Hashimoto and potential PCOS? Blood test results

[malvisia]

Hi all,

Have been diagnosed with Hashi years ago, but recently had odd symptoms, horrible painful acne, skin discolorations, weight gain, low mood. Did the day 3 hormonal profile and looks like results might be pointing towards PCOS? Or is it just badly managed Hashi? Results of full thyroid profile from 7 weeks earlier within the norm, so high TSH must be due to me forgetting to take levo in the past week...

Any thoughts would be great

[Aslangal]

I don’t know enough to give you advice but someone will be along soon I am sure who can interpret your results. 😀

[fuchsia-pink]

Your TSH is too high and your free T is too low. I'm not surprised you don't feel great and have put on weight. But you must remember to take your levo every day or you could end up very ill indeed - it's so important that you take it that your prescriptions are free (in England - they're free anyway in eg Scotland).

Is there any way you can make it part of your early morning or bed-time routine - eg putting tablets next to toothpaste? [mine are on my bedside table next to my glasses over-night, so I put on glasses and take tablets in the morning]

[SlowDragon Administrator]

Looking at previous post you had levothyroxine reduced from 175mcg to 100mcg

How much levothyroxine are you currently taking

You are extremely under medicated now

See GP for 25mcg dose increase in levothyroxine and insist that B12, folate, ferritin and vitamin D are tested ....likely very low

B12 implicated in acne

Bloods should be retested in 6-8 weeks after each dose increase

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

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 .

Last dose of Levothyroxine 24 hours prior to blood test. (taking delayed dose immediately after blood draw).

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

List of private testing options

thyroiduk.org/getting-a-dia...

Medichecks Thyroid plus vitamins including folate (private blood draw required)

medichecks.com/products/thy...

Thriva Thyroid plus antibodies and vitamins By DIY fingerpick test

thriva.co/tests/thyroid-test

Blue Horizon Thyroid Premium Gold includes antibodies, cortisol and vitamins by DIY fingerprick test

bluehorizonbloodtests.co.uk...

If you can get GP to test vitamins and antibodies then cheapest option for just TSH, FT4 and FT3

£29 (via NHS private service ) and 10% off if go on thyroid uk for code

thyroiduk.org/getting-a-dia...

monitormyhealth.org.uk/thyr...

Medichecks - JUST vitamin testing including folate - DIY finger prick test

medichecks.com/products/nut...

Medichecks often have special offers, if order on Thursdays

[malvisia in reply to SlowDragon]

Thanks for your response SlowDragon. As I said full thyroid profile including vit B12 & D levels done about 7 weeks ago shown all in normal levels, TSH at 0.4, TT4 118, FT4 21.9, antibodies also well below the threshold. My only concern is the elevated testosterone and LH, I think (only think) that increase in TSH is only due to me being too lax with the levo pills, I am back at 150 daily to answer your question

[SlowDragon Administrator in reply to malvisia]

Well that was 6 weeks ago

Presumably this test above has only just been done?

Your TSH is now far too high at 6.18 and Ft4 near bottom of range

Levothyroxine must be taken EVERYDAY

Likely you have low vitamins as direct result

Suggest you get weekly pill dispenser and ensure you take it every day

Retest full thyroid and vitamins in 6-8 weeks

[Newbie321]

I am very much a newbie to this having only recently been diagnosed, but have been looking at fertility and hormone levels for quite a while.

I would say this looks like Thyroid related rather than PCOS for the reasons below. If you get more symptoms, particularly any that are not common with elevated TSH and your periods are irregular once you have regulated TSH consider a follow up, but the symptoms you mentioned could also be the TSH.

PCOS as a syndrome needs 2 of the 3 following 1. elevated androgen levels 2. Irregular periods and 3. cysts on your ovaries, but also should eliminate other causes. So if you only have slightly elevated testosterone but not the other indicators it is unlikely to be PCOS. In addition the Hashimoto can cause similar irregularities.

You have slightly elevated prolactin, which is consistent with increased TSH (both triggered by the same stimulus in the pituitary) so if your TSH is managed this should drop. It is also associated with stresses and other stimuli - for example waking up early can increase the levels for a short period and is not a cause for concern.

The LH level is slightly high for the reference range, but that range is based on the assumption you are in early follicular stage. As you get nearer to ovulation the range goes up to 95 so if this was on day 7 of your cycle it is unlikely to be of any concern and isn't indicative of PCOS .

On the testosterone levels, while it is slightly elevated this can be for a number of reasons including stress, high intensity exercise and other reasons and is not at a level I have seen for PCOS. Deficiency in some vitamins and minerals can also raise testosterone levels slightly, which as pointed out by others can occur with Hashi

Hope this helps!