Do I have a thyroid problem?

[CharleeP]

Hi all, I have no idea if I have a thyroid problem, but I think I do. I have been struggling to conceive and whenI have I have suffered miscarriages.

I also noticed 3 years ago a small goitre in my neck. I had tests done in the summer as I spoke with my GP about being tired and my neck and my fertility problems, but they said everything looked normal and I took their word for it. I have now been told by various sources that GP’s do not know how to interpret the results so I am now not sure if I have a problem or not.

Can anyone interpret the below results please? :-

Serum TSH level - 1.99 mlU/L (0.3-3.94)

Serum Folate level - 14.8 ug/L (ref range >3.8 ug/L)

Serum Vitamin b12 - above range 814 ng/L (197-771 outside red range)

Serum Creatinine level - above range 84 umo/L (44-80 outside ref range)

GFR calculated abbreviated MDRD - 65 m/Lmin/1.73m2

Serum C reactive protein level - <1mg/L (<5.0)

Serum sodium level - 139 mmo/L (136-145)

Serum potassium level - 4.2 mmo/L (3.5-5.1)

Serum urea level - 5.2 mmol/L (2.1-7.1)

Liver function:

Serum total protein level - 72 g/L (64-83)

Serum bilirubin level 8 umo/L (<21)

Serum alanine aminotranferase level - above range 56 iu/L (<33)

***I did have another liver function blood test and all came back normal as the above was borderline) ***

Bone profile:

Serum calcium level - 2.37 mmol/L (2.15-2.55)

Serum inorganic phosphate level - 1.12 mmol/L (0.81-1.45)

Serum albumin level - 47 g/L (35-52)

Serum alkaline phosphates level - 57 iu/L (35-104)

Serum adj calcium concentration- 2.23 mmol/L (2.15-2.55)

[SlowDragon Administrator]

Just testing TSH is completely inadequate

You need TSH, Ft4 and Ft3 plus both TPO and TG thyroid antibodies tested

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)

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 antibodies and vitamins

medichecks.com/products/adv...

Thriva Thyroid plus antibodies and vitamins By DIY fingerpick test

thriva.co/tests/thyroid-test

Thriva also offer just vitamin testing

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 down to £26.10 if go on thyroid uk for code

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

monitormyhealth.org.uk/thyr...

Essential to test vitamin D too

Monitor my health can test vitamin D

[CharleeP in reply to SlowDragon]

Thank you, that is super helpful. I will speak to my GP on Monday and order a test for anything I can’t get tested on.Fingers crossed it is not anything to worry about but at least I will know.

[shaws Administrator in reply to CharleeP]

Few GPs will order a Full Thyroid Hormone Test, I hope yours will do so.

[SlowDragon Administrator]

What vitamin supplements are you currently taking...if any?

What’s the range on GFR result?

[CharleeP in reply to SlowDragon]

I’m taking Pregnacare conception (vita optics).

GFR just says what I have written - there was nothing in brackets.

[SlowDragon Administrator in reply to CharleeP]

Ask GP about GFR result

Typically GFR under 90 is considered abnormal

Obviously this may be different in your results

nhs.uk/conditions/kidney-di...

[CharleeP in reply to SlowDragon]

That is odd. Very concerning why they haven’t picked that up. I will definitely be asking about that.

Thank you

[SlowDragon Administrator in reply to CharleeP]

Before considering TTC TSH should be under 2.5

Obviously yours is, but it’s slightly higher than average

Was this test done as early as possible in morning before eating or drinking anything other than water, as this gives highest TSH

Median TSH graph

healthunlocked.com/thyroidu...

[CharleeP in reply to SlowDragon]

I can’t remember, I am guessing that it was the morning but may have at least had a cup of tea with milk. No one told me not to and it was a walk in blood test so I can’t remember. Sorry. I’m guessing that means it could be higher than it should have been then?

[SlowDragon Administrator in reply to CharleeP]

That was why I asked

[CharleeP in reply to SlowDragon]

Morning, My GP took my blood for TSH, T4, T3 and Vit D - she wouldn’t rest for antibodies or the other vitamins as she said I had these in my last blood tests in the summer. I didn’t push too hard as intend to do a private test if things look squewif.

I just got my ‘normal’ results over phone so don’t have the full breakdown, but could you tell me if it’s wise to look deeper please? -

TSH - 1.89

T4 - 14.6

T3 - 4.7

I had the test first thing before eating and drinking.

[SlowDragon Administrator in reply to CharleeP]

Results don’t mean much without the ranges

Ft4 looks on low side ....but need range to be certain

No vitamin D result?

Obviously need to test thyroid antibodies

And ferritin, or full iron panel test for anaemia

[CharleeP in reply to SlowDragon]

Morning,

I have are my full results from my private thyroid test, please can you confirm whether these are in fact normal as they have told me. From what you have said above, my TSH seems to be too high to conceive.

