Eli Needs a little advice

[elsiemcleod]

I'm new here, have had hypothyroid for about 6 years ,female and 69 years of age, usually fit for my years. About 6 weeks ago went to GP as feeling body was feeling jangly and couldn't sleep .Dr advised it was anxiety which I had never had in my life. Never asked about thyroid or said he would take blood to check it out,prescribed propanolol slow release , but they didn't agree with me. I decided to go to nurse to check thyroid as I think he really should have checked that as well in the first instance. Got results back t3 0.18 ft4 23.4 , previously tests were ( t3 1.2) ( ft4 18.6 ) always feel better when ( t3 around 1.0 ) nurse phoned advising GP reducing levo from 100 to 75. Have asked several times for full thyroid tests and have been turned down, so decided I would do the test through Blue Horizon as I have been feeling really unwell for weeks. Results came back within 2 days.(TSH 3.48) (T4 Total 129 .0) ( FT4 22.1 ) ( FT3 3.74)

Anti Thyroidperoxidase abs 43 Anti Thyroglobulin Abs 15 Vitamin D (25 OH ) 80 Vitamin B12 282 Serum Folate 39.50 Cortisol ( Random) 710.0 CRP 3.16 Ferritin 465.0 Magnesium 0.94

Also have a really sore tongue for sometime as well.

Have been advised by Dr's comments that I make appointment for GP to discuss issues, that's if I can get an appointment these days . Tsh has jumped up really quickly in such a short time can't understand in 4 weeks reducing levo from 100 to 75 it would go this high. Concerned that I might be going hyper. B12 is low, cortisol high which may be could be anxiety also my ferritin for some reason is high.

Think I may have slight anxiety now as I have'nt been feeling to well for weeks

My GP wanted me to take a antidepressants as seems to think this is the problems but since having these results done I'm not so sure and I have refused these at this time.

Putting medical report in to my GP Monday morning so will see what he comes up with. Doubt if he will be very happy.

Would really appreciate any advice that can be given, thanks.

23/02/21 telephoned GP this morning to see if he had read my report as I thought he would have contacted me yesterday. Spoke to practise manager who informed me that dr stated that results didn't tie in with their lab testing and advised that I retest in 2 months time. I stated that am still feeling unwell and concerned about my high Ferritin levels and extremely sore tongue and low B12, I asked should I be taking a course of b12 . On that the practise manager said she would make a appointment for bloods to be done on Thursday . Still don't know if I will get a anywhere .

[greygoose]

Hi elsiemcloed, welcome to the forum.

I'm afraid it's really difficult to make any intelligent comments without the ranges for those blood test results. Ranges vary from lab to lab, so we need those that came with your results.

Why did the nurse suggest the doctor reduce your dose? Was the TSH very low? You haven't given a TSH result for that first set of results. But, you're only over-medicated if your FT3 is over-range. I don't get the impression that yours was.

Tsh has jumped up really quickly in such a short time can't understand in 4 weeks reducing levo from 100 to 75 it would go this high. Concerned that I might be going hyper.

Given that you are hypo - and that's why you're taking levo - it's impossible for you to become hyper. The thyroid doesn't work like that. You could be over-medicated, but that's hardly likely with a TSH of 3.48. What's happening is that you have become more hypo due to the unnecessary reduction of your dose of levo. You need your old dose restored.

Anti Thyroidperoxidase abs 43

If I remember the Blue Horizon ranges correctly, it looks as if you have Hashi's. Did you already know that? That could account for your numbers jumping around.

Vitamin B12 282

That's much, much too low. Do you take any supplements?

Think I may have slight anxiety now as I have'nt been feeling to well for weeks

More likely that your anxiety, depression and your not feeling well are due to your low FT3. It rather looks as if you have a conversion problem, but not possible to say for sure without the ranges.

[elsiemcleod in reply to greygoose]

Conversion list (tsh 0.27-4.20,) mIU/L (t4 total 66-181) nmol/L (free T4 12.0 - 22.0) pmol/L (Free T3 3..1-6.8) pmol/L (thyroidperoxidase abs 34 ) ( thyroglobin abs 115) klU/L(Crp 5.0) mg/L (Ferritin 13-150) ug/L (magesium 0.66-0.99) mmol/L

( Serum Folate 8.83-60.8) nmol/L (B12 145- 569) pmol/L

( Vit D 50-175)nmol/L. SORRY should have put this this in . Gp would not give me full thyroid test asked several tmes seemingly NHS labs don't do it. Or that's that I was told. I really wanted to find out if I had hashi? Thank you for your help. I put blue horizon results in this morning to medical centre and spoke to practise manager, who said they would bet back to me today , sadly I have had no phone call today.

The nurse checked with dr and it was his choice to reduce my levo.

Thanks

[greygoose in reply to elsiemcleod]

tsh 3.48 (0.27-4.20,) mIU/L

t4 total 129 (66-181) nmol/L

free T4 22.1 (12.0 - 22.0) pmol/L

Free T3 3.74 (3..1-6.8) pmol/L

thyroidperoxidase abs 43 <34

thyroglobin abs 15 <115

Crp 3.16 <5.0 mg/L

Ferritin 465 (13-150) ug/L

magesium 0.94 (0.66-0.99) mmol/L

Serum Folate 39.5 (8.83-60.8) nmol/L

B12 282 (145- 569) pmol/L

Vit D 80 (50-175)nmol/L

OK, so I've put the results and ranges in a form that is more easily understood.

Your TSH is too high, meaning that you are under-medicated.

Your FT4 is slightly over-range, but that's not a problem.

The problem is that your FT3 is very low. So, propranolol or no propranolol, it looks like you are a very poor converter.

Your TPO antibodies are over-range, so you do have Hashi's.

The rest I think the others have covered.

[jimh111]

Propranolol impairs T4 to T3 conversion and so will mess up your thyroid status and blood test results. Propranolol is used to treat hyperthyroidism.

Avoid antidepressants, they will obscure real underlying problems.

You may have been a little hyper so it was reasonable to try reducing your levothyroxine but maybe the drop to 75 mcg was too much. You could try 75 mcg one day 100 the next and then have a blood test after a few weeks, with NO propranolol.

See what GP says about high ferritin, I don't know anything about this.

[SlowDragon Ambassador]

Have you stopped taking propranolol, or were you taking propranolol when this test was done?

Your B12 is extremely low

Request/insist on testing for Pernicious Anaemia before starting any B supplements

Sore tongue is likely due to low B12

Low B12 symptoms

b12deficiency.info/signs-an...

Ferritin is high. This needs further investigation. It can be slightly raised due to inflammation of Hashimoto’s. But this is higher even than that. GP should do full iron panel test to see if iron is also high. Some Hashimoto’s patients have hemochromatosis (iron overload)

Your Ft3 is now very low....too low

You will either need increase in levothyroxine or addition of small doses of T3 prescribed alongside levothyroxine

Suggest you increase levothyroxine to 100/75mcg alternate days and retest in 6-8 weeks

Getting started on B12 injections or daily B vitamins will also help improve thyroid results

[shaws]

Welcome to our forum and I'm sorry you have hypothyroidism.

To alter anything within your post, click on the down arrow next to 'More' and select edit.

If GP is suggesting anti-depressants, I doubt he has tested both Free T3 and Free T4 and we need both to be in the upper part of the ranges. T4 is inactive and T3 is active. Levothyroxine is T4 and supposed to convert to T3 which is the Active thyroid hormone and our heart and brain have the most T3 receptor cells.

This is the method for blood tests for thyroid hormones:-

Always get the earliest appointment (even if you have to make appointment weeks before). It is a fasting test and do not take thyroid hormones before but afterwards. This helps keep the TSH at its highest and may prevent an unecessary decrease in your dose. The majority of doctors think that a very low TSH means we've become hypERthyroid but that's not the case.

Always get a print-out of your results for your own records and post if you have a query.

I hope you feel better soon.

[shaws]

Many doctors seem not to have much knowledge about how best to treat patients who have dysfunctional thyroid glands and stick to a very 'basic' treatment as they're advised.

We used to have 'options' if we weren't improving on levothyroxine but they've slowly removed these and many people have suffered as they were well on the options.

It's well seen, I believe, that those who make these decisions really do not appreciate how unwell people can be when we've dysfunctional thyroid glands, considering the brain and heart have the most T3 receptor cells.

Not one doctor/specialist etc could diagnose me. Whereas our 'old-fashioned doctors' knew all clinical symptoms (no blood tests then) and we were given a trial of NDTs. (made from animals' thyroid glands). If we improved we stayed on NDTs, gradually adjusted to ensure patient was well.

Despite NDTs saving lives from 1892 onwards this was withdrawn by those I'd imagine had more knowledge about dysfunctional thyroid glands, without notice, and left many patients in the lurch and no warning.