Test results

[Pastelart]

Have just had tests done through Monitor My Health. They suggest that I have sub clinical hypothyroidism. Would be grateful for your interpretation.

[SlowDragon Administrator]

Yes, quite possibly

Take these results to GP request FULL thyroid and vitamin testing

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

Is there history of autoimmune thyroid disease in your family

Suggest you print out tick list of hypothyroid symptoms to show GP ...assuming you have some

List of hypothyroid symptoms

thyroiduk.org/if-you-are-un...

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 and thyroid antibodies

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)

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...

NHS easy postal kit vitamin D test £29 via

vitamindtest.org.uk

If TPO or TG thyroid antibodies are high this is usually due to Hashimoto’s (commonly known in UK as autoimmune thyroid disease).

About 90% of all primary hypothyroidism in Uk is due to Hashimoto’s. Low vitamin levels are particularly common with Hashimoto’s. Gluten intolerance is often a hidden issue to.

Link about thyroid blood tests

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

Link about Hashimoto’s

thyroiduk.org/hypothyroid-b...

[Pastelart in reply to SlowDragon]

Hi SlowDragon, I did the test early in the morning and consumed water only. Thank you for your advice, will follow up.

[Jazzw]

Well, good to know that even though you didn’t manage to fill the vial, it was enough blood! That’s a win!

Looks like this is a similar result to what you’ve had before—and I know how blooming frustrating that feels. TSH is gradually getting higher though.

You’re definitely brewing full-blown hypothyroidism but probably aren’t going to be near enough for your “stick to the rules” GP.

[Pastelart in reply to Jazzw]

Hi Jazzw, my first test failed, but they kindly sent a replacement. The person I was dealing with by email, was extremely helpful and friendly.I can’t see that I will be treated in my lifetime, just another old person, why bother!

My husband is chronically ill and extremely underweight and I managed to persuade the doctor to prescribe Ensure plus. Now after a month ( he’s doing well on them) they’ve reduced the prescription to only two weeks in the month 😩 He hardly ever goes to the doctor, as I care for him and still they’d rather save a bit of money than him! Unbelievable.

[SlowDragon Administrator]

See flow chart on top of page 2

As you have symptoms you should be offered trial on levothyroxine as TSH is over 5

gp-update.co.uk/Latest-Upda...

[Pastelart in reply to SlowDragon]

Thank you SlowDragon. Why are over 60’s excluded for treatment?

[SlowDragon Administrator in reply to Pastelart]

Over 60’s aren’t excluded from treatment, but need to introduce levothyroxine slowly. Starting on 25mcg.

Blood test 6-8 weeks after each dose increase

Dose levothyroxine is increased slowly upwards in 25mcg steps until TSH is always under 2

[jimh111]

The slightly elevated TSH might indicate your thyroid has failed just a little bit but your fT3 and fT4 are good. It is most unlikely your problems are due to your thyroid gland. This doesn’t mean you can’t be hypothyroid due to something impairing peripheral thyroid hormone action but doctors only look at the thyroid. Hence, your elevated TSH might get you treated but I wouldn’t use it as a reliable guide. Also, since you have good hormone levels ‘correcting’ your TSH is unlikely to be sufficient to get you well.

The question is whether you are hypothyroid. You’ve had lots of blood tests but I don’t se a description of your signs and symptoms, can you give a full description here so we don’t have to look at lots of previous posts.

[Pastelart in reply to jimh111]

Thank you all.

I have lots of symptoms, jimh111

Low temperature

Overweight and not able to lose any despite healthy diet and weight loss programme

Carpal Tunnel

Restless legs

Ridges and splitting nails

Very dry skin, especially on feet , which are flakey and cracked

Two years ago suddenly had high cholesterol and blood pressure

and was diagnosed with pre diabetes

My iron dropped out and after numerous tests, no reason was found

Insomnia

Intolerance to heat

Periodontal disease and receding gums

Tooth sensitivity

Muscle weakness pain and fatigue

Bone pain

Hiatus hernia

Hair loss

Dry eyes

Hair loss on eyebrows

Eczema on feet

Skin tags

Numbness and pins and needles

Trigger finger

GERD

Chest wheezes

Snoring

Impaired exercise capacity

I was generally very fit and well till just over two years ago when everything started to go pear shaped. Have had every test under the sun, endoscopy, colonoscopy, MRIs

All have come back normal apart from the iron.

Sorry, the list is very long, but you asked, LOL

[jimh111 in reply to Pastelart]

This list certainly could be due to hypothyroidism. I don’t believe such signs and symptoms would be caused by your slightly high TSH and reasonable fT3,fT4 BUT the elevated TSH might get you treatment. Also, if you are hypothyroid just getting your TSH down to e.g. 0.5 and fT3, fT4 up will be sufficient but that’s a consideration for later.

I wonder if your possible hypothyroidism could be caused by environmental toxins that can disrupt thyroid hormone action. Did you move house / job or get second hand furniture or have any other changes around the time you started to become unwell?

[JAmanda in reply to jimh111]

I had a look at your website but couldn't find anything about toxins... can you give examples? and I was interested in seeing more about magnesium deficiency which you mention but couldn't find anything really there... I've had magnesium deficiency for years - so you think it causes ibs..?

