Hi. I’m a 70 yo very active male and have always felt the cold worse than 99% of any group I’m with. I leave bbq’s early, concerts in church halls early and always have at least one more layer on than anyone else (apart from my daughter that is). I run at a lower temp than most typically 35 on waking, 36 midday and 33/34 in the evening. Twice in the last month when the long sunny spells ended I went “hypo” that day and my temp dropped to around 32.4 at 11:30. And then down to 32.8 at 16:00. On both occasions I had to retire to bed to recover my temp, it is the only cause of action I find effective. My GP surgery has done blood tests over the last 20 odd years but these never show any obvious TSH or T3 or T4 errors, although they have been marginal on some. I’m waiting to see an endocrinologist (the 2nd one) and hope they can come up with a theory.
I’m physically active and still play competitive sport twice a week and gym 3 times per week. Resting heart rate is 52 - 55, cardio fitness (Fitbit term they say is like VO max) is 50 (midrange for my age is 35)
Only other thing is daughter shows exactly the same symptoms.
Any budding endos out there like to throw in some theories.
Any suggestions appreciated.
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Hurstfield
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Without lab results it's impossible to say much....sorry!
"these never show any obvious TSH or T3 or T4 errors"....this quote is not reassuring! It means nothing I'm afraid. Being "in range" does not mean that the person is optimally medicated
For good thyroid function....
TSH needs to be close to 1,
FT4 and FT3 need to be close to 75% through their respective ranges
Vitamin D, vitamin B12 folate and ferritin all need to be optimal
Just general info - since he appears to be concerned about a possible thyroid problem.
Thought it might be useful if he managed to get hold of his previous test results....as SD has now suggested in her more comprehensive reply.
That's why I added the link about getting a diagnosis....which I now see isn't highlighted. Ooooops! However the same link is highlighted in SD's reply, so I'll leave it be.
I hope both he and his daughter find the answers they need.
First thing is, do you have any actual blood test results?
You are legally entitled to printed copies of your blood test results and ranges.
The best way to get access to current and historic blood test results is to register for online access to your medical record and blood test results
UK GP practices are supposed to offer everyone online access for blood test results. Ring and ask if this is available and apply to do so if possible, if it is you may need "enhanced access" to see blood results.
In reality many GP surgeries do not have blood test results online yet
Alternatively ring receptionist and request printed copies of results. Allow couple of days and then go and pick up.
Important to see exactly what has been tested and equally important what hasn’t been tested yet
Frequently only TSH and Ft4 tested, completely inadequate
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 levels and thyroid antibodies
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)
Is this how you do your tests?
Private tests are available as NHS currently rarely tests Ft3 or thyroid antibodies or all relevant vitamins
Could it be low iron or B12? Besides Hypothyroid, Peripheral artery disease and Diabetes also comes up in my google search for always cold and deficiencies.
First thanks for your speedy response I have gone through my files and have found the last test for which I have a print out. There was one in Jan 2018 but I do not have a print out.
so here goes with one I have from 3Oct2017
Serum TSH level (WTL506) normal 3.21 mL/min (range is 0.38 - 5.33)
Serum testosterone (WTL506) normal 15.4 nmol/L (range 10.0 - 35.0)
Se prostate specific Ag level (WTL506) 0.9 ug/L (range 0.0 - 4.0)
Fluoride Glucose normal 4.7 mmol/L (range 3.3 - 6.0)
Urea & eletrolytes normal
serum sodium 136 mmol/L (range 135.0 - 145.0)
serum potassium 4.84 mmol/L (range 3.50 - 5.00)
Estimated GFR serum creatinine 79 umol/L (range 62.0 - 124.0)
FBC
haemoglobin estimate 147 g/L (range 130 -170)
RBC count 4.14 10*12/L (range 4.5 - 6.5)
MCV 101 fL (range 83 - 101)
MCH 35.4 pg (range 27.0 - 32.0)
MCHC 351 g/L (range 315 - 360)
Total White cell count 3.5 10*9/L (range 4 - 10)
Neutrophil count 2.06 10*9/L (range 2 - 7)
percentage neutraphils 58.8%
Lymphocite count 0.99 10*9/L (range 1 -- 3)
percentage lymphocites 28.2%
Monocyte count 0.33 10*9/L (range 0.2 - 1.0)
percentage monocytes 9.4%
Eosonophil count 0.09 10*9/L (range 0.02 - 0.50)
percentage easonophils 2.6%
Basophil count 0.04 10*9/L (range 0.00 - 0.10)
percentage basophils 1%
Platelet count 210 10*9/L (range 150 -410)
mean platelet volume 7.8 fL
Serum C reactive protein 2.9 mg/L (range 0.0 - 6.0)
serum total bilirubin level 9 umol/L (range 1 - 21)
serum total protein 72 g/L )(range 60 - 80)
Sorry I thought I had some with T3 and T4 levels on them, but clearly don't.
