Normal results but feel awful

[EastLondon]

Hi, I’m currently suffering with lots of symptoms of hypothyroidism - hair loss, feeling cold, weight gain, dry skin, constipation. I’ve had my TSH, FT3 and FT4 checked which all came back as normal. I have good iron levels but low B12 levels. To be frank, I just don’t feel right and have a strong history of hypothyroidism (mother, aunt and grandmother). Is there anything else I can do? Does anyone know of a London based Endocrinologist with an open approach and that would so more tests? Thank you

[Lalatoot]

Initially you need to find out what the normal results are. Thyroid results cover a range of numbers. For example one range for the hormone ft4 is 9 to 19. I would be told I was normal if my result was 9 and also if my result was 19 or any number in-between. So normal doesn't mean the result is right for you.Ask for the results and share them on here.

[SeasideSusie Remembering]

EastLondon

I’ve had my TSH, FT3 and FT4 checked which all came back as normal.

Can you please post these "normal" results, with their reference ranges (as ranges vary from lab to lab). Seeing the actual numbers will help us to help you.

For a full picture you need:

TSH

FT4

FT3

Thyroid antibodies

Vit D

B12

Folate

Ferritin

The above tests you can do privately with one of our recommended labs (either by fingerprick test or venous blood draw at extra cost), and you should do this before even considering seeing an endo.

If your GP hasn't done all these tests the following are recommended:

Medichecks ADVANCED THYROID FUNCTION medichecks.com/products/adv...

Check this page for details of any discounts: thyroiduk.org/getting-a-dia...

or

Blue Horizon Thyroid PREMIUM GOLD bluehorizonbloodtests.co.uk...

Check this page for discount code thyroiduk.org/getting-a-dia...

[EastLondon in reply to SeasideSusie]

Results are as follows: TSH 1.74 (0.35 -4.94)

FT4 14.7 (9.0-22.0)

FT3 4.06 (2.63-5.70)

Thyroid antibodies - don’t have this

Vit D 46 (75-150) nmol/l

B12 168 (187-883) pg/ml

Ferritin 36 (13-150)

Folate 4.5(3-20)

[SeasideSusie Remembering in reply to EastLondon]

Can you add the ranges please, as I said they vary from lab to lab and we can't interpret your results without the ranges that came with them.

What is unit of measurement for Vit D - nmol/L or ng/ml?

What is unit of measurement for B12 - ng/L or pg/ml?

[EastLondon in reply to SeasideSusie]

Updated now

[SeasideSusie Remembering in reply to EastLondon]

EastLondon

TSH 1.74 (0.35 -4.94)

FT4 14.7 (9.0-22.0)

FT3 4.06 (2.63-5.70)

A normal, healthy person would have a TSH of no more than 2, often around 1, with FT4 around mid-range-ish. Nobody knows where our levels lie in health because we aren't tested for a baseline. However, your TSH comes within the area of a normal, healthy person and your FT4 is 43,85% through it's range so a bit below mid-range. These levels could be normal for you and they are certainly classed as euthyroid.

Thyroid antibodies - don’t have this

It might be worth getting these checked at some point as raised antibodies can suggest autoimmune thyroid disease which will eventually lead to hypothyroidism.

Currently your nutrient levels are poor and this could be where your problem lies. I would look to optimising these then see how things are.

Vit D 46 (75-150) nmol/l

The Vit D Society and Grassroots Health recommend a level of 100-150nmol/L.

To reach the recommended level from your current level, you could supplement with 5,000iu D3 daily.

Retest after 3 months.

Once you've reached the recommended level then you'll need a maintenance dose to keep it there, which may be 2000iu daily, maybe more or less, maybe less in summer than winter, it's trial and error so it's recommended to retest once or twice a year to keep within the recommended range. You can do this with a private fingerprick blood spot test with an NHS lab which offers this test to the general public:

vitamindtest.org.uk/

Doctors don't know, because they're not taught much about nutrients, but there are important cofactors needed when taking D3.

D3 aids absorption of calcium from food and Vit K2-MK7 directs the calcium to bones and teeth where it is needed and away from arteries and soft tissues where it can be deposited and cause problems such as hardening of the arteries, kidney stones, etc.

D3 and K2 are fat soluble so should be taken with the fattiest meal of the day, D3 four hours away from thyroid meds if taking D3 as tablets/capsules/softgels, no necessity if using an oral spray.

My suggestion for D3 is Doctor's Best D3 softgels which are a good quality, clean supplement with no excipients, just D3 and extra virgin olive oil.

My suggestion for Vit K2-MK7 is Vitabay or Vegavero brands.

Magnesium helps D3 to work. We need Magnesium so that the body utilises D3, it's required to convert Vit D into it's active form. So it's important we ensure we take magnesium when supplementing with D3.

Magnesium comes in different forms, check to see which would suit you best and as it's calming it's best taken in the evening, four hours away from thyroid meds if taking magnesium as tablets/capsules, no necessity if using topical forms of magnesium.

naturalnews.com/046401_magn...

drjockers.com/best-magnesiu...

afibbers.org/magnesium.html

B12 168 (187-883) pg/ml

This is below range, this could be causing many problems and you need to speak to your GP about this. Check for signs of B12 deficiency here:

b12deficiency.info/signs-an...

b12d.org/submit/document?id=46

If you have any list them to discuss with your GP and ask for testing for B12 deficiency and Pernicious Anaemia. Do not take any B12 supplements or folic acid/folate/B Complex supplements before further testing of B12 as this will mask signs of B12 deficiency and skew results.

