroid function is within range, but thyroid antibodies off the clock! I’ve now had a vitamin D test, which I had this morning.

I found out by booking a further Gp appointment yesterday after work, not happy with yet another “normal” blood test. Whilst in waiting room I realised they’d booked me an appointment with a nurse practitioner, was about to walk out and give up at that point as I thought it wouldn’t be much help seeing him... how wrong was I! He was brilliant, asked about my symptoms and actually listened, then talked me through my blood test.

LeilaT profile image
LeilaT

Hey Craig, do you mind me asking what your symptoms are? I’m going through a very similar situation, though I’m waiting for my results now...

in reply toLeilaT

Hi. Few things going on at min... tiredness, pains/pins and needles in hands and sometimes feet, pain in wrist, dizziness, tired/weak muscles, had an RTI, balance, post nasal drip. Really getting me down at min

Monique66 profile image
Monique66

Hi Craig914, i know from personal experience some of these symptoms can be due to a lack of Vitamin D, please let us know how it goes with the blood test.

Hi, managed to eventually get some results off the doctors.

The GP has emailed the Endo for advice reference the TPO levels and I am on vitamin D tablets as prescribed yesterday by GP.

TSH 1.56 miu/L (0.3-5.5)

Free T4 17.8 (12.0-22.0)

Free T3 5.4 (3.1-6.8)

Peroxiside anti 277 (<34)

Vitamin D 25nmol/L (55.0-144.0)

C Reactive Protein <0.5 miu/L (<0.5)

Creatine kinase level 94iu/L (24.0-195.0)

SlowDragon profile image
SlowDragonAdministrator in reply to

You also need B12, folate, ferritin tested

Your vitamin D was very low

The others may be too

Have you had Graves' disease confirmed by TSI or TRab antibodies test?

High TPO antibodies is more likely Hashimoto's, though you can have high TPO antibodies with Graves Disease

We see quite a few early stage Hashimoto's patients misdiagnosed as Graves, as medics have assumed low TSH and high FT4/FT3 is Graves

Early stage Hashimoto's often starts with temporary hyper type blood tests and symptoms

For full Thyroid evaluation you need TSH, FT4 and FT3 plus both TPO and TG thyroid antibodies tested for Hashimoto's or Graves.

Private testing for suspected Graves - TSI or TRab antibodies

medichecks.com/thyroid-func...

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)

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

Medichecks currently have an offer on until end of May - 20% off

thyroiduk.org.uk/index.html

If TPO or TG antibodies are high this is usually Hashimoto's, (also known by medics here in UK more commonly as autoimmune thyroid disease). Can also be raised due to Graves

About 90% of all hypothyroidism in Uk is due to Hashimoto's.

Low vitamins are especially common with Hashimoto's or Graves

Food intolerances are very common too, especially gluten.

So it's important to get TPO and TG and TSI or TRab 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_...

Changing to a strictly gluten free diet may help reduce symptoms, help gut heal and slowly lower TPO antibodies

While still eating high levels of gluten ask GP for coeliac blood test first or buy test online for under £20, just to rule it out first

Assuming test is negative you can immediately go on strictly gluten free diet

(If test is positive you will need to remain on high gluten diet until endoscopy, maximum 6 weeks wait officially)

Trying gluten free diet for 3-6 months. If no noticeable improvement then reintroduce gluten and see if symptoms get worse

chriskresser.com/the-gluten...

amymyersmd.com/2018/04/3-re...

thyroidpharmacist.com/artic...

scdlifestyle.com/2014/08/th...

drknews.com/changing-your-d...

restartmed.com/hashimotos-g...

in reply toSlowDragon

Hi SlowDragon,

Recent tests... any suggestions? Little confused with them being in range and still feeling s**t, thanks. 👍🏻

Also, not sure I mentioned previously, the endo wrote back to my GP and advised against his retesting my thyroid function of 1-3months! Endo said no point and do it in 12months... also stated that raised antibodies are common amongst someone who has previously had a thyroid issue (I was overactive 7 yrs ago).

I’d convinced myself this was the issue but they just don’t seem to think it is.

Blood haematinic levels

Serum ferritin level 280 ug/L [30.0 - 400.0]

Serum vitamin B12 level 398 ng/L [197.0 - 771.0]

Serum folate level 4.7 ug/L [3.89 - 26.8]

SlowDragon profile image
SlowDragonAdministrator in reply to

Ferritin is good

Folate and B12 are low

Your GP very unlikely to agree to testing for pernicious Anaemia

Two options

Pay for further testing of B12 including MMA and homocysteine

Or try adding a daily good quality vitamin B complex

One with folate in not folic acid

Eg Igennus super B complex (suggest you start with just one per day- not full dose of 2 per day)

Do you have any low B12 symptoms?

You need vitamin D tested

Test for £29 via NHS postal kit

vitamindtest.org.uk

High thyroid antibodies often cause symptoms

Strictly gluten free diet helps thousands

in reply toSlowDragon

Vitamin D was very low, previously posted. 25 (50-144). Had the loading dose and now on maintain dose.

Symptoms very much around vit D but also have pins and needles, sore tongue (they say it’s inflamed taste buds), irritable, tiredness, numbness/tingling in hands and feet and sometimes face.

SlowDragon profile image
SlowDragonAdministrator in reply to

All those suggest B12 deficiency symptoms - swollen younger, pins & needles

b12deficiency.info/signs-an...

Very common to have low B12 symptoms with thyroid issues, especially with high antibodies

Common for B12 symptoms to get worseafter improving very low vitamin D as well

Explains why here

drgominak.com/sleep/vitamin...

B12 and folate on the low side. Supplementing a good quality daily vitamin B complex, one with folate in not folic acid may be beneficial.

chriskresser.com/folate-vs-...

B vitamins best taken in the morning after breakfast

Recommended brands on here are Igennus Super B complex. (Often only need one tablet per day, not two. Certainly only start with one tablet per day after breakfast. Retesting levels in 6-8 weeks ).

Or Jarrow B-right is popular choice, but is large capsule

If you are taking vitamin B complex, or any supplements containing biotin, remember to stop these 7 days before any blood tests, as biotin can falsely affect test results

endo.confex.com/endo/2016en...

endocrinenews.endocrine.org...

As you also have specific low B12 symptoms you may also need sublingual B12 tablets for several months

Vitamin D needs retesting twice yearly. Common to need higher maintenance dose than average with high thyroid antibodies

Trying a strictly gluten free diet for 3-6 months strongly recommended

If no noticeable improvement then reintroduce gluten and see if symptoms get worse

chriskresser.com/the-gluten...

amymyersmd.com/2018/04/3-re...

thyroidpharmacist.com/artic...

scdlifestyle.com/2014/08/th...

drknews.com/changing-your-d...

restartmed.com/hashimotos-g...

healthcentral.com/article/t...

in reply toSlowDragon

Really helpful, thank you so much.

Hi SlowDragon,

I’ll revisit GP and ask for other vitamin tests. Thanks.

I had an overactive thyroid about 7 yrs ago.

I seem to have many symptoms that point to an under active thyroid now but am I right in saying they can be very similar? GP’s I’ve seen and I’ve seen plenty recently, just dismiss the idea of it being thyroid.... I’ve been told it’s a number of different issues not one, and I’ve also been given a leaflet and forms for counselling 🤬

SlowDragon profile image
SlowDragonAdministrator in reply to

This obsession with assuming someone is depressed and needs counselling when actually they have clear physical issues going on is far too prevalent

Would they send someone with broken leg to counselling or to get leg put in plaster!!!

Worth asking for cholesterol test too. High cholesterol is linked to being hypothyroid

nhs.uk/conditions/statins/c...

If you have an underactive thyroid (hypothyroidism), treatment may be delayed until this problem is treated. This is because having an underactive thyroid can lead to an increased cholesterol level, and treating hypothyroidism may cause your cholesterol level to decrease, without the need for statins. Statins are also more likely to cause muscle damage in people with an underactive thyroid.

Three different GP’s have mentioned either counselling or depression! Had a FBC 3 times now in last 3 months. Cholesterol is fine at minute.

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