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
2017 results show low B12 and folate
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
I have suffered with this a lot longer than 15 years, and had numerous GP visits, the first one I was referred to a psychologist, because their diagnosis was “it-was all in my mind “ after 12 sessions nothing to report. Eventually I went private, because now I was having very bad anxiety, and other psychological issues which was affecting my job. The private Endo found that I had vitD in single figure (8) and parathyroid was 128, he put me on high dose of vit D for 8 weeks, and also said I will suffer hypothyroidism in the future. I have suffered with joint pain, muscle twitches cramps, lychen planus, anxiety, indecisiveness, hoarding, lack of motivation and lots more issues. In 2013 I had to take early retirement due to these problems. Currently I still have all the symptoms plus in the last 3 months or so I have
Some sort of hives or rash or hives ( slightly raised skin) around both eyes and temples and a little way down the cheeks, which sometimes itches and will have a burning sensation which can be calmed by splashing cold water.
I had to do online consultation with GP (as they won’t do face to face), including photos of facial rash and was prescribed antihistamine which had no effect on the hives/ rash.
Food intolerances, constipation, bloating, joint pains, muscle spasms (intermittently) , feeling cold in hands feet and head. Lack of interest in interacting with family, unable to motivate myself to carry out daily routines, and mild form of hoarding mentality. One of the biggest problems is anxiety, indecisiveness and overthinking, brain fog and memory. There are a few more which I can’t remember right now.
If I had a private blood test what would be the next step?
I had two appointments for Endo for July and August made over a year ago both cancelled.
Should I see a Endo privately after the blood test or see the Endo and be guided by him?
First step is to get FULL thyroid and vitamin testing
Are you in the UK?
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 with Hashimoto’s
Are you still supplementing vitamin D?
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 .
Medichecks often have special offers, if order on Thursdays
Have you had coeliac blood test done
Hashimoto's affects the gut and leads to low stomach acid and then low vitamin levels
Low vitamin levels affect Thyroid hormone working
Poor gut function can lead leaky gut (literally holes in gut wall) this can cause food intolerances. Most common by far is gluten. Dairy is second most common.
According to Izabella Wentz the Thyroid Pharmacist approx 5% with Hashimoto's are coeliac, but over 80% find gluten free diet helps, sometimes significantly. Either due to direct gluten intolerance (no test available) or due to leaky gut and gluten causing molecular mimicry (see Amy Myers link)
Changing to a strictly gluten free diet may help reduce symptoms, help gut heal and slowly lower TPO antibodies
While still eating high gluten diet ask GP for coeliac blood test first or buy test online for under £20, just to rule it out first
The predominance of Hashimoto thyroiditis represents an interesting finding, since it has been indirectly confirmed by an Italian study, showing that autoimmune thyroid disease is a risk factor for the evolution towards NCGS in a group of patients with minimal duodenal inflammation. On these bases, an autoimmune stigma in NCGS is strongly supported
In summary, whereas it is not yet clear whether a gluten free diet can prevent autoimmune diseases, it is worth mentioning that HT patients with or without CD benefit from a diet low in gluten as far as the progression and the potential disease complications are concerned
Despite the fact that 5-10% of patients have Celiac disease, in my experience and in the experience of many other physicians, at least 80% + of patients with Hashimoto's who go gluten-free notice a reduction in their symptoms almost immediately.
Come back with new post once you get results of thyroid and vitamin testing
“According to the current TSH reference interval, hypothyroidism was not diagnosed in about 50% of the cases in the afternoon.”
“Further analysis demonstrated inadequate compensation of hypothyroidism, which was defined in 45.5% of the morning samples and in 9% of the afternoon samples”
TSH levels showed a statistically significant decline postprandially in comparison to fasting values. This may have clinical implications in the diagnosis and management of hypothyroidism, especially SCH.
B12 and folate low
Low B12 extremely common as we get older
Don’t start taking ANY B vitamins until after this blood test
Had my bloods done through BH on Wednesday awaiting results.
Decided to carry out online consult with GP, requesting blood tests by posting the following:
NOW WE JUST NEED TO KNOW WHAT KIND OF HELP YOU WOULD LIKE:
Tell us how we can help you I think I may need a referral I think I may need treatment
Please provide us with details of your problem
Have you tried anything to treat yourself?
Is there any particular treatment you would like to request?
Would you like help from a particular person at the surgery? If the person that you requested is not available, another member of the team at the practice will contact you.
You said: "I have been suffering with the following conditions: Cold feet,Pins & needles,Heavy eyelids,Muscle cramps,Heat/cold intolerance,problems,Dizziness,Constipation,Haemorrhoids,Head hair loss, Brittle hair,Eyebrow loss (outer third),Eyelash loss,Dry skin,Eczema,Psoriasis,Choking fits,Dry mouth,Halitosis,Poor focusing,Dry/gritty eyes,Blurred vision,Numbness in Toes,Puffiness of Eyes, hissing in ears, Panic attacks,Memory loss & confusion,Loss of drive, Depression,Anxiety,Personality change"
I need the following blood tests carried out as I am suffering with autoimmune Thyroid disease ( Hashimotos).
TSH, FT4 and FT3 plus both TPO and TG thyroid antibodies tested.Also vitamin D, folate, ferritin and B12"
GP emailed the following reply:
The message is:
"Dear Mr. Vimalachandran,
Thank you for your further email in which you list, once again, the distressing, varied and disparate collection of symptoms from which, on reviewing your notes, you appear to have suffered for a number of years now. I note that, over that time, you have had a wide range of investigations and seen a variety of specialists including dermatologist, rheumatologist, endocrinologist and psychologist without establishing an all-encompassing single diagnosis. I suspect, therefore, that you may be suffering from a number of, not necessarily linked issues, for which there is no single answer and might include psychological as well as physical causes, and for which we might not actually find a cause.
Having said that, I do note the positive thyroid autoantibodies in 2017. I also note that your thyroid function was good at the time and has remained so since. It is therefore probably not now necessary to repeat these 3monthly but having been not done since last October, are worth repeating now. I will ask our nurses to get in touch to arrange an appointment for thyroid function and a few other screening blood tests to exclude anything else new physically going on immediately.
If anything arises from these that need action then we will be in touch but (as can been seen by the length of this email)your long set of problems don't easily lend themselves to management on-line and, I'd suggest, that further consultations should be on by telephone instead.
I hope that this is helpful and you are in agreement with this course of action.
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