Do I have Hypothyroidism?

[Sparkle44]

Hi I have just seen my blood results on Patient Access and have a GP appointment tomorrow. Just wondering if my results mean that I have Hypothyroidism? Under active thyroid?

-TSH 4.31 miu/L (normal range 0.27-4.2)

-T4 13.1 pmol/L (normal range 12-22)

I suffer with:

- Extreme Fatigue

-Weight gain! Put on 2 stone since March 2020 despite eating 1 meal a day and being conscious about eating healthy.

-Hair thinning / falling out

-Nails brittle / tearing

-Dry Skin

-Mood swings - real low periods

- Puffy face

-Swollen neck (just had neck ultrasound)

Just a feeling of being unwell and weak in the body!

I have an appointment scheduled with GP tomorrow and my Endocrinologist is due to call later this afternoon- as I also have a micro pituitary tumor (not sure if this is related).

I also have a lot of hormones below the normal range: DHEAS / Androgen Free Index / Testosterone.

I am 47 and not currently peri-menopausal. I am regular as clockwork every month. I do however have 4.8cm x 4cm cyst on my right ovary which has apparently been there since 2017!

Just feeling wretched and wanting to feel better! Any advice would be greatly appreciated.

TSH Blood result attached. I also have low Folate which is being investigated as been like this for nearly 2 years now despite taking Folic Acid. Not sure if it’s related?

Folate - 2.2 ug/L (Normal range 3.9-26.8)

Thanks in advance x

[jimh111]

Your symptoms very much suggest hypothyroidism. In view of your other low hormones I think your doctor should check TSH, fT3 and fT4 just in case your fT3 is low which would suggest you have a pituitary problem. Regardless of the blood test results try and get your doctor to prescribe levothyroxine on the basis of your signs and symptoms and marginal fT4.

[Sparkle44 in reply to jimh111]

Hiya thanks for your reply. I have posted the TSH and T4 results below. I can ask for a T3 test if it would be helpful. In terms of the pituitary I have a pituitary micro adenoma which is essentially a benign tumor. It’s only small but defo affecting my hormone balance. The elevated TSH and low end T4 are new. Just wondering if this would be treated with medication and if it explains my symptoms. Thanks

[jimh111 in reply to Sparkle44]

Yes it would explain symptoms but if your fT3 is low or low normal it would give more confirmation that there is a minor pituitary problem also.

[Sparkle44 in reply to jimh111]

I have a confirmed pituitary tumor Thanks so much though. I will get my GP to repeat the T3 test. Best wishes

[FancyPants54]

At the age of 47 you are perimenopausal I'm afraid. You don't need to be having irregular periods for that. You will be suffering hormone loss (progesterone and oestrogen will be getting lower) alongside your other issues. So don't push that to one side and think it's nothing to worry about. Peri stars years before menopause and affects us all differently.

There's a programme on Channel 4 (I think) tomorrow night about menopause. It's fronted by Divina MacCall and is promising to be rather good. 9pm? Make a note and give it a watch. See how many light bulbs might go off for you.

But yes, with a FT4 down at the bottom of the range you definitely have a thyroid issue going on. I suspect your FT3 is going to be really rather low. You need TSH, FT4 and FT3 all testing together and make the appointment first thing in the morning, before 9am when TSH is highest so that you get a look at the real situation. TSH in the afternoon can look a lot more OK and cause a GP to dismiss the issue. Don't drink any caffeine before the test.

[Sparkle44 in reply to FancyPants54]

Thank you so much! I am defo going to tune into that show tomorrow. I didn’t know I was peri menopausal - so that’s the period before menopause based on age. Oh gosh I am not looking forward to menopause. I am already having memory confusion and low moods I am not sure why my GP didn’t add T3 on the blood form. I will request that tomorrow as the Endocrinologist has asked the GP to also do Thyroid Antibodies blood tests (not sure if that’s T3). My Endo consultant rang me this evening and it was a battle to convince her that my symptoms were not just Vit D and Folate related. Felt exhausted at the end! She reluctantly agreed to a 3 month trial of Throxine at 25mg.

[FancyPants54 in reply to Sparkle44]

Perimenopause can start any time. It can last for 10 years or so. But by the time you are 45 you are suffering some effects of it whether you realise it or not. Your symptoms of low mood and brain fog are proof enough. I hope you watched the programme. It was very informative. But you can now find out loads more if you read the contents of the Menopause Doctor website menopausedoctor.co.uk It's a brilliant resource.

Antibodies are not the same as T3 I'm afraid. So you have a 3 month trial of 25mcg Levo. Hm, she's setting you up to fail. You need to take the tablet for 6-8 weeks and then get a retest. First thing in the morning - before 9am, nothing to eat or drink other than water before the test and don't take your tablet until after the test. It's normal to then need a dose increase to 50mcg and again 6-8 weeks later retest and increase. If you just take 25mcg for 3 months you may end up feeling worse than before you started. So ring up and book those blood tests in advance and insist that you are seen to discuss the treatment.

Good luck.

[Sparkle44 in reply to FancyPants54]

Thanks so much! Will do x

[SlowDragon Administrator]

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 at least annually

Low vitamin levels are extremely common, especially if you cause of hypothyroidism is autoimmune thyroid disease (Hashimoto's) diagnosed by raised Thyroid antibodies

90% of primary hypothyroidism is autoimmune thyroid disease also called Hashimoto’s

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)

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/

NHS easy postal kit vitamin D test £29 via

vitamindtest.org.uk

[Sparkle44 in reply to SlowDragon]

Wow you are a legend! Thank you sooooo much for taking the time and energy to write to me with this fantastic advice. I had my TSH AND T4 blood test at 11am in the morning and it was only due to me reading on the internet that ideally you shouldn’t eat - so I didn’t eat or drink at least 3 hours before the test.

I have had a number of Vitamin tests and I am also under the Adult Metabolic clinic who are doing investigations alongside Gastroenterology and Endocrinology. So far I have found Endocrinology to be the least interested in my symptoms but due to the fact that I had read up on my hormone imbalances and presented my symptoms in an assertive way, the consultant agreed to me going on a trial of Thyroxine 25mgs for 3 months and then to repeat the Thyroid Function Test. I am not sure if taking this medication is a good idea as she seemed fairly reluctant and said I might get palpitations.