firstly, thanks for reading. After having quite obvious symptoms and seeing my reflexologist whom advise that she felt I had a thyroid problem, i had bloods done at my local GP (2 months ago) and my tests came back 'normal', lower end TSH and mid FT4 (see below); with low neutrophils and elevated C reactive proteins. My GP dismissed my thyroid concerns and I've continued to have symptoms. Last week I finally got the GP to do some more blood tests again. This time (despite being told everything was 'satisfactory', I asked for a print out of my results and it's now showing still 'normal' levels, but TSH has increased and FT4 is slightly lower; C reactive proteins are still elevated and notes say positive/high for Coeliac Disease screening. I don't know if theres a link between these things but i thought i'd mention it anyway).
I've been looking up some materials and potential links between what's happening with my results, my GP even said herself that most thyroid issues present symptoms before it shows in blood work. I've been reading that increased inflammation can be a sign of thyroid issues building, that initially it may be mild hyperthyroidism but then over months change to full blown hypothyroidism (which would makes sense if I'm consistently measuring high CRP and my TSH and FT4 are slowly changing).
It's frustrating because i know the levels are still 'normal' but I also know how I feel. In addition to this, I 100% go by what presents in my feet (reflexology diagnosis), it's always been correct for me, so I just wanted to see if anyone here had any experience with slow onset hypothyroidism or even thyroiditis; and or any opinions on what i've said above. I'm not wishing this illness on myself at all, but I'm extremely intuitive with my body and truly feel that there is something untoward happening to my body, very much related to my endocrinology and it seems silly and incredible that Drs would wait until I'm 'officially' unwell to point this out.
I've ordered a comprehensive test from Medichecks, but now feel reluctant to use it straight away as I've had these tests done from the GP. However, with the high CRP, and the fact that the GP doesn't even test Thyroid antibodies and FT3 etc, maybe it's worth having a look and seeing if anything else comes up.
Please see basic results with reference points below. If you need more info please let me know. Any and all comments and opinions (polite ones) welcome. Thanks.
Note: All vitamins etc seemingly normal.
Symptoms: Extreme fatigue, pins and needles in hands and legs, hairline thinning, large weight gain and difficulty losing weight, sleeplessness, depression, always cold, especially hands and feet, constipation despite taking additional fibre, supplements and softeners, irregular menstrual cycle/no cycle.
What are the results/ranges? The only thing we can glean from what you've said is that the results are somewhere within their ranges, but it's where within the range that is important. The pins and needles you are experiencing could be low B12. Fatigue could be low ferritin, as can hair loss.
my tests came back 'normal', lower end TSH and mid FT4
Your FT4 is not mid-range. In July it was 33% through range, in September it was 25%.
There is a big difference in your TSH, from 0.93 to 2.1
Did you do both tests under the same conditions? There are circadian rhythms where thyroid hormones are concerned so results can only be compared accurately when tests are done exactly the same each time. 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 can give false results (both Medichecks and Blue Horizon advise to leave Biotin/B Complex off).
These are patient to patient tips which we don't discuss with doctors or phlebotomists.
If it was me I'd be doing the Medichecks test now rather than wait. Hopefully you've ordered the ULTRAVIT test. CRP can be raised due to inflammation, inflammation can be indicative of autoimmune thyroid disease (Hashi's).
Ok so, you’ve answered what I thought/ suspected. I’ve looked through all my results and lots of things are at the ‘lower’ end. The first blood test was first thing in the morning having fasted (July). The second blood test was afternoon and i’d eaten by then, but surely that means my TSH could potentially be even higher than 2.1
I’ll post pictures of both the results. I got the medichecks ultimate performance test as it worked out cheapest for testing almost everything I have concerns about. It has everything the Thyroid UltraVit has but a whole lot more; hormones, cortisol, liver, kidney, cholesterol...basically everything. I made a big list of everything I wanted to get checked in terms of pituitary function, PCOS testing and thyroid function...did research of the best tests for those things and the Ultimate performance test covered almost everything apart from rT3 but I’ll see what comes up first and then may have that checked after. But some of the things that can identify thyroid issues when linked (so I’ve read) like Luteinising hormon, Sex Hormone binding globulin and testosterone...are all in that test. Pricey but worth it, because if there’s obvious things all pointing in the same direction outside of just TSH ranges, then I feel like I can put a better argument to my GP.
Do I need to create an entirely new post to add pictures of tests?
You can only post one picture in the opening post of a thread. It's best not to spread things over multiple threads when discussing the same thing. Just type the results in and keep everything together in the one thread.
The second blood test was afternoon and i’d eaten by then, but surely that means my TSH could potentially be even higher than 2.1
No. TSH is highest early morning and lowers throughout the day. Eating can also lower TSH. So combine those two together and your TSH is going to be lower in the afternoon after eating than an early morning, fasting test.
ok so i'm confused. Sorry...this is new to me. Let me know if this could be correct.
So after my fasting early morning test in July, where my TSH measured 0.93, that could potentially have been the early hyperthyroidism as my result was a low reading at a time when it should read it's highest??