Thank you

CRP HS 0.23 mg/L (Range: < 5)

Ferritin 119.00 ug/L (Range: 13 - 150)

Folate - Serum >19.8 ug/L (Range: > 3.89)

Vitamin B12 - Active 111.000 pmol/L (Range: > 37.5)

Vitamin D 64.00 nmol/L

Deficient <30

Insufficient 30 - 50

Consider reducing dose >175

(Range: 50 - 175)

TSH 2.45 mIU/L (Range: 0.27 - 4.2)

Free T3 4.70 pmol/L (Range: 3.1 - 6.8)

Free Thyroxine 15.000 pmol/L (Range: 12 - 22)

Thyroglobulin Antibodies <10 kIU/L (Range: < 115)

Thyroid Peroxidase Antibodies <9.0 kIU/L (Range: < 34)

[SlowDragon Administrator in reply to CharleeP]

Presumably you have been taking pre conception vitamin supplement?

Which one exactly?

Yes thyroid is borderline and struggling

TSH just on high side, Ft4 and Ft3 both on lower side of normal

No thyroid antibodies

However 20% of Hashimoto's patients never have raised antibodies

Especially with your history of lump in thyroid would strongly recommend getting ultrasound scan

£150 privately.

PM me for details

healthunlocked.com/thyroidu...

Paul Robson on atrophied thyroid - especially if no TPO antibodies

paulrobinsonthyroid.com/cou...

Folate, B12 and ferritin are good

Vitamin D is too low

GP will often only prescribe to bring levels to 50nmol.

Some CCG areas will prescribe to bring levels to 75nmol or even 80nmol

leedsformulary.nhs.uk/docs/...

GP should advise on self supplementing if over 50nmol, but under 75nmol (but they rarely do)

mm.wirral.nhs.uk/document_u...

NHS Guidelines on dose vitamin D required

ouh.nhs.uk/osteoporosis/use...

But improving to around 80nmol or 100nmol by self supplementing may be better

ncbi.nlm.nih.gov/pubmed/218...

vitamindsociety.org/pdf/Vit...

Once you Improve level, very likely you will need on going maintenance dose to keep it there.

Test twice yearly via vitamindtest.org.uk

Vitamin D mouth spray by Better You is very effective as it avoids poor gut function. There’s a version made that also contains vitamin K2 Mk7

amazon.co.uk/BetterYou-Dlux...

It’s trial and error what dose we need,

Calculator for working out dose you may need to bring level to 40ng/ml = 100nmol

grassrootshealth.net/projec...

Government recommends everyone supplement October to April

gov.uk/government/news/phe-...

Taking too much vitamin D is not a good idea

chriskresser.com/vitamin-d-...

Web links about taking important cofactors - magnesium and Vit K2-MK7

Magnesium best taken in the afternoon or evening, (but must be four hours away from levothyroxine )

betterbones.com/bone-nutrit...

medicalnewstoday.com/articl...

livescience.com/61866-magne...

sciencedaily.com/releases/2...

Vitamin K2 mk7

betterbones.com/bone-nutrit...

healthline.com/nutrition/vi...

2 good videos on magnesium

healthunlocked.com/thyroidu...

List of hypothyroid symptoms

thyroiduk.org/signs-symptom...

Email Thyroid UK for list of recommend thyroid specialist endocrinologists.......NHS and Private

[e-mail]

You may find it difficult to get an endocrinologist to agree to treat ....you will have to underline you are trying to conceive

If you get prescribed levothyroxine

The aim of levothyroxine is to increase dose upwards until Ft4 is in top third of range and Ft3 at least half way through range (regardless of how low TSH is) ...

Extremely important to have optimal vitamin levels too as this helps reduce symptoms and improve how levothyroxine works

[CharleeP in reply to SlowDragon]

Thank you for this. I have emailed for a list of thyroid specialists and will get in touch. I did have an ultrasound on my lump and all came back benign and I was discharged. I mentioned concerns on my thyroid and they said there was no problem and checked for cancer too and could not see any concern.

I presume I do not need to revisit this unless the lump in my neck changes? (Which is what they told me).

[SlowDragon Administrator in reply to CharleeP]

Just read in earlier reply you are taking this vitamin supplement

vitabiotics.com/products/pr...

Did you stop this for 5-7 days before test

It contains biotin. This can falsely affect test results

Generally we always recommend stopping all supplements that contain biotin a week before ALL BLOOD TESTS

[CharleeP in reply to SlowDragon]

No I didn’t stop taking my supplements. So I have wasted £70? Not ideal.

[SlowDragon Administrator in reply to CharleeP]

Well it might have affected result.....it’s impossible to say

Suggest you work on improving low vitamin D by increasing dose to 2000-3000iu daily

Get new test in 4-6 weeks via Monitor My Health.

Just TSH, Ft4 and Ft3

£29 (via NHS private service ) and 10% off down to £26.10 if go on thyroid uk for code

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

monitormyhealth.org.uk/

Remember to stop taking any supplements that contain biotin a week before

Only do test early Monday or Tuesday morning and then post back via tracked 24 hour postal service

As before do test as early as possible in morning before eating or drinking anything other than water

Meanwhile look at getting ultrasound scan of thyroid

[CharleeP in reply to SlowDragon]

Could things be much worse than it appears then? I wish I knew before taking the test, this is starting to really stress me out now.