Hello, this is my first time posting. I have been looking on this board for the last few days and you all seem impressively informed so was hoping i might be able to get some advice..
I am 37 and for the few years been having what i thought may be perimenopausal symptoms. it occurred to me that there is a cross over with hypo symptoms of which i have many. After may trips to the GP and not much help i was finally offered a blood test for what they called the 'tired all the time' tests. They are all normal by NHS standards but i am wondering if any of you clever people have any further thoughts on the results below. Am i barking up the wrong tree thinking it could be a thyroid issue? Is it worth getting further private tests? Any feed back gratefully received.
I am so fed up feeling so unwell and not making any progress in getting better.
HbA1c - 31 umol/L (30.00-41.00)
Folate - >24.0 ug/l (>4.10ugl)
Ferritin - 18 ug/L (10.00-291.00)
B12 - 721 ng/L (160.00 - 820.00ng/L)
Free T4 15.9 pmol/L (9.00-22.00 pmol/L)
TSH 3 mU/L (0.10 - 4.00 U/L)
I take B12, Folic acid and spatone liquid Iron.
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Have you had a full iron panel? I presume you are not taking levothyroxine in which case your thyroid hormone is normal. You need a vitamin D test as low vit D can cause fatigue.
Haemoglobin is not the same as a full iron panel, have you no TiBC level? If not then go back to doc and ask for it to be done. Looks like you might have a problem holding onto iron so you need to find out. Fatigue likely connected to low iron. You need a vit D test if you are supplementing and have not had one since supplementing.
Well, you can only ask. It might be some other problem underlying but if you're feeling so tired something could be wrong. Have you ruled out sleep disorders?
Your TSH should be 1 or lower and your Ferritin is much too low so I think you might be hypothyroid. Some other members who are much more knowledgeable than me will be along to comment shortly.
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Even if you aren't officially anaemic, or iron-deficient, you would feel much better with a ferritin around mid-range i.e. about 150 - 160 with the range you've given. But before thinking of supplementing iron I would suggest getting further tests done.
Have you had a Full Blood Count done? That can give further info on iron and anaemia.
Once you have further information for us write another thread giving the results and reference ranges and ask for feedback.
I did have a full count done and all was normal, Hemoglobin was 141 g/l (115.00-165.00) So assuming I am not anemic? I can see the ferritin was low but not sure how to interpret that when the Hemoglobin was normal.
You would still feel better with greater iron reserves - which is what ferritin is.
Just for comparison...
The Spatone you are taking contains 5mg iron per sachet.
When my iron and ferritin were very low I was prescribed ferrous fumarate 210mg, one to be taken three times a day. This dose supplied me with 207mg of iron per day.
It is a good idea when taking therapeutic levels of iron to get iron and ferritin levels tested every 6 - 8 weeks. (Your spatone definitely doesn't classify as a therapeutic dose.)
Thank you, If the GP says it’s all normal how can I go about getting treated? I have been going for 3 years with these symptoms and this is the first time I’ve even been tested. This is where I come unstuck as they just don’t want to help.
In the end I had to test and treat my own iron deficiency.
Iron supplements - even those which are prescribed - can be bought in pharmacies (in the UK) without a prescription these days. I buy my own from Tesco Pharmacy. I test myself when I think it is appropriate using tests from various companies such as Blue Horizon or Medichecks.
If you want feedback on blood test results we can often help with thyroid-related results - and low nutrients are definitely part of having thyroid disease. So post them when you have any and ask for feedback.
I've been a bit unclear in saying how I got my low iron treated. I got a prescription from my doctor for two months worth of iron supplements. I'd had to practically beg for them because my ferritin result was just over the bottom of the range.
I learned, purely by accident as a result of something the pharmacist said, that I didn't actually need a prescription for the iron supplements, I could just buy them.
Knowing that my chances of getting another prescription from the doctor were slim I started buying my own rather than beg for another prescription.
I learned a couple of years later, after buying a complete copy of my GP records, that my serum iron was under the range and had been for at least three years before I started supplementing.
It took me 21 months of supplementing at maximum dose to raise my ferritin to mid-range. I still supplement, but I take a maintenance dose now. If I stop then my ferritin drops like a stone.
I do testing privately roughly every 9 - 12 months now, although when I was actively trying to raise my ferritin I tested more frequently.
The reference to TSH being 1 or lower is for when someone is already diagnosed hypothyroid and on levothyroxine.
A normal healthy person would have a TSH no more than 2-ish with FT4 around mid-range-ish. Your TSH is on the high side and you would be diagnosed hypothyroid in some countries whose cut off level is 3. Here in the UK, unfortunately, it is 10 unless raised antibodies are also present along with an over range TSH and then an enlightened doctor should prescribe Levo.
Your Ferritin level is extremely low. Low Ferritin can suggest iron deficiency anaemia so you should ask your GP to do an iron panel and full blood count. Low Ferritin causes many symptoms, see
As you are taking B12 and folic acid, presumably you have had very low levels/deficiency when tested? If so, low levels/deficiencies can be caused by autoimmune thyroid disease, aka Hashimoto's, which is where the immune system attacks the thyroid and gradually destroys it. So it would be a good idea to get Thyroid antibodies tested. Your GP can only do Thyroid Peroxidase (TPO) antibodies tested and if this comes back negative he will say everything is fine. There is another antibody test - Thyroglobulin (TG) that can also suggest Hashi's but this can only be done when an endocrinologist requests it. You an have negative TPO antibodies but positive TG antibodies so it's important not to rely on a negative TPO result. It's also possible to have Hashi's without raised antibodies.
Thank you that is super helpful. I wasn’t tested prior to taking b12 and folic acid but I felt awful and getting no help from my GP so was trying to help myself. Taking the folic acid made a startling difference to how I felt so I must have been deficient. I shall go back to the GP a bit better informed. Thank you
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