[jimh111 in reply to JAmanda]

Endocrine disrupting chemicals (EDC) are environmental toxins that disrupt endocrine hormone action. There are a few that affect thyroid hormone action, usually with little effect on the pituitary and so blood tests come back normal. I cover this in the Acquired Resistance to Thyroid Hormone (ARTH) topic with an introduction in the Endocrine Disrupting Chemicals (EDCs) subtopic.

Magnesium deficiency is covered in the IBS topic. This was my initial research as I had IBS before obvious signs of hypothyroidism. I worked in computing so functional disorders like IBS are similar to computer programs that go wrong, hence I used a similar strategy to finding a solution. By taking IBS knowledge back to first principles I came to the conclusion that intracellular magnesium deficiency has a fundamental role in that it causes abnormal smooth muscle contraction and hypersensitivity to the type of pain in IBS and associated conditions.

There can be many causes of magnesium deficiency, in my case a process of methodological elimination pointed to hypothyroidism long before I developed signs of severe hypothyroidism. Of course I was told I couldn’t be hypothyroid because my blood tests said so.

[Pastelart in reply to jimh111]

Morning jimh111, there were no changes two years ago, except that I had to give my gym membership up due to pain and fatigue.

[jimh111 in reply to Pastelart]

Oh. I’m at a bit of a loss then. I don’t think your thyroid has failed badly enough to explain your symptoms. However, this definitely does not mean you shouldn’t be given a trial of levothyroxine. The proof is how you respond to a reasonable dose (50 mcg or more). Do you get better or start to feel hyper.

[Pastelart in reply to jimh111]

Thank you jimh111, I’m not holding my breath that I’ll be offered a trial. My doctors bristle when I mention thyroid. For the last 6 weeks or so my temperature has gone down to 34.4 and hovers at around 35.5and lower. My normal temperature is 36.6or 7.I bought some magnesium, but haven’t replaced as I don’t know which one to take. All other vitamins were good, vitamin d was 80, so currently supplementing. Magnesium wasn’t tested.

[jimh111 in reply to Pastelart]

I don't think body temperature is reliable unless it is very low, I tend to ignore it. I did however find my legs were like a block of ice when I was very hypo.

You can't test for magnesium as they can't measure intracellular levels which is the important factor. I take magnesium citrate but other forms are good except for magnesium oxide, sulphate and hydroxide.

[Pastelart in reply to jimh111]

I think 34 to 34.5 is a very low temperature, to be fair. My doctor thinks so as well. Thank you for your help, jimh111.

[Kisca in reply to Pastelart]

Hello 👋Try Solgar magnesium citrate it's very good xx

[Pastelart in reply to Kisca]

Thank you Kisca

[tattybogle in reply to jimh111]

Looking at your previous results:-

2yrs ago......... TSH 4.9 ?

1 y ago............ TSH 2.6

4 months ago TSH 2.93 .....fT3 5 [3.1-6.8]..... fT4 13.3 [12-22]

Now .................TSH 6.39......fT3 5.3 [3.1-6.8]....fT4 15.6 [12-22]

Negative for TPOab. /TGab.

You mention a previous 5.9 result for TSH, but i can't find it .

The good news :-

I would say it IS possible that a TSH of just 6.39 can fit with with symptoms even while fT4/3 in range. Your fT4 is only about 30% through range , and struggling thyroids do increase T3 levels to compensate. so i wouldn't say the high fT3 rules out a failing thyroid .

I did have bad hypothyroid symptoms with TSH 5.7 /6.8, and this had been going on for 5 yrs before i got tested . My fT4 was still around 30%.

But i had extremely high TPOab , and i was only about 35yrs old, so i was treated with Levo, and it helped.

Also my TSH went up convincingly from 5.7 to 6.8 within a couple of months, and my fT4 fell from 32% to 29% on the same tests. So, when they saw the antibodies it persuaded them to give Levo.

The bad news :-

I can see why a GP would be unwilling to try Levo at the moment , since the 2.6 / 2.93 results don't look very convincing of a trend to hypothyroidism , and there's no antibodies to help convince them , and your age is also going against them wishing to try Levo with those results.

[jimh111 in reply to tattybogle]

We also tend to forget (or not recognise) that the thyroid could be attacked by infections other than the usual suspects. The only way forward is a trial of thyroid hormone, we may never find the original cause of hypothyroidism. It took me two decades to find my problem.

[Pastelart in reply to jimh111]

Thank you tattybogle and jimh111

[SlowDragon Administrator in reply to Pastelart]

Suggest you print out this list

Tick all symptoms that apply

thyroiduk.org/wp-content/up...

Ask for ultrasound scan of thyroid

20% of Hashimoto’s patients never have high thyroid antibodies

Request trial of levothyroxine (minimum 50mcg )

[Pastelart in reply to SlowDragon]

Thank you SlowDragon, I have had a neck scan, follow up appointment with them last week and apparently my thyroid gland is healthy. It seems that I’m looking for something to fit into my belief that I am hypo, but I would honestly rather not have it. At the same time, I desperately want to find out what has caused me to me to become so unwell. I’m going to push for a trail and see where we go. What would I have done without all of the advice and information I’ve received on this life saving forum? Can’t thank you all enough. It is so refreshing to be listened to.

[SlowDragon Administrator in reply to Pastelart]

Lower stomach acid is common as we get older

It could be a mix of getting older, causing low stomach acid....this leads to poor nutrient absorption and low vitamin levels

Obviously need to find cause of low ferritin levels

[Pastelart in reply to SlowDragon]

They’ve been there, done that and moved on. Don’t seem to have the slightest concern 😖