Help with Test results and what to do next? - Thyroid UK

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Help with Test results and what to do next?

JJericho profile image
12 Replies

Hey

I have been feeling unwell the last few years. I am 32 male and really struggling with health issues. I had no idea what was happening with my body, (I genuinely thought I was dying). However results for high TSH, low vit D and low folate as well as reading this forum has made me think it may be my thyroid. I've really appreciated reading through and all the helpful tips given on this site. I am going to list all my symptoms below

I am always tired and have bad muscle aches particularly in my legs. I feel like I need to sleep constantly and get really warn out doing simple tasks like climbing the stairs. All my muscles ache and cramp. I always have been active and in to my fitness, yet really have no energy. I have put on over 2.5 stone in weight the last six months.

My brain fog has got worse and worse I feel like I've lost all my intelligence and struggle to even concentrate on basic things like following tv and conversations.

I feel really cold all the time, I suffered very badly with this in winter. Its a deep cold feeling and I found it impossible to get warm. Particularly in my fingers

I have had a lot of hair loss very suddenly evenly on the top of my head and my eyebrows have lost hair, my facial hair has really noticeably slowed growth. I also have ED.

Recently I have constant constipation no matter what I eat and earlier this year I had symptoms of IBS for 3 months that just went away. I also have suffered with bad acid reflux.

I also have a tightness/ slight soreness at the bottom of my throat that almost feel cold in my throat.

Genuinely just feeling terrible which has really got worse the last 2 years

Below are my results which were taken in my last full test about 8 weeks ago.

TSH 7 miu/L (0.3 - 5.5) Above Range

Serum free T4 level 13 pmo/L (10 - 22)

Serum B12 462 ng/L (211-900)

Serum Ferratin 344ng/L (15-400)

Serum Folate 2.3ngm/L (4-20) Below Range

I take both iron and vitamin D. I have taken vitamin D supplements on prescription for 6 months as last time I was tested I was below range but don't know the exact results.

After this test my gp has put me on folic acid supplements. My initial test was at 8.30 in the morning with no food. I was told to retest in 6 weeks. My second test was at 3pm in the afternoon and I drank a lot of coffee and ate before. They only tested my TSH and it was 2.5 (0.3 - 5.5). I haven't booked a follow up appointment as I wanted to get advice first. The TSH level has dropped significantly and my symptoms have not improved? Would the time/eating make this much of an impact?

I 'm suffering badly from symptoms and out of work, any help would be really appreciated. I know the doctors may say my first test was a false result, how likely is this?

Thanks so much

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JJericho
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SeasideSusie profile image
SeasideSusieRemembering

JJericho

My initial test was at 8.30 in the morning with no food.

My second test was at 3pm in the afternoon and I drank a lot of coffee and ate before.

Would the time/eating make this much of an impact?

Yes. TSH is highest early morning and lowers throughout the day.

Eating lowers TSH as explained by member Diogenes who is advisor to Thyroid UK and a scientist/thyroid researcher.

Coffee affects TSH.

When doing thyroid tests, we advise:

* Book the first appointment of the morning, or with private tests at home no later than 9am. This is because TSH is highest early morning and lowers throughout the day. If we are looking for a diagnosis of hypothyroidism, or looking for an increase in dose or to avoid a reduction then we need TSH to be as high as possible.

* Fast overnight - have your evening meal/supper as normal the night before but delay breakfast on the day of the test and drink water only until after the blood draw. Eating may lower TSH, caffeine containing drinks affect TSH.

* If taking thyroid hormone replacement, last dose of Levo should be 24 hours before blood draw, if taking NDT or T3 then last dose should be 8-12 hours before blood draw. Adjust timing the day before if necessary. This avoids measuring hormone levels at their peak after ingestion of hormone replacement. Take your thyroid meds after the blood draw. Taking your dose too close to the blood draw will give false high results, leaving any longer gap will give false low results.

* If you take Biotin or a B Complex containing Biotin (B7), leave this off for 7 days before any blood test. This is because if Biotin is used in the testing procedure it will give false results (Medichecks definitely use Biotin, they have confirmed this and the amount of time to leave the supplement off).

These are patient to patient tips which we don't discuss with doctors or phlebotomists.

TSH 7 miu/L (0.3 - 5.5) Above Range

Serum free T4 level 13 pmo/L (10 - 22)

Those results are definitely hypothyroid and would get you a diagnosis in some other countries. In the UK we have to wait until it reaches 10 unless positive thyroid antibodies are present and then an enlightened doctor may start Levo. Your symptoms also point to hypothyroidism.

I know the doctors may say my first test was a false result, how likely is this?

I would say unlikely, especially considering your symptoms. When testing for the first time and having an over range TSH, it's normal to repeat the test just in case it was a non-thyroidal illness causing the raised TSH. Unfortunately, your second test wasn't done under the same circumstances and the timing has made a difference to your result. You really could do with a full thyroid panel to include

TSH

FT4

FT3

Thyroid antibodies - Thyroid Peroxidase (TPO) and Thyroglobulin (Tg).

You probably wont get FT3 and thyroid antibodies done with your GP but we do have recommended private labs who do all sorts of thyroid and other test bundles with either a fingerprick or venous blood draw test.

Serum Ferratin 344ng/L (15-400)

I take both iron and vitamin D. I have taken vitamin D supplements on prescription for 6 months as last time I was tested I was below range but don't know the exact results.

Are your iron tablets prescribed? If so why, when your Ferritin is now so high in range? Have you had an iron panel, do you know your serum iron result? You should ask for a print out of all your results from the reception desk at your surgery.

If your Vit D is prescribed - did you have loading doses totalling 300,000iu over a number of weeks? If so then you had Vit D deficiency.

Have you finished the loading doses?

Were you retested?

What dose are you taking now?

There are important cofactors needed when taking D3 which your GP wont know about, I don't suppose you're taking magnesium and Vit K2 are you?

JJericho profile image
JJericho in reply to SeasideSusie

Thank you for the response.

I admit I am clueless on the vitamin D side, I know I had vitamin D deficiency back in April and have been taking tablets since. Honestly a bowel specialist told me I was vitamin D deficient and I just went and brought tablets over the counter, I haven't spoke to my GP about it. It was a bit of an after thought at the time but I realise its links to thyroid are important and I will make an appointment and discuss it with my GP. My current dose is 10 micro grams of d3.

The only vitamins I take are d3, folic acid and iron. I started taking iron about 6 months ago because I thought my symptoms might be blood flow related and have just continued taking it, it was never prescribed. Should I stop taking iron? I will discuss with my GP on my next appointment.

Thanks

SeasideSusie profile image
SeasideSusieRemembering in reply to JJericho

I have taken vitamin D supplements on prescription for 6 months as last time I was tested I was below range but don't know the exact results.

I know I had vitamin D deficiency back in April and have been taking tablets since. Honestly a bowel specialist told me I was vitamin D deficient and I just went and brought tablets over the counter, I haven't spoke to my GP about it.

So those two statements seem to contradict each other. Can you please clarify? If you had them on prescription, how much was prescribed and for how long? Were you retested by your doctor?

Is the 10mcg what you are buying yourself? That is a tiddly amount and wouldn't raise the level of a suburnt flea. Also tablets are the least absorbable form of D3. Softgels are the best of the swallowed supplements, and there are also oral sprays and sublingual liquids.

You really need to retest Vit D now. Please either ask your GP to retest your Vit D or do a private test with an NHS lab which offers this test to the general public:

vitamindtest.org.uk/

Post your result on the forum, tag me if you like and I will point you in the direction of where you can find out what dose you need and the important cofactors that are needed when taking D3.

I started taking iron about 6 months ago because I thought my symptoms might be blood flow related and have just continued taking it, it was never prescribed. Should I stop taking iron?

Too much iron is as bad as too little. It can be toxic. We shouldn't take iron tablets unless we know we need them so that means an iron panel and full blood count being done. Your high in range current ferritin level doesn't suggest that you need to take them.

JJericho profile image
JJericho in reply to SeasideSusie

I'm sorry it was my mistake, I never picked up my prescription and just brought them over the counter instead. I didn't really think specifically about it when writing my first post but when given more thought, this is what happened apologies for been misleading . I realise now this was a mistake and I will go and see what amount the prescription was for and start taking an appropriate dose. Again at the time I brushed over the vitamin D (thinking it might be seasonal) but I will get clarification on this. Again this has been very helpful and I can ask my GP about this:).

Thanks for the advice I will stop taking the iron, if I can get a diagnoses I will try and push for more vitamin tests. It takes about 2 weeks just to get blood drawn in my area so I will ask for a more comprehensive test than just the TSH and see what I can get.

SeasideSusie profile image
SeasideSusieRemembering in reply to JJericho

As I mentioned, there are important cofactors needed when taking D3 and it's important to take the right D3 dose and type of supplement. Come back with your results for further help.

greygoose profile image
greygoose

The time difference and eating/drinking coffee certainly could cause your TSH to drop, but it's impossible to say by how much. We always recommend having your blood draw before 9 am, after fasting over-night - just water until after the blood draw.

But, even at 2.5 your TSH is too high for a healthy thyroid. And, whilst your symptoms sound very much like hypo, some of them could also be due to low zinc or magnesium - both of which you probably have. But, no point in testing magnesium, because the results would not be helpful. Just take some - about 400 mg.

I would not take folic acid, if I were you, I would get myself a good B complex, containing methylfolate and methylcobalamin (B12), and take that. You B12 could possibly do with being higher.