Please don't ignore this dire B12 result, check out the first video here (you don't need to watch all of it, the first few minutes are enough to get a good idea):

b12deficiency.info/films/

Folate 4.5(3-20)

Folate and B12 work together. Your folate is low (recommended is at least half way through range) but doesn't come into the "deficiency" category. You could discuss with your GP and he may prescribe folic acid. If not you can help raise your folate level by eating folate rich foods and supplementing with a good quality B Complex such as Thorne Basic B or Igennus Super B.

Don't start taking a B Complex until further testing of your B12 has been carried out and B12 injections (or supplements) started.

When taking B Complex this needs to be left off for 7 days before any blood test as it contains Biotin and if Biotin is used in the testing procedure (which most labs use) then it can cause false results.

Ferritin 36 (13-150)

This is low. As your GP to do an iron panel to test for iron deficiency and a full blood count to test for anaemia.

Don't consider taking an iron supplement unless you do an iron panel, if you already have a decent level of serum iron and a good saturation percentage then taking iron tablets can push your iron level even higher, too much iron is as bad as too little.

[SlowDragon Administrator in reply to EastLondon]

You obviously need thyroid antibodies tested

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

Are you in U.K. and are these test results from GP

Please add ranges on vitamin D, folate, ferritin and B12

B12 result looks extremely low

(assuming serum B12 test via GP)

Folate and ferritin you probably have results wrong way around

Folate 4.5

Ferritin 36

Vitamin D assuming nmol unit is too low

Low vitamin levels are closely linked to being hypothyroid

Improving low vitamin levels is likely first step

Optimal vitamin levels are

Vitamin D at least around 80nmol and around 100nmol maybe better

Serum B12 at least over 500

Folate and ferritin at least half way through range

[shaws Administrator]

Did you get the very earliest blood test appointment? Did you fast and not eat or take coffee before blood test? If not your results will not be accurate.

We, once diagnosed, do not want 'normal' we want optimum results i.e. that we feel well again and have no clinical symptoms.

We need FT3 to be near the top of the range as that is the 'active' hormone needed in the millions of T3 receptor cells in our body and the heart and brain contain the most.

T4 (levothyroxine) is an inactive hormone and is supposed to convert to T3.

If you wish to consult privately an Endocrinologist, contact Thyroiduk.org.uk. as it is the organisation behind this forum and you can become a member as it is TUK who have a very small staff are continually doing their best to change attitudes of the professionals.

[EastLondon]

I had the tests in the middle of the day after a normal day of eating and drinking, through an endocrinologist. I do take vitamin D, B12 and methyl folate supplements but have had low levels for years that I’ve stuffed to move. I’ve also had anti-nuclear antibody tests that was positive with a speckled pattern of >1:1280. I’m not sure if that is additive to the other results

[Lotika in reply to EastLondon]

Just PM’d you re a London endo. He has not treated me personally, but he is the endo I would go to if / when I go private. Hope it helps if you choose to go down that route.

[shaws Administrator in reply to EastLondon]

Always get your blood drawn at the very earliest appointment - make it weeks ahead so you have a choice.

If you take your thyroid dose early a.m. don't take it until after blood is drawn as it could mess up the figures.

You can have breakfast afterwards.

Also request B12, Vit D, iron, ferritin and folate. Everything has to be optimal.

[Hidden]

Hi Sounding like me was wondering if i'd posted under another name as i'm in London also! lol

[shaws Administrator]

I'm sorry you feel rough. 'Normal' is meaningless if we do not feel 'normal' but are symptomatic.

You've had some helpful responses which will assist you to go forward slowly. It's no good rushing - slow and careful until symptom-free is the method. It may take longer than you would imagine but slowly, with responses from members and a good GP who will listen to you.

I know that might be difficult if sourcing your own but if GP prescribes one that you feel is improving your health tell the pharmacist what the manfacturer's name is so he can source it each time.

You state:

I’ve had my TSH, FT3 and FT4 checked which all came back as normal. That may be o.k. for GP or Endocrinologist but we need TSH to be around 1 or lower and Free T4 and Free T3 in the upper part of the ranges. as also stated by other members.

If we feel ill we are surprised as we are taking thyroid hormone replacements and expecting to feel much better. The method of slow and steady with increases should bring you to an 'optimum'.

[EastLondon]

Hi everyone, I hope it’s ok to repost on this thread. I’ve had private tests done now to look at the full range of thyroid factors and have got the following back:

TSH 3.86miu/l

TPOAb 105 Kiu/L

TgAB 22 ku/l

T4 115 nmol/l

FT4 13.2 pmol/l

FT3 5 pmol/l

Active B12 27 pmol/l

Ferritin 18 ug/l

Folate 10.1 nmol/l

Vit D 75 nmol/l

Sorry I wasn’t provided ranges with these tests.

I supplement B12, folate and vit d daily and have been tested for pernicious anaemia in the past. All tests were done at the start of day without any food or water.

Any thoughts?

Thanks,

Fiona