Interpretation of results in readiness for Endo... - Thyroid UK

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Interpretation of results in readiness for Endo appointment?

Anaheim profile image
6 Replies

Hello all, I posted here about 8 months ago and received lots of helpful advice, I’ve since had lots of reading and lots to try and understand.

My TSH has been suppressed at <0.01 for over a year now but I don’t have typically sky high T3 and T4. GP referred me to the hospital where I was told in 2019 that my results are not typical which makes me harder to know how to treat.

Bloods for visit in 2019

Tsh <0.01 (0.35 - 3.5)

Free T4 11 (8 - 21)

Free T3 6.1 (3.8 - 6)

I was told that antibodies and everything else was normal but I haven’t seen them despite asking.

On examination I was found to have a small goiter, they decided to do a watch and wait and said they would see me again in a few months and start me on a low dose of carbimazole to see if it reduces symptoms, I also left with a referral for sleep apnea (due to high bp) but everything’s been tested and I don’t have any issues here.

My main symptoms are itching skin, but only arms,shoulders, back of scalp and one spot on my back, constantly tired and really struggle to concentrate, I forget words which is so frustrating and have a general ‘cant be bothered’ attitude which isn’t me, weight isn’t budging despite restricting calories, I am always constipated, even using different types of laxatives doesn’t help. My blood pressure is high, it’s better than it used to be but I am now taking 4 different bp meds, systolic has finally dropped but diastolic is still over 100. GP is monitoring this and has just upped dosage again but says that she will arrange a hospital referral if it does not drop in the next fortnight.

I have hand tremors and jerky hands when doing anything precise, early in the day I am freezing cold, to the point where I shake, even my voice, but towards the end of the day I get uncomfortably hot, my head and back sweats, I sleep with a fan on and windows wide open. I suffer with ‘palpitations’ one minute my heart is racing, then it goes really slow and feels like it thumps, the thumps make me dizzy. Basically I feel a bit rubbish.

I’ve just had a medichecks test done prior to my hospital visit at the end of this month, blood drawn at 8am and fasting. NHS are only testing tsh, T3 and T4 hence me getting these tests.

I need to supplement Vitamin D and folate but is there anything that I should be questioning or aware of before seeing the Hospital on the basis of these recent results? Should I be asking questions about central hypothyroidism? I’m not an assertive person and don’t want to ask questions that may be sneered at, if that makes sense.

TSH <0.01

FT4 16.2 (12 - 22)

FT3 6.8 (3.1 - 6.8)

VIT D 38.2 (50 - 175)

VIT B12 49.9 (>37.5)

FOLATE 3.42 (>3.89)

FERRITIN 179 (13 - 150) I don’t supplement but could be caused by being overweight.

CRP HS 0.41 (<5)

THYROGLOBULIN ANTIBODIES 11.9 (<115)

THYROID PEROXIDASE ANTIBODIES 26.6 (<34)

I’ve just realised that this has turned into a bit of an essay despite trying to keep it brief!

Thank you for reading

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Anaheim profile image
Anaheim
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6 Replies
SlowDragon profile image
SlowDragonAdministrator

So are you still on carbimazole?

Your Active B12 is also too low...any result under 80 is considered suspicious

Getting vitamin D and B vitamins may help

Vitamin D

GP will only prescribe to bring levels to 50nmol.

But improving to around 80nmol or 100nmol may be better

ncbi.nlm.nih.gov/pubmed/218...

vitamindsociety.org/pdf/Vit...

Once you Improve level, you may need on going maintenance dose to keep it there.

Test twice yearly via vitamindtest.org.uk

Vitamin D mouth spray by Better You is very effective as it avoids poor gut function. There’s a version made that also contains vitamin K2 Mk7

It’s trial and error what dose we need

ouh.nhs.uk/osteoporosis/use...

Government recommends everyone supplement October to April

gov.uk/government/news/phe-...

Also read up on importance of magnesium and vitamin K2 Mk7 supplements when taking vitamins

betterbones.com/bone-nutrit...

medicalnewstoday.com/articl...

livescience.com/61866-magne...

sciencedaily.com/releases/2...

Bone pain

easy-immune-health.com/pain...

naturalnews.com/038286_magn...

Vitamin K2 mk7

betterbones.com/bone-nutrit...

healthline.com/nutrition/vi...

If vitamin D is low, B vitamins may be too. As explained by Dr Gominack

drgominak.com/sleep/vitamin...

healthunlocked.com/thyroidu...

Anaheim profile image
Anaheim in reply toSlowDragon

Thank you, I haven’t started taking carbimazole yet, hospital advised that they would prescribe a low dose on this visit if nothing has improved. I shall get some B vitamins as well, thanks for the links also

SlowDragon profile image
SlowDragonAdministrator in reply toAnaheim

Only add one supplement at a time and wait at least 10-14 days to assess any changes

Supplementing a good quality daily vitamin B complex, one with folate in not folic acid may be beneficial.

chriskresser.com/folate-vs-...

B vitamins best taken in the morning after breakfast

Igennus Super B complex are nice small tablets. Often only need one tablet per day, not two. Certainly only start with one tablet per day after breakfast. Retesting levels in 6-8 weeks

Or Thorne Basic B or jarrow B-right are other options that contain folate, but both are large capsules

If you are taking vitamin B complex, or any supplements containing biotin, remember to stop these 7 days before any blood tests, as biotin can falsely affect test results

endo.confex.com/endo/2016en...

endocrinenews.endocrine.org...

Low B12 symptoms

b12deficiency.info/signs-an...

SlowDragon profile image
SlowDragonAdministrator

Ask for ultrasound scan of thyroid

20% of Hashimoto's patients never have raised antibodies

healthunlocked.com/thyroidu...

Plus you need TSI or Trab antibodies tested for Graves’ disease

SlowDragon profile image
SlowDragonAdministrator

Also perhaps ask for adrenal testing

Symptoms changing from morning to evening suggests cortisol issue

regeneruslabs.com/products/...

cdn.shopify.com/s/files/1/0...

NHS doesn’t offer saliva test

Donought profile image
Donought

Hi - gosh reading your post was like looking into a mirror, except my TSH is higher at 0.27 but my FT4 and T3 are roughly the same. I think my GP just didn't know what to make of it so has ignored it. But I've started with the high blood pressure (140/110 and 140/136 - genuine readings), poor glucose control and the itching on my back and upper arms. It had stopped for a while but I've started HRT (for a trial of 6 weeks if only to prove to the GP that my issues are adrenal/ thyroid and not all linked to menopause (I'm 46 and been having symptoms for 5 yrs)) and since starting HRT my itchiness has come back. I also get the palpitations, then slow heart rate etc.

Did you manage to improve things with supplementing? I've had low Vit D, Ferritin, B12 etc and do feel so much better when I'm in the higher end of ranges - sadly still struggling with ferritin :(

Hope you're feeling better. Take care.

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