Are you taking anything for the acid reflux? I wouldn't take PPIs, if I were you, which is what doctors usually prescribe for that. They are not good things to take, and your acid reflux is more likely to be low than high. What you need is something to increase the acid, not lower it. Something like apple cider vinager in water before meals.

If you're taking vit D, are you taking the co-factors, like magnesium and vit K2-MK7? And, are you taking vit C with your iron? You can take a good dose of vit C, and it will help with your constipation, something like 2/3000 mg spread out through the day.

I doubt your first TSH was a false result because it goes with the low FT4. It's far more likely that the second test was wrong, due to the time and drinking coffee. But, in any case, you cannot compare them because they weren't done under the same conditions. Next time, make sure you have the blood draw early. :)

A TSH of 7 is definitely hypo, but, doctors would want a second test with the same result to diagnose. Because there can be other things, like infections that can cause the TSH to rise. But, you also need your antibodies tested - Thyro Peroxidase antibodies. These will show if you have autoimmune thyroiditis, which would mean that the levels can jump around a bit. (It's actually a lot more complicated than that, but I'll spare you the details for the time being. Get your diagnosis first.) :)

JJericho profile image
JJericho in reply to greygoose

Thanks for the reply. I think the best thing to do would be to ask for a retest from the GP, I will ask for the anti bodies. I will do one online for antibodies if I cannot get one from the GP.

Thank you for the advice concerning vitamins. I am only taking Folic acid, D3 and iron tablets currently, no other medication. I have been careful with my diet and the acid reflux seems to have lowered but all other symptoms are remaining. I will start taking magnesium and spend a bit of time looking at diet and supplements that can help with hypo. Thank you for the advice I will see how I get on with the GP and hopefully this will give me a better understanding.

greygoose profile image
greygoose in reply to JJericho

There aren't really any supplements that can help with hypo, although all your nutrients need to be optimal. And, for goodness sake, do not get one of those supplements that call themselves 'thyroid support. They are full of things that a hypo really should not take. Like iodine. They're a bit of a scam, really.

I would strongly advise you to take vit C with your iron, and vit K2-MK7 with your vit D. They are very important co-factors. And, try zinc for muscle aches. Zinc is also important for converting T4 to T3. And, a B complex instead of folic acid, as explained above. :)

Mama196 profile image
Mama196

Hi I’ve suffered weak achy joints as my major symptom and recently miscarriages. Thyroid issues only picked up while trying to conceive several years ago.

My tests over the last several years have always shown normal results and with slight tweaks to thyroid medication the GP said all was ok but my achy muscles have gotten much worse.

Since miscarriages in last year I’ve done a lot of research and I made sure my last blood test was at 8:30 and 24 hours after my last medication dose. This finally showed my TSH was too high, they increased my dose and within 1 week all my aches and pains had gone (after 2 years, I really still can’t believe it!)

From my understanding, your symptoms seem classic thyroid so it must come down to testing. If you do everything you can to maximise an accurate test result and it’s still normal then maybe time to consider other things.

I read a good book by Dr Kharrazian which explains that you can easily switch between hypothyroidism and hyperthyroidism as your thyroid gland gets damaged and it can confuse the situation for Drs, unless they know about this!

Good luck, I really hope you get answers- it does not sound like you’re too healthy if tired all the time.

Mama196 profile image
Mama196 in reply to Mama196

Also I followed the advice of the really helpful posters above and it worked- this app is so incredibly helpful! PS My TSH was 4.5 at last test and I’m now on 125mcg levothyroxine- waiting a few weeks to retest and hoping it will now be closer to 1 so we can try and conceive again. Results should be interesting to see.

JJericho profile image
JJericho in reply to Mama196

Thanks for the advice and I am glad your feeling better. I will need to get tested for autoimmune disease.

Yeah I am feeling really unhealthy, I am going to ask my GP for another test and will post the outcome on here.

Good luck with your retests and hope the results are better.

SlowDragon profile image
SlowDragonAdministrator

Essential to see exactly what your vitamin D results were before you started supplementing

Depending how low results were, depends what levels of supplements you required

Local CCG guidelines

clinox.info/clinical-suppor...

GP will only prescribe to bring vitamin D up to 50nmol. Aiming to improve by self supplementing to at least 80nmol and around 100nmol may be better .

Once you Improve level, very likely you will need on going maintenance dose to keep it there.

Retesting twice yearly via vitamindtest.org.uk

Vitamin D mouth spray by Better You is good as avoids poor gut function.

It's trial and error what dose each person needs.

Government recommends everyone supplement October to April

gov.uk/government/news/phe-...

Levels of vitamin D need retesting

vitamindtest.org.uk

Getting full Thyroid testing, most likely privately is next step

TSH, FT3 and FT4 plus both TPO and TG thyroid antibodies

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

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