THEN...At my most recent test my TSH was 2.1 in the afternoon and after eating, assuming that the food and time of day had lowered my TSH, would the result not be potentially be even more than 2.1? (numerically). So this would suggest that my TSH has amped up significantly? This would go hand in hand with what I read about autoimmune thyroid issues like Hashimotos? Where initially tests come back as hyper, then after around 2months show as hypo and continue as such?
I feel like I'm on the verge of really figuring out what's happening here, but I need solid info to take to my GP. Just trying to get a handle on what you've said and what the results say. I'll list all the blood results shortly.
So after my fasting early morning test in July, where my TSH measured 0.93, that could potentially have been the early hyperthyroidism as my result was a low reading at a time when it should read it's highest??
TSH: 0.93 ...................0.2 - 4.5 mU/L
FT4: 13 .......................9-21 pmol/L
Not necessarily. It could be your normal levels. A normal healthy person would generally have a TSH no higher than 2, with FT4 probably mid-range +. But we are all individual so nothing is set in stone. But I wouldn't particularly interpret that result as early hyperthyroidism.
THEN...At my most recent test my TSH was 2.1 in the afternoon and after eating, assuming that the food and time of day had lowered my TSH, would the result not be potentially be even more than 2.1? (numerically).
Testing in the afternoon would mean a lower TSH than morning. The amount by which TSH can be lowered by food is probably only slight so there may not be much potential for your TSH with that test to be higher.
This would go hand in hand with what I read about autoimmune thyroid issues like Hashimotos? Where initially tests come back as hyper,
Yes, that's possible as Hashi's can start with a "hyper" episode.
then after around 2months show as hypo and continue as such?
Because of the normal fluctuations associated with Hashi's, one can't say for definite that it would continue as hypo, it will fluctuate at random and be unpredictable and can swing between hyper and hypo and back again.
When the other blood tests are visible, it might make things clearer.
Has anything been said about your low haematocrit and low haemoglobin in September? This can suggest anaemia. Was a red blood cell count done? I'm not suggesting anything because I don't know enough, just that.
B12: 333ng/L (180-2000) [previously 309ng/L] ng/L is the same as pg/ml
As you can see, although within range, it is very low within a very wide range.
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."
Some people with B12 level in the 300s have been found to need B12 injections. Do you have any signs of B12 deficiency - check here:
This has dropped considerably. Folate is recommended to be at least half way through range.
Folate and B12 work together.
For a complete picture of your core nutrients, you need Ferritin and Vit D testing.
I've checked what the Medichecks Ultra Performance test includes and it covers everything you need thyroid-wise plus lots of others. I think you should just wait now and post the results of that test when you get them and we can look at everything together.
Make sure you follow the advice given about the conditions under which a thyroid test should be done outlined in reply to your previous post here:
and because the Ultimate Performance test includes a full iron panel it's essential this test is done after an 8-12 hour fast (you can drink water). Because you don't want to go without food too long book the blood draw for this test as early as possible in the morning and have nothing to eat after your evening meal the night before the test, and because you want your thyroid tests to be as accurate as possible do the test no later than 9am if possible.
Who is going to do the blood draw? Have you arranged this already?
Bear in mind that Medichecks want the blood sent back on the day it's drawn and for it to arrive the next day. Do not post it on a Friday or the weekend. Best days to post it are Monday-Wednesday.
If you are posting it yourself it's advisable to use Royal Mail's Special Delivery Guaranteed by 1pm Next Day service. Hand your parcel over the post office counter and make sure you get the receipt with tracking number. If they fail to deliver by 1pm the next day you can claim the cost of the service back.
I’ve booked to get the bloods drawn at a clinic nearby. It’s a cosmetic surgery clinic but they do blood draws for medichecks as well. The appointment is 9:15 which is the earliest they had for the next month (hence it being a little while away). Will that impair the results? I wanted to do it as soon as possible but that was the earliest time on the nearest date.
July
Red cell count: 4.64 ...........3.8 - 5.8 10^12/L
September
Red Cell count: 4.10........3.8 - 5.8 10^12/L
My GP did mention iron levels in July but as I recall, she said they were ok and that shouldn’t be a cause of my fatigue. Having said that, I periodically get quite anaemic so she’s accustom to seeing my levels being very low, so “ok” probably means better than usual. I do usually take iron supplements but since being so constipated I’ve stopped them. I do make a point of filling up on good sources of dietary iron. But sure, I could definitely still be anaemic.
I’ve had a look at the link you posted for the B12 deficiencies. Only a couple of those symptoms ring true for me and they are ones I’ve listed above. I’m looking forward to getting the medichecks bloods done to get a better look at what’s going on. Thank you very much for the input on when to have them done.
Hi Zenbear, taking vitamin C with your iron helps with the constipation. Not sure if 500 mg or 1,000 mg would suit you best but you would find out. Hope that helps. Jo xx
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I’m fine. Really?
Thyroidectomy or not? Thyroidmegaly and multi modular goiter. 
methinks it's time to add some T3......thoughts ?
Teva, Teva, every where, Nor any tab of Venc
Just needing a bit of tlc :)
