Please, - help needed with my son's results and symptons

[Golli]

Since April, my son , who is 37, has been feeling tired and drained , especially in the mornings. These symptons come and go, some weeks are worse than others, but low level weeks , seem to be more frequent. He has dull pain under his Right rib cage , on and off, not severe.....and has ,what he describes as , "weird pains", randomly in different parts of abdomen......mostly just uncomfortable.

He had a phone consultation with GP , who organised blood tests .

HE'S ON NO MEDICATION.

His Blood Results (TAKEN 13/08/20, FASTING) are :

FT4 11.2 pmol/L (12-22)

TSH 5.98 mU/L (0.27-4.20)

FT3 ------NOT DONE.( TYPICAL!)

SERUM VITAMIN B12 445 ng/L (191-663)

SERUM FOLATE 7.1ug/L (3.89-26.8)

SERUM FERRITIN 38.5ug/L (30-400)

CRP 0.3 (0-5)

FULL BLOOD COUNT WAS DONE , HERE ARE THE ONES THAT WERE FLAGGED:

MEAN CORPUSC. HAEMOGLOBIN 33.2pg (27-32)

MEAN PLATLET VOLUME 11fl (8-10)

TOTAL WHITE CELL COUNT 3.32 e9/1 (4-11)

DIFFERENTIAL WHITE CELL COUNT :

PRINT OUT STATES: RED CELL MORPHOLOGY COMMENT = POIKILOCYTOSIS2

GP discussed results with my son by phone, told him his white cell count was low, and thyroid was low, suggested he start levethyroxine, 50mcg and repeat bloods in one month. My son doesnt want to and hasn't started levo and wants to wait until next blood test on 7/09/20 to see if thyroid has improved. I'm wondering is this the right approach, should he get his antibodies checked ? (im still trying to sort out my own thyroid problems since 2007 , and sincerely hope he is not facing the hurdle of thyroid disease, ! )

G P, Didn't mention anything about the POIkilocytosis2 comment , which we just noticed when we got a print out of blood results today. (ive looked it up and seems to be connected with anaemia)

My son has been taking supplements for the past couple of months, they are

Vit B12 1200ug daily and Vit D+k 3000iu/75ug daily.

He stopped Vit B12 5 days before blood test ( its in spray form)

He is vegetarian/ almost vegan, doesn't smoke or drink.

He is trying to boost his levels and is researching nutrients and vegetarianism.

I've had so much help from this forum and would gratefully appreciate any help for my son also. Thank you. Apologies for the long post.

[fuchsia-pink]

What a nice GP to give him a "starter" dose of levo before his TSH reaches 10! Very kind

He's clearly hypo - his TSH is out of range (too high) and his free T4 is out of range (too low). A test of antibodies will confirm if he has Hashis - the biggest single cause of hypothyroidism.

An under-active thyroid won't "cure" itself. So he can try and get well and take the levo he has been given, increasing the dose as required, or not: his choice x

[Golli in reply to fuchsia-pink]

Thank you for your reply , ...actually there is only one Gp in our practice and he was off that day , a female Gp locum covering , so she was the kind one, not so sure our Gp would have been so kind !or informed.

I’ve said to my son, that if he is auto immune, , hashi, he will need thyroid hormone replacement , but he is adamant at the moment, he will wait to see what way it goes or at least till next results . Fingers crossed.

[Localhero]

Hi there

Sorry your son has been feeling so bad.

You’re right, his FT3 should have been done. However, his FT4 is under range and his TSH over. This indicates his thyroid isn’t working properly and his body is working doubly hard to try to keep things going. No wonder he feels tired and has these other symptoms.

I’m glad he’s researching nutrition etc because with this going on his nutritional status is likely to be compromised. He might benefit from a strictly gluten free diet if he isn’t already.

I’m no expert but I’d say your son should definitely start taking the levothyroxine that the doctor has prescribed and not make the mistake of thinking things will just get better. In addition to FT3, he should also check thyroid antibodies, at least to know what he’s dealing with. I believe 90% of thyroid problems in the UK are Hashimotos, an autoimmune form of the illness.

I know it’s hard for him - and indeed you - to imagine he has to face this. But, frankly, the sooner the better from a long-term health perspective. And, also, the more he can, like you, adopt full responsibility for his health and treatment, and not unwittingly hand responsibility to the NHS or medical profession for it, the better he’s more likely to feel.

[Golli in reply to Localhero]

Thank you so much for your response Localhero, I’ve expressed these sentiments already to him , I’ve a feeling it’s going to be a battle to get the T3 and antibodies done , as our practice won’t do them,, ( sometimes I sneakily ask nurse to do my T3 , when I’m getting my bloods done ,but it depends which nurse it is!) So may have to get private bloods done.

Left my thyroid issues to medics/ NHS for the past 10 years or so , to my detriment, only these last few months I’ve been more proactive in dealing with all the problems / symptoms. , I’m starting to make progress, a long way off , but think going in right direction.

All best to you and thanks again.

[Nanaedake]

There's no vitamin D result? What did the doctor say to do about Iron levels? Did he have a full iron panel done? He's clearly hypothyroid and needs to start taking the levothyroxine prescribed.

The pains and tiredness may be related to poor iron or vitamin D levels though.

[Golli in reply to Nanaedake]

My goodness, thank you for pointing that out. Vitamin D not listed in results. As I stated in post, he has been supplementing vitD the last couple of months.

Not sure if it was full iron panel , there’s lots of results listed under Full Blood Count heading and differential White Cell Count Heading, but I just included the flagged results in the post .

As far as I know Dr didn’t say anything about Iron levels.

[Hay2016]

With abdominal pains and low ferritin did gp even blink. If this is accompanied by change in bowel habits he needs to have that investigated but may be low due to vegetarianism. Thyroid is glaring but don’t let anything else slip through the cracks.

[Golli in reply to Hay2016]

Thank you for your response Hay2016, ......

I can bet on it that Gp didn’t blink!.with those results. ... but It was a phone consult, so can’t be sure😀.

Bowel habits are unchanged.

He is making sure his diet is optimal ,with leafy greens , beans, etc to make up for his non dairy ../ meat free diet.

He’ll have to make sure all the appropriate tests are done at next appointment, but I may be a battle unfortunately.

Keep well

[Hay2016 in reply to Golli]

Yep my sons 21 and daughters 18, battle to get them to take things seriously for themselves. Then add drs in to mix. 😢 good luck

[Golli in reply to Hay2016]

I relate to that. Thanks for your kind words ,

[penny]

This is purely rhetorical but...why won’t your son take thyroid hormones? If he were diagnosed with diabetes I assume that he’d take the insulin.