First time test results ?

[Harhun]

First post as had recent tests.

I have been feeling severely fatiqued, restless, anxious and generally unwell for months now. I have been receiving b12 injections for past 2 years. I've a family history of thyroid issues.

My results came back with

TSH :0.9 mu/l . Range (0 7 to 4.2 U)

Free T4 : 20.1 pmo/l . Range (10 to 22 u)

I've been asked to have more bloods done for thyroid antibodies? Any advice on levels seem to be near the top of one and bottom of the other ?

[Lalatoot]

Near the top of one and bottom of the other is the way it is with TSH and FT4. TSH is a stimulating hormone that tells the thyroid to produce more FT4. If your FT4 gets high then the body lowers production of T4 by lowering TSH.

[Harhun in reply to Lalatoot]

I presume that these results are normal thyroid levels then ? Not sure about the ant bodies testing .

[Lalatoot in reply to Harhun]

Yes they are in the normal ranges. But you need to find where in the range of normal you feel best. For example the ft4 range is 10 to 22. How do you feel at 20.1? It might be that you need to be at 17 or at 22. We each have to find our normal.

[Harhun in reply to Lalatoot]

Ok I get your reasoning now. It does seem a wide range, I certainly have been feeling extremely fatigued, a little jittery and having trouble sleeping, ruled out a few other things and have been on B12 for years. I am totally lost with this all and I am struggling as I am usually a very active person.

I do appreciate your help.

Thanks again

[Lalatoot in reply to Harhun]

Go to thyroid UK website and read up on antibodies and thyroid basics.

It is only by educating yourself that you will get better. Unfortunately doctors don't often have much understanding of thyroid issues so we need to be our own advocates.

[silverfox7]

A high FT4 makes me wonder if you have a conversion issue but without a FT3 reading taken at the same time we can’t tell it that is the case. FT3 could be very low so that would give you symptoms. If you ask your doctor to check VIT D, folate, B12 and Ferritin but not optimal then supplementing to get them optimal then that can help with conversion. The easier answer is to add T3 but that is expensive so your doctor may not want to do that and you would need to see an endocrinologist to get it prescribed.

I have heard you can get FT3, FT4 and TSH tested for £29 via the NHS but I don’t know how you go about doing that. Hopefully someone will answer that for you.

[SlowDragon Administrator]

you say you are having B12 injections, were you tested for Pernicious Anaemia?

Low B12 common with autoimmune thyroid disease (hashimoto’s)

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

Ask GP to test vitamin D, folate and ferritin levels

You may 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 .

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

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 )

monitormyhealth.org.uk/thyr...

[Harhun in reply to SlowDragon]

Hi thank you for your reply, it's much appreciated.ive been on b12 injections for 2-3years for Pernicious Anaemia, however nothing else was tested at the time, this was after severe fatique and stomach issue identified by endoscope.i have been waiting over 2 weeks now for antibodies results, is this normal ? Unfortunately thyroid issues is within my family, with my mother actually having a serious stroke on the back of hers being undiagnosed.... so I would like to get to the bottom of this.

Thanks again

[SlowDragon Administrator in reply to Harhun]

Thousands of UK patients forced to get FULL testing privately

How often are you getting B12 injections?

[Harhun in reply to SlowDragon]

Hi currently every 3 months for B12

[SlowDragon Administrator in reply to Harhun]

Many people find that isn’t regular enough.....it was an arbitrary decision based on finance rather than patient preference. You can ask for more frequent injections

b12deficiency.info/blog/201...

recommended on here when getting B12 injections to supplement 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...

But recommend you get Folate tested first before starting on vitamin B complex