Central hypo - LH, FSH testosterone, estradiol and cortisol levels

[liaratsoni]

Hi everyone!

I am currently nearly a week into being treated for the suspected secondary hypothyroidism and today got the letter my endo sent to the doctors about his plan for treatment. He performed a huge amount of tests aside the thyroid ones and said they were normal. I trust him but I just wondered what people on here particularly with knowledge/experience about central hypo/pituitary probs think? Unfortunately he didn't include ranges or units on letter just the numbers so I only have the following.

Tests were taken around 12.30pm and I had eaten breakfast earlier in day:

Prolactin 154

Oestradiol 60

Testosterone 0.4

Cortisol 241

FSH 7.2

LH 4.2

Interestingly I was initially told I had PCOS in 2017 (which he doesn't believe is a concrete diagnosis) and interestingly when I was tested back then my prolactin was 475, testorsterone was 1.4, oestradiol was 177 and as with typical PCOS my LH was double the FSH at 10.6 to 4.9 but now its the other way around!

I have amenorrhea and the endo suspects it should be alleviated by adequate thyroid treatment though he said it will likely take a while and doesn't except to see return of periods by next time I see him in January.

[Mary-intussuception]

Do you have your Thyroid blood tests results? Did you have any Antibodies tested?

You could ask the hospital for copies of your records (free of charge now). Specify that you want all records including print outs of all blood tests results.

Have you considered asking your GP or Consultant to test levels of Vitamin D? Also B12, Folate and Ferritin?

What dose of Levothyroxine have you started on ? Do you take it early morning with water only and an hour before breakfast?

[liaratsoni in reply to Mary-intussuception]

Yes my thyroid hormones were as follows:

T4 12.8

T3 3

TSH 1.73

I previously had private blood tests that showed no antibodies so my endo has diagnosed me with suspected central hypothyroidism.

I was already vitamin D deficient and have been on supplements for many months and my ferritin was 29 so too low but I have terrible digestive problems and can't stomach meat or iron supplements right now. B12 I was incredibly low before and I had B12 deficiency symptoms so have been on B12 injections since June and folate was good in range.

I have 25mcg for the first 4 weeks (I am 1 week in) but then 50mcg for two months until I see him in January. I take it with water at 8.55 and don't eat to near 10

[Mary-intussuception in reply to liaratsoni]

Is your Vitamin D level being monitored? I guess you are on a daily maintenance dose now of somewhere between 800 IU and 2000 IU?

Your Ferritin is better than mine was! I can't take iron pills either.

You really do need to get the units and ranges for people to comment.

Were you tested for Pernicious Anemia?

[liaratsoni in reply to Mary-intussuception]

My doctor is meant to be monitoring my vitamin d but getting them to is another story! I am on 2000iu a day at present. I had iron deficiency anemia in late 2017 and my ferritin was 3 so it's definitely not the worse its been! :L Yes I was hoping he'd post ranges but he didn't. I was most interested in the FSH strangely being double LH and the lowness of the testosterone. I have been tested for PA and the IF came back negative but though it isn't conclusive as the test is so unreliable the doctor gave me injections anyway and now I know I'm hypo I wonder whether it's just the result of that rather than PA.

[Mary-intussuception in reply to liaratsoni]

Are they the only Thyroid tests you've had by NHS - no Free T3?

Were your private tests Hypo?

You could still have PA, you could put a post over on the PA forum. There is another test you could ask for.

If you get copies of your hospital records you 'll have the ranges & full info.

[liaratsoni in reply to Mary-intussuception]

My private tests were almost identical to the NHS ones. Thank you I will look into getting the hospital records

[SlowDragon Administrator in reply to liaratsoni]

You are legally entitled to printed copies of your blood test results and ranges

You can test vitamin D here £29 - NHS postal kit

vitamindtest.org.uk

The aim of Levothyroxine is to increase the dose slowly in 25mcg steps upwards until TSH is under 2 (many need TSH significantly under one) and most important is that FT4 in top third of range and FT3 at least half way in range

Bloods should be retested 6-8 weeks after each dose increase

Recommended on here that all thyroid blood tests should ideally be done as early as possible in morning and before eating or drinking anything other than water .

Last dose of Levothyroxine 24 hours prior to blood test. (taking delayed dose immediately after blood draw).

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

NHS guidelines on Levothyroxine including that most patients eventually need somewhere between 100mcg and 200mcg Levothyroxine.

nhs.uk/medicines/levothyrox...

Also what foods to avoid (eg recommended to avoid calcium rich foods at least four hours from taking Levo)

Have you had ultrasound scan of thyroid?

20% of Hashimoto's patients never have raised antibodies

healthunlocked.com/thyroidu...

Your ferritin is terrible. Has GP done full iron panel testing for Anaemia.

[liaratsoni in reply to SlowDragon]

I had a FBC done as I have recurring unexplained fluctuating leukopenia/neutropenia so I am monitored - at above test time hemoglobin was 124 but unfortunately I don't currently know any other results other than that my white cell count was 2.8 which has been my current 'normal' for the last couple of years. I haven't had an ultrasound of thyroid though it looks like the problem is in my pituitary gland. My ferritin was 16 for 2 years up until may but doctors always said it was 'normal' of course!

[SlowDragon Administrator in reply to liaratsoni]

They should really do ultrasound scan of thyroid. Easiest and cheapest thing first

Perhaps followed by MRI of brain

Pituitary function test too (expensive blood test)

[Ginny52 in reply to SlowDragon]

What is the pituitary function test?

[liaratsoni in reply to SlowDragon]

Thank you I will ask about this next time

[SlowDragon Administrator in reply to liaratsoni]

Link about pituitary tests

pituitary.org.uk/informatio...