I'm a 35 year old male, and i found your forum through my searching recently.
I've been suffering from some odd symptoms for the past year or so, which have progressively worsened.
Terrible Brain Fog, Blurry Vision (helped by a glasses prescription, general feeling of being spaced out (almost drunk), aches pains, General fatigue, Carpal Tunnel (i'm actually under another doctor who wants to operate on me, although i'm resisting).
I'm generally really healthy, don't drink much alcohol, don't suffer from stress, exercise daily and i'm pretty fit generally.
I firstly was convinced that i had a blood sugar problem due to waking and feeling exhausted and sometimes having huge lapses in energy randomly, that is normally fixed by eating a meal. I used Thriva for a full blood test and everything came back normal including HbA1c for diabetes. No other obvious problems with b12, Iron, Vit D etc
At my wits end, i googled my symptoms and it kept coming up with thyroid connections, but these seemed to mostly be written with females in mind. I've also never really heard of any of my male friends suffering from thyroid issues. I thought it a long shot, but knowing that my mother suffers with thyroid problems i figured i'd send off for a private test to at least rule it out.
Blood sample was taken first thing in the morning on an empty stomach. Don't know if this matters, but it seems to be their general advice for blood test samples.
Test results retuned the following which really surprised me:
TSH 4.38mlU/L - which was high by their advice
FT4 17.70 pool/l - which was normal
T3 5.30 pool/L - which was normal
I'm due to speak to the private company who conducted the test - Lets get Checked, but obviously they probably can't really help and i'm guessing will tell me to make an appointment at my general GP.
Is there any advice for me to be taken seriously by my GP and are my results out of the ordinary for a fit 35 year old guy? I also recently went to see my GP who sent me for a fertility test, with quite surprising results - Very Very low sperm count. I'm now thinking that this could all be affected.
Any advice on interpreting the results would be really appreciated, as i'm sort of relieved to finally find an answer to the brain fog and cognitive issues, but don't really know how to proceed with a GP?
Thanks
John
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john_83
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Rather than just saying 'normal', it would be helpful if you could put the actual range. There's no such thing as 'normal' where thyroid is concerned, it just means 'in-range'. But, 'in-range' isn't always 'normal'. If you see what I mean. The ranges are too wide, and it depends where in the range the results fall.
Having said that, a TSH of over 5 is hypo. You are hypo when your TSH hits 3. But, you cannot base a diagnosis on a one-off blood test, because there are many reasons why the TSH can be raised. But, it might encourage your doctor to retest himself. Usually, two tests are done, a couple of months apart.
Your FT4/3 appear quite good at the moment - as far as one can tell without the ranges - but that's because the TSH is flogging your thyroid to death to get it to produce that hormone. It won't be able to go on like that forever, and the Frees will probably drop, and the TSH rise, in an attempt to stimulate the thyroid. So, it really needs an eye kept on it, whatever the doctor says.
There are quite a few men on here with hypothyroidism - not always easy to tell by their pseudonyms, but I'm sure they will all start manifesting tomorrow. It's not an exclusively female disease, although more women than men are likely to develop it, but that's probably because our endocrine system is more complicated than the male.
When a doctor says 'normal', all he means is 'in-range'. He doesn't mean the result is right for you because he doesn't know if it's right for you. And, if you have symptoms, it obviously isn't right for you.
The ranges, for the most part, are far too wise - and they vary from lab to lab. So, we need to see the ranges that went with your results to be able to tell whether they are too low, too high or whatever. I would never accept results in the form you've written them, I would insist on having the ranges.
B12 - 463pmol/l
Without the range we cannot tell if this is a serum result or an active result. If it's serum, it's too low, should be at least 550. If it's active, it's much, much too high.
Ferritin 268 ug/l
There are a huge variety of ferritin ranges. On some, this would be a good result. On others, it would be much too high, which could indicate other problems.
Apparently all of these are either normal or optimal for results.
This is just your doctors opinions. We don't like doctor opinions, we like the facts - i.e. the ranges, so that we can make up our own minds.
Just read your new post below. Despite my insistance on ranges, that doesn't apply to the TSH. A TSH is always a TSH. And, you are hypo when your TSH reaches 3. In some countries you will be treated when your TSH reaches 3. In others, they like it to go over 4/4.5. But the UK is the only country in the world that insists a TSH has to be over 10 before they will diagnose. It is cruel and wicked, and all down to money, as it means that they diagnose fewer people, leaving a lot of other to suffer. Further more, doctors know next to nothing about symptoms. They don't do them in med school. They spend only one afternoon on the whole endocrine system during the whole time they are in med school - so you can imagine how little time is devoted to the thyroid. Not time to talk about symptoms! The symptoms you mention can be found on just about every symptom list going. But, because they didn't do them in med school, doctors believe there isn't much in the way of symptoms for hypo, when, in fact, there are over 300.
Unfortunately, there's not much chance that an endo will know any better - unless he takes a special interest in it. The vast majority of endos - if not the totality - are diabetes specialists. Thyroid just isn't sexy! Don't ask me why. So, research any endo you wish to see carefully, before committing yourself. Whether he's NHS or private, he will just have had the same very basic training and know little about thyroid.
Many thanks for your detailed response. I'm not sure i have the information regarding the ranges. They just game me the exact reading and stated that it was "normal". I think i'm going to do some research and try to find an endocrinologist who specialises in Thyroid as you advised.
I just know that something isn't quite right and i have many of the symptoms people are talking about.
Yes, they'll do that if they can get away with it. Because deep-down, they don't want you to know your levels - which is a sign that they're not sure what the hell they're doing. The majority of doctors don't like informed patients. But, the law in the UK says that you are entitled to your results, and that includes ranges. If it were me, I'd go back and ask for a print-out, because that will have the ranges on it.
Just as an aside, I live in France. I go for a blood test in a high street clinic, early in the morning - they stop taking blood at 10.30, so no arguments about you can have an early morning test because it's non-fasting - they don't even ask if you're fasting - and the open at 8 o'clock. And, at the end of the day, you can go back and pick up your own results. Used to be two copies in the envelope: one for you and one for your doctor. These days, doctors get the results via internet, but there's still a copy for you if you go and pick it up. Nobody ever questions your right to have it. It is yours.
So, your TSH is over-range - we've already discussed that.
Your FT4 and FT3 are around mid-range, but only because the TSH is flogging the thyroid. You need all that TSH to get euthyroid Frees - which is not 'normal' in itself. But, doctors don't take the results as a whole, they look at them individually and therefore come to the wrong conclusions. They need to be looked at in relation to each other.
I hate conflict, and when you sometimes hardly have energy to string a coherent sentence together it's very harde to pluck up courage to face even a possible mild confrontation.
So I was very nervous the first time of asking for a copy of the results. But the receptionist printed them out straight away, no questions. Don't ask the doctor, just go to reception.
The Information Commissioner's Office is quite clear that things like codes and numbers need to be capable of being understood if you request the information as a Subject Access Request. Saying your FT4 is 17.70 without a range does not allow for understanding and interpretation. That could be middle, top or over range based on what we have seen here over the years.
As ranges vary by lab, it is inappropriate to do any interpretation without the ranges. (Some tests vary hugely, others hardly at all.)
Next step is to get full Thyroid testing including thyroid antibodies
Vast majority of thyroid issues are autoimmune confirmed by high thyroid antibodies
Yes 9 out of 10 diagnosed Thyroid patients are female. Would suspect many more men are undiagnosed as medics tend to think only women get Thyroid disease
Your TSH is high....it may be a temporary blip.....usual advice is to retest in 2-3 months
For full Thyroid evaluation you need TSH, FT4 and FT3 plus both TPO and TG thyroid antibodies tested. Also EXTREMELY important to test vitamin D, folate, ferritin and B12
Low vitamin levels are extremely common, especially if you have autoimmune thyroid disease (Hashimoto's) diagnosed by raised Thyroid antibodies
Can you add your "normal" vitamin results and ranges. With thyroid disease we need optimal vitamin levels
You will probably need to get full Thyroid testing privately as NHS refuses to test TG antibodies if TPO antibodies are negative
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
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
"9 out of 10 diagnosed Thyroid patients are female. Would suspect many more men are undiagnosed as medics tend to think only women get Thyroid disease "
It's like the idea that men can't get breast cancer. Likely even rarer than hypothyroidism but it does happen.
I've been to see my GP this morning, explained my symptoms and he said that in his opinion and according to bmj.com - my results are normal and nothing out of the ordinary.
He said that TSH levels are considered high, only when they reach 10.0 - he had to google this to find out.
I then explained about my other symptoms, carpal tunnel, dizziness spaced out, fertility problem, brain fog, vision problems... He didn't seem to think any of this was connected and recommended an ECG for a slow heart rate of around 47bpm - blood pressure was fine. I am pretty fit, but i don't know if that is due to my exercise regime or something else. I'm fit by average standards, but not marathon fit.
I managed to get a GP referral from him to go and see someone privately if i wish, i had to ask for this however. He was not concerned with the thyroid question.
Maybe my next step is to see an endocrinologist privately? i have a referral letter from the gp if i want one, so i could make an appointment directly?
I think it would be wiser, and cheaper, to try and see another GP first if you can. The one you saw is obviously useless on thyroid. Ask the receptionist (they know the doctors and which are the most conscientious and sympathetic.
What you want is a clinical trial of thyroid hormone. I always say that, because it's just a trial, you can't blame or sue them if it makes you worse!
In fact you might have grounds to sue for neglect if they continue to refuse you. If you mention the possibility that should get things moving!
And not all endos are helpful either, even private ones. Thyroid UK has a list of recommended endos. SlowDragon do you have the email? I'm not sure how to find it.
Run from that doctor and find a specialist if you can. I did suffer for years without knowing it was my thyroid by the time it was checked I had a tsh in the 70.’s
Just a little update on the results of a second test containing antibodies. Carried out by Medichecks (first test was Thriva)
Medichecks Feb 13th 2020
TSH 3.72 (0.27 - 4.2 R)
T3 5.27 (3.1 - 6.8 R)
FT4 17 (12 - 22 R)
Thyroglobulin Antibodies 15.4 (<115R)
Thyroid Peroxidase Antibodies 9 (<34R)
So on the basis of this second test, and according to Medichecks my TSH is still high at 3.72 although down a little on the first test of 4.38, but still higher than normal. Kind of proves that something is amiss and it isn't a false test. Everything else however looks within range and very low on the Antibodies test, so that isn't looking like a problem.
Thriva (First Test approx 5 weeks before)
TSH 4.38 (0.27 - 4.2 R)
T3 5.30 (3.1 - 6.8 R)
FT4 17.70 (12.0 - 22.0 R)
Problem now is that i went to see my GP (as mentioned in the previous post), and unsurprisingly he was not interested. He said that anything under 10 is considered normal. From what is said on this forum and further reading i've done, it does seem this is an overlooked problem in the UK.
Could a TSH of this level be making me feel this unwell? since my last test i've had terrible brain fog, lethargy, and feeling spaced out - seems to be worse in the morning then gradually improving into the evening when i feel quite normal.
I found a few local Endocrinologists who i could see at the cost of around £180 for the consultation, then i can only imagine the extra cost of blood tests etc.
Should i possibly try ordering some Levothyroxine online through an online prescription and taking for 2 months to see the difference? I could retest myself to check levels. Is a private endocrinologist going to take me seriously at these levels of TSH? Also, when i enquired about the prices of seeing the end privately, i asked the receptionist if he could then refer me to someone on the NHS if he thought it necessary to medicate (I'm thinking of the long term cost if this is going to be lifelong thing). She said that if i see someone privately, all prescriptions for medication (i may need) would be paid for privately for ever? is this the case?
Any advice would be much appreciated. Amazing to have such helpful people to talk to about this when the professionals won't listen.
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Blood results & very patronising doctor! Any advice appreciated
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