I have been experiencing symptoms (listed below) for about 3-4 years now. GP advised I had low Vitamin D & B12. Vitamin D issue rectified with oil capsules prescribed by GP, was prescribed a high dosage of Vitamin B12 in tablet form for 3 months, when I went back and was retested the B12 levels we're lower than before so GP advised it was an absorption issue. I was started on B12 injections then. Got 8 injections in the space of a few weeks. Haven't had one in over a year now. Got retested recently and she advised the B12 level was on the low side of normal but as was within range nothing she could do. She wouldn't give me copies of blood tests so don't have figures on B12 levels, will get this tested privately too. Got thyroid levels tested privately, see results below. Feel like I'm not getting anywhere with the GP, and at the end of my tether as am not being taken seriously. Hoping that someone can point me in the right direction or offer any advice on how to understand the blood results? Thank you
Symptoms I Am Experiencing:
Extreme fatigue, Weight gain & inability to lose weight, dry skin, very poor short term memory, brain fog, difficulty concentrating, constipation, anxiety, very low motivation, night sweats of the head/chest
Can you please add the reference ranges for your results, these vary from lab to lab so to interpret your results we need the ranges that came with them.
From this page you just need to go from Step 3 onwards.
Doctors wont give you your results as a matter of course. You need to ask for them, and asking a doctor is not a good idea, they don't like you knowing, so always ask the receptionist for a print out of your test results every time you have any tests, they're usually back 2 or 3 days after the blood draw.
Hi SeasideSusie, Thanks for your reply! Apologies, I have now edited to include reference ranges. I have asked my GP a few times and she refused outright, so will definitely take your advice next time and ask the receptionist. Thanks again.
If you are in England then GPs are supposed to offer online access to results but apparently not all do (I live in Wales and my area doesn't do this).
I just go to the receptionist, ask for my "test results from xx day last week", they're printed there and then and in my hand within one minute, along with a smile from the receptionist.
TSH: 2.59 mIU/L (0.27 - 4.2 mIU/L)
Total T4: 68.00 nmol/L (59 - 154 nmol/L)
FT4: 11.90 pmol/L (12 - 22 pmol/L)
FT3: 4.90 pmol/L (3.1 - 6.8 pmol/L)
In a normal healthy person one would expect to see TSH no higher than 2 with FT4 about mid-range or higher.
Your TSH isn't that bad.
YourTotal T4 is very low in range do it's no surprise that your FT4 is so low.
Your body is trying to produce as much T3 as possible because it's the thyroid hormone that every cell in our bodies need.
I am not medically trained, and I am not diagnosing, but what could be indicated here is Central Hypothyroidism. This is where the problem lies with the hypothalamus or the pituitary rather than a problem with the thyroid gland. With Central Hypothyroidism the TSH can be low, normal or slightly raised, and the FT4 will be low.
TSH is a pituitary hormone, the pituitary checks to see if there is enough thyroid hormone, if not it sends a message to the thyroid to produce some. That message is TSH (Thyroid Stimulating Hormone). In Primary Hypothyroidism the TSH will be high. If there is enough hormone then there's no need for the pituitary to send the message to the thyroid so TSH remains low.
However, with Central Hypothyroidism the signal isn't getting through for whatever reason. It could be due to a problem with the pituitary (Secondary Hypothyroidism) or the hypothalamus (Tertiary Hypothyroidism).
Your GP can look at BMJ Best Practice for information - here is something you can read without needing to be subscribed:
You could do some more research, print out anything that may help and show your GP.
As Central Hypothyroidism isn't as common as Primary Hypothyroidism (where the TSH would be high/over range and the FT4 low) it's likely that your GP hasn't come across it before. You may need to be referred to an endocrinologist. If so then please make absolutely sure that it is a thyroid specialist that you see. Most endos are diabetes specialists and know little about the thyroid gland (they like to think they do and very often end up making us much more unwell that we were before seeing them). You can email Dionne at
tukadmin@thyroiduk.org
for the list of thyroid friendly endos. Then ask on the forum for feedback on any that you can get to. Then if your GP refers you, make sure it is to one recommended here. It's no guarantee that they will understand Central Hypothyroidism but it's better than seeing a diabetes specialist. You could also ask on the forum if anyone has been successful in getting a diagnosis of Central Hypothyroidism, possibly in your area which you'll have to mention of course.
Your antibodies are low and those results don't indicate autoimmune thyroid disease (Hashimoto's).
Got 8 injections in the space of a few weeks. Haven't had one in over a year now. Got retested recently and she advised the B12 level was on the low side of normal but as was within range nothing she could do.
I don't know enough about this to comment but I thought that once on injections you stayed on them and there was no point in retesting because results will always be skewed. However, you could post on the Pernicious Anaemia Society forum who will be able to give you more information
Vitamin D issue rectified with oil capsules prescribed by GP
What was your original level?
What did your GP prescribe? Loading doses totalling 300,000iu D3?
Were you retested after the loading doses? If so what was the result?
Have you been prescribed a maintenance dose?
Sorry for all those questions, but if you had Vit D deficiency then supplementing tends to be for life. It's essential to get a new level after the loading doses have finished, and then a maintenance dose needs to be taken and this is based on the new level. Then it's important to retest twice a year to maintain a good level.
There are also important cofactors necessary when taking D3 which it's unlikely your GP will know anything about.
If you post this information I can then make further comment.
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