Advice please - new here.

[Bodie15]

Hi there

Thanks in advance for reading & I’m looking for some advice. I’m sorry I don’t have reference ranges as I’ve either been told these results or seen them on screen.

I went to see GP believing myself to be menopausal - he arranged some blood tests. Menopause came back clear but I had raised TSH of 5.5. I was advised to come back 4 weeks later for another blood test. This returned TSH of 6.5, I was then advised to come back in 6 months. As I wasn’t happy with this I booked in to see GP - then he advised this was mistaken advice as I showed TPO antibodies of 201 - my T4 was 12.1 down from 13.4 on previous visit.

He requested another blood test - I’ve had partial results (over phone) and TSH is now down to 5.10 waiting till Monday for TPO & find out what GP thinks.

My concern is that he will put me on a watch & wait routine & the reason this bothers me is I’m still exhausted, feeling achy & unmotivated amongst other things.

My GP is generally good in my opinion but is there anything else you’d recommend if this is his position? Also is fluctuations in TSH usual?

All test were done at the same time (before 9am) without food.

Thanks for reading.

[SilverAvocado]

Bodie15, in this case the ranges aren't really necessary, because its quite clear cut. These are high TSH results.

This stands for Thyroid stimulating hormone. Its a chemical messenger produced in the pituitary to tell your thyroid to make more hormone. A person with a healthy thyroid would have a TSH of about 0.8-2. If thyroid hormone in the body drops low, then the TSH will rise to indicate we need more.

My personal cut off is about 2.5, if a TSH rises above that we can be pretty sure that there is something going on with the thyroid. All your measures have been quite a bit higher than that. Unfortunately doctors will have a higher threshold. Some take the top of the range as their cut off, which will likely be between about 3.5 and 4.5, so yours are clearly over. Unfortunately some wait for it to go as high as 10.

[SlowDragon Administrator]

With high thyroid antibodies levels do fluctuate

For full Thyroid evaluation you need TSH, FT4 and FT3 plus both TPO and TG thyroid antibodies tested.

Also 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 vitamins at next visit

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

Hashimoto's affects the gut and frequently leads to low stomach acid and then low vitamin levels

Do you have any gut symptoms?

Low vitamin levels affect Thyroid hormone working

Poor gut function can lead leaky gut (literally holes in gut wall) this can cause food intolerances. Most common by far is gluten. Dairy is second most common.

According to Izabella Wentz the Thyroid Pharmacist approx 5% with Hashimoto's are coeliac, but over 80% find gluten free diet helps, sometimes significantly. Either due to direct gluten intolerance (no test available) or due to leaky gut and gluten causing molecular mimicry (see Amy Myers link)

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

While still eating high gluten diet 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...

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

restartmed.com/hashimotos-g...

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[Bodie15 in reply to SlowDragon]

Thanks both for replies, I will discuss with my GP the additional tests on Monday, and consider private testing/purchase of gluten test if its not an option with surgery.

In terms of gut health I’ve thought for awhile I’ve got ibs/something similar as I’m often constipated and or bloated.

Looking through here, I’ve a number of symptoms I’ve just sidelined for other reasons. Weight gain, tiredness, bloating & constipation, amongst a few.

Thanks for replying and I’ll update with the outcome next week.

[Bodie15 in reply to Bodie15]

Just to update you both as you took the time to reply, as expected I’m on a watch & wait because my TSH (5.10) & TPO antibodies (183<35) both reduced. I’ve been referred to an Endocrinologist but obviously that could be months away.

Back in 4 weeks for another BT.