She has Hashimotos and symptoms but GP can only test TSH. I had Medichecks done for her and results are in range, Would appreciate helpful comments.
CRPHS 0.6mg/1 (Range 0-5)
Iron Status/Ferritin 18mg/1 (13-15
Folate Serum 6.1mg/1 (>2.9)
B12 Active 96pmol/L (25.1-165)
Vit D 69nmol/L (50-200)
TSH 1.42 (0.27-4.2)
FT3 4.9 (3.1-6.8)
FT4 16.0 (12-22)
TGAb 396 (0-15)
TPOAb 225 (0-34)
She had already had a course of iron supplement after the TSH test etc showed it up as low so as this is not more than 3 months later it is worrying that it is still low. She asked for a prescription from GP after these tests but the practice does not accept Medichecks tests. I have got her started on Vit D + K2. She has been brainwashed into thinking that in range tests are proof of healthy thyroid. When I first saw the results I was relieved that she seems to be converting T3 to T4. That is confirmed by the DIO2 test showing she has not inherited the faulty gene from me.
However symptoms persist. She gets exhausted and has anxiety about her two young children, imagining horrible accidents will befall them. She has just had an 8 week course of CBT which achieved nothing. She cannot lose her baby weight and is scatter brained in spite of holding down a part time responsible job. Her premenstrual depression is worse. Baby is now 15 months old.
I don't feel I can say she needs treatment for hypothyroidism without more authority. Her results are less than halfway through range and FT3 is further through range than FT4. However, I don't know whether some people would feel well on that.
I have so many other family concerns as well as my own illness, so it would be a huge source of relief if I could have some useful observations from you guys on here. Yes I am shelving some responsibility but I trust your judgement more than mine.
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Are you saying she’s not currently on any levothyroxine or replacement thyroid hormones
Her ferritin is dire
It can take months and months to improve low ferritin levels
Is she vegetarian or vegan
humanbean may pop along re iron and ferritin and supplement options
Heavy periods are classic sign of being hypothyroid and will lead to low iron and ferritin ask for full iron panel testing for Anaemia
Look at increasing iron rich foods in diet
Eating iron rich foods like liver or liver pate once a week plus other red meat, pumpkin seeds and dark chocolate, plus daily orange juice or other vitamin C rich drink can help improve iron absorption
This is interesting because I have noticed that many patients with Hashimoto’s disease and hypothyroidism, start to feel worse when their ferritin drops below 80 and usually there is hair loss when it drops below 50.
Thankyou for your speedy and informative response. I will pass it on to her. She is not on any treatment for hypothyroidism. She found out she had Hashimoto’s when it was discovered during surgery to remove a parathyroid gland adenoma four years ago. The path to that is a story in itself. Afterwards she felt better and had had enough of doctors so decided to take no action till she had miscarriage after IVF. She sought endocrine help when shebecame pregnant again. She was put on alow dose of Levo but it made her so unwell she stopped taking it. Fortunately the baby was born healthy. The birth was difficult and she lost a lot of blood. This may have been where this started. Your point about coeliac tests is pertinent. She gets bloated and uncomfortable after eating bread. She has toyed with the idea of going gluten free but cannot sustain it. I hesitate to say more willpower is needed as I appreciate she had a lot on her plate. Thankyou for your wise advice which will pass on to her.
North west. We were both under the impression that a low dose for a pregnant woman with in range bloods was inline with received wisdom and guidelines. So are you saying they have got that wrong too? It makes me shudder at the possible repercussions. Thankyou for your advice and incredible knowledge. I will get with her on this as soon as I can.
I really feel for you - It's so hard to watch people suffer ill-health when you KNOW they don't have to, but ultimately the choice has to be hers.
My ferritin has been hovering around 15/18 for at least 5 years. Last week I had a private iron transfusion for iron deficiency. My GP wasn't interested because I wasn't anaemic and I couldn't tolerate iron tablets without horrible constipation.
The consultant who did the transfusion said that a ferritin level of:
•less than 15 was total deficiency
•30 was considered 'very very low'
•less than 100 is very hard to treat yourself
It was eye-opening in terms of how the NHS views ferritin; unless you're totally depleted of iron it's 'normal'.
Is she veggie or vegan? Does she have very heavy periods?
On my diagnosis, my T4 was a bit lower than your daughters but my T3 was about the same. I felt absolutely wretched. I was essentially sitting down all day, looking at my phone because I had no energy to do anything more. My anxiety was out of control, and no amount of CBT or meditation helped control the thoughts. I'm almost optimally medicated now and looking back on it, I was in the grips of OCD. Once I started levo, the meditation started to help as I was more able to see that those thoughts weren't my own and I was able to 'ride them out'.
I very rarely get anxious these days. The difference is astonishing.
All you can do is try to lead her to the information and hope it sinks in. Can you put the list of symptoms from Thyroid UK in front of her? would that help?
I am touched by your obvious empathy. Thankyou for your suggestions. I will show her the symptoms but she has so often been exposed to the general and medical belief that these originate from mental illness that she believes, at least half the time that that is what is wrong with her. Would you mind if I pass on your story of your own experiences? I think it might convince her otherwise. Also I would like to know if the consonant who gave you iron infusions was private and what area he practices in. This may require a private message. Many thanks for sharing this with me.
Absolutely, please do share it with her if it helps!
I also spent many years believing that it was my fault. I couldn't cope with life and that my brain was broken and that was that and I just needed to find a way to live with that.
I simply cannot tell you the relief and empowerment (and anger!) That came with realising that it could be fixed.
I think anxiety has been so normalised in the last few years (which is great!) But it seems to me that people have forgotten that sometimes it can be fixed and there is a very real physiological reason for it.
Optimal for CRP is below 1 so result is very good, suggesting there is no active inflammatory disease going on at the moment. But with her high levels of thyroid antibodies indicating she has Hashimoto's Thyroiditis this could change in the future.
Her ferritin is very bad. According to this page from NICE :
In all people, a serum ferritin level of less than 30 micrograms/L confirms the diagnosis of iron deficiency.
The way that low iron/ferritin is dealt with by doctors in the UK is to give people a couple of months worth of iron supplements then just assume that everything is fine and dandy. But if the patient has very heavy periods, a short menstrual cycle, or any other risk factor for low iron/ferritin then they will just go back to being low or deficient in no time.
I had below range iron and low in range ferritin due to a GI bleed. Once the bleed was fixed it took me nearly two years of taking maximum dose iron to get my ferritin up to middle of the range. I also have a family history of iron deficiency and I absorb it poorly. When I decided to start testing and treating my own iron panels I discovered that with increasing iron and ferritin my lifelong anxiety disappeared and my lifelong depression was very much reduced. People don't think of iron as being of relevance in mental health problems, but I'm of the opinion that any nutrient deficiency can have an undesirable impact on mental health. I take a maintenance dose of iron now, