I have all the symptoms of Hypothyroidism yet my GP states I need to just be retested in 3 months.
Please can someone advise on my latest bloods:
TSH 6.09 (0.27-4.2)
T4 16.3 (12-22)
Serum folate 2.8 (3.9-26.8)
Serum ferritin 18 (30-400)
B12 255 (191-663)
Others attached
Quyejoyce1
Is that your first thyroid test with elevated TSH? If so then it's normal to repeat in 3 months time.
Low nutrient levels can have symptoms of their own, some of which overlap with symptoms of hypothyroidism.
Serum folate 2.8 (3.9-26.8)
Below range = folate deficiency. See your GP, he should prescribe folic acid.
B12 255 (191-663)
B12 and folate work together. Your B12 is low in range although doctors think that anywhere in range means that everything is fine. Check for signs of B12 deficiency here:
b12deficiency.info/signs-an...
If you have any then list them to discuss with your GP and ask for testing for B12 deficiency and Pernicious Anaemia. Do not take any B12 supplements or folic acid/folate/B Complex supplements before further testing of B12 as this will mask signs of B12 deficiency and skew results.
Doctors are supposed to take more notice of symptoms than numbers where B12 is concerned so you may have to be assertive if you do have symptoms. There have been many people with a B12 level in the 300s who have been found to need B12 injections.
Serum ferritin 18 (30-400)
Below range. Low ferritin can suggest iron deficiency anaemia. Ask your GP to do a full blood count and iron panel.
Do not let your GP fob you off about your ferritin and folate results, some say that just because "it's only a bit below range so it's fine", if that's the case then ask why they bother having ranges if they are going to ignore them.
Was this your first over-range TSH result? If so, it's perfectly normal that your doctor wants a retest because many things can cause a high TSH that have nothing to do with the thyroid. It's just a safety precaution to prevent misdiagnosis. Although it's probably not necessary to wait three months. Six weeks would probably be enough. 
However your folate and B12 are too low, and your GP probably won't pick up on that because they're in-range - just too low in-range.
Your ferritin is below range, so he should be doing an iron panel to find out why.
When you go for your retest, make sure you:
* get an early morning appointment - before 9 am - TSH is highest early morning, and it's the TSH that most doctors look at, we need it as high as we can get it
* fast over night, but drink plenty of water
Thank you Greygoose and SeasideSusie
To give a bit of background, my periods have changed over the last 6 months to extremely heavy. My cortisol was low at 170 and I was referred to endo. I have had a SST and cortisol has risen during this. (Awaiting full results from Endo). My bloods in Nov showed TSH 4.8 and FT4 16.8
I have depression and just been diagnosed with an enlarged heart Which he has referred me for an echo. GP has prescribed folic acid two weeks ago and over the counter iron.
I also have frequent headaches as well as lots of minor symptoms. Tired all the time back ache, minor chest pain etc
My concern is he doesn’t appear to be looking at me holistically and only treating the individual issues.
Quyejoyce1
GP has prescribed folic acid two weeks ago
Check the list of signs/symptoms for B12 deficiency that I linked to. If you have any then stop the folic acid, discuss the symptoms with your GP and ask for further testing of B12 as suggested.
and over the counter iron.
Absolutely not good enough for below range ferritin unless you've already had full blood count and iron panel and that iron deficiency anaemia has been discounted.
According to NICE Clinical Knowledge Summary cks.nice.org.uk/anaemia-iro...
• A serum ferritin level of less than 15 micrograms/L confirms iron deficiency.
You are so close to that level that further investigation is a must.
Click on all of those headings in the menu on the left hand side, read them and discuss further investigations with your GP.
OK, so this is your first over-range TSH, and your doctor is following the protocol for diagnosis.
Doctors know nothing about nutrients, so I doubt the wisdom of prescribing you folic acid. But, let's wait and see what SeasideSusie has to say about your B12.
My concern is he doesn’t appear to be looking at me holistically and only treating the individual issues.
Well, that's perfectly normal, I'm afraid. GPs don't know enough about anything to look at their patients holistically. You need a holistic doctor for that. For the average GP, every symptom should be treated as a separate disease and prescribed a drug accordingly. That's the way it always is.
Thank you both again. I will definitely follow up on the B12 and Iron panel tests. Hoping next endo appointment also has some answers
You're welcome.
See GP again for through testing for low ferritin
You also need BOTH TPO and TG thyroid antibodies
If antibodies are high this is Hashimoto's, (also known by medics here in UK more commonly as autoimmune thyroid disease).
About 90% of all primary hypothyroidism in Uk is due to Hashimoto's.
20% of Hashimoto's patients never have raised antibodies. So an ultrasound scan of thyroid recommended
healthunlocked.com/thyroidu...
Low vitamins are especially common with Hashimoto's. Food intolerances are very common too, especially gluten. So it's important to get TPO and TG thyroid antibodies tested at least once .
Link about thyroid blood tests
thyroiduk.org/tuk/testing/t...
Link about antibodies and Hashimoto's
thyroiduk.org.uk/tuk/about_...
thyroiduk.org.uk/tuk/about_...
List of hypothyroid symptoms
thyroiduk.org.uk/tuk/about_...
Very important to test vitamin D too with hypothyroidism, especially with hashimoto’s
ncbi.nlm.nih.gov/pubmed/286...
Vitamin D deficiency is frequent in Hashimoto's thyroiditis and treatment of patients with this condition with Vitamin D may slow down the course of development of hypothyroidism and also decrease cardiovascular risks in these patients. Vitamin D measurement and replacement may be critical in these patients.
endocrine-abstracts.org/ea/...
Evidence of a link between increased level of antithyroid antibodies in hypothyroid patients with HT and 25OHD3 deficiency may suggest that this group is particularly prone to the vitamin D deficiency and can benefit from its alignment.
Thank you Slowdragon. Will definitely look into this.
Getting all four vitamin levels tested and supplement to bring to optimal levels will help reduce symptoms
Getting thyroid tested in 2-3 months INCLUDING thyroid antibodies
If GP won’t test antibodies then get tested privately
Making sure to get blood test as early as possible in morning before eating or drinking anything other than water gives highest TSH and most consistent results
Read posts here daily ...learn as much as possible about hypothyroidism
Private tests are available. Thousands on here forced to do this as NHS often refuses to test FT3 or TG antibodies
thyroiduk.org.uk/tuk/testin...
For thyroid including antibodies and vitamins
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
If you can get GP to test vitamins and antibodies then cheapest option for just TSH, FT4 and FT3 £29 (via NHS private service )
If I'm reading this right, this is your SECOND test with over range TSH. Is that right?
Yes, bloods in first post are two weeks old which show TSH 6.09 and free T4 16.03. Bloods taken at endo in November show TSH 4.8 and FT4 16.8, doctor has these results. In addition I had bloods taken in October which resulted in the referral to endo in the first place but because the GP couldn’t find them in with the other results on the emis system he didn’t even look or take the endo or those into consideration. Needless to say a complaint will be shortly lodged.
well i think NICE guideline 1.5.4 apply to you, and your Dr should consider a trial of Levo.
(TSH under 10 but over range with symptoms)
nice.org.uk/guidance/ng145/...
The guidelines came in before Christmas so you can allow Dr to save face by it being new.
Thank you Wetsuiter. That’s very very helpful. Will definitely follow this up.
Hi all
Well my GP ordered an antibodies test to be undertaken in 3 months time based on my pushing. Meanwhile, endo discharged me with a plan to start thyroid meds once I get the all clear with my current enlarged heart which is currently being investigated by cardiology. Some progress at least with a plan
And at I did manage to get some B12 injections too but no loading dose. Better than nothing I guess!
Help me to understand what my results mean...please
Please help me
Hi wondered if someone help me.
Please help
Can anyone help me to understand my blood results?