I had effectively given up trying to get anything done but then had those 2 incidents just recently so decided to have one last go.
Not sure if I mentioned it but it was after the recent hot spell and on the 1st colder day it rained. I was working in the garage and noticed I was slowing down and not thinking straight so I came in for a warming drink and took my temp (orally with my normal Boots thermometer) it was 32.4C. 10 days later after another warm spell the weather changed again and another incident, this time only down to 32.8C but still cold enough to make me retire to bed to get warm.
I will ask the surgery if I can get copies of any T3 and T4 tests specifically if they can obtain the one from Jan2018.
In the meantime thanks for your time and await further thoughts.
My results are back and they are all normal but I had 2 "cold events" in May and 2 in June - my definition of a cold event is when I feel I appear to lose core temperature and get to a stage where I can't recover it without retiring to bed under a quilt.
So interesting that my test on 25June carried out by County Pathology appeared so normal. Here they are
Inflammation CRP HS 0.5 mg/L (Range: < 5)
Iron Status
Ferritin 306 ug/L (Range: 30 - 400)
Vitamins
Folate - Serum 11.44 ug/L (Range: > 3.89)
Vitamin B12 - Active 74.300 pmol/L (Range: > 37.5)
Laboratory Report ( Thyroid Check UltraVit Blood Test )
Only suggestion was to go back to my GP and discuss which I am doing and awaiting an endo referral.
Other things to note, that may be relevant, are
1. I traditionally run on the cold side, so start the day at around 34/35C, peak at 35/36C and end the day at 33C.
2. I also note that when exercising which I still do and have always done - I appear to heat up and perspire very easily compared to most.
3. In the evening after a gym class or 10mile bike ride my temp is typically <33.5C even before my heart rate has returned to anything like normal (resting rate is 54-56bpm)
4. My temperature when I have a "cold event" is invariably <33C
(all temps monitored orally with a branded digital thermometer)
I'll keep you posted on endo checks, if/when I get one.
Test was done around 08:15 after I'd finished mucking out the horses and I have to confess I had a cup of tea (no sugar) around 06:30 when I went over to the stables.
My diet is pretty good, very little processed food - normal breakfast is porridge/almond milk/collagen powder/blueberries for breakfast.
Normal lunch is something snacky, if its sunny it will be a cheese/salad (mostly salad) wrap if cold then possibly a couple of eggs. Evening meals are fish or casserole or local butcher burgers/sausages with pasta and veg.
Weaknesses are chocolate (I limit this as much as poss) and a couple of beers.
In terms of head trauma I've never had a major one. A couple of concussive knocks playing sport (field hockey) and a couple of falls resulting in broken ribs rather than damaged head. Ah just remembered a very early one when I was about 13 - I went over the handlebars of my bike and removed front teeth on a cobbled road - definitely concussed that time but that's the only time I know of.
btw what is "central hypothyroidism" not sure what the central refers to?
I think there may a genetic component as my daughter exhibits almost identical symptoms.
Hope this adds something to the debate and I'll email about the good endos, thanks for that.
Igennus Super B is good quality and cheap vitamin B complex. Contains folate. Full dose is two tablets per day. Many/most people may only need one tablet per day. Certainly only start on one per day (or even half tablet per day for first couple of 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
I think you are hypothyroid and need Levothyroxine. My Dad is 78 and takes a 100mcg of Levo a day which is classed as suitable for someone who is elderly. My Dad's wife also is hypothyroid and I think a lot of older people are but they are not given any treatment because their TSH is within guidelines. I would pay for a private blood test which is more detailed than what the NHS do. I always use Medichecks because they do discounts for this site. Once you get the results post them on here for members to advise you.
Just to add I am always cold all the time and I have thyroid disease.
I also note that when exercising which I still do and have always done - I appear to heat up and perspire very easily compared to most.
This may be a sign that you have too little or too much cortisol. Cortisol is one of the stress hormones (the other one is adrenaline), and is produced by the adrenal glands.
If your body needs more thyroid hormones than your thyroid is capable of producing then the body compensates by producing more cortisol, and possibly more adrenaline too. This leads to cortisol levels being high. In some cases though, the adrenal glands can't produce more cortisol indefinitely and levels start to drop dramatically and become very low.
A link you could read that might be helpful - it's only available in the internet archive now :
Some people have followed the instructions and have found it helpful - it doesn't cost anything other than a sheet of graph paper and lots of temperature taking so may be worth trying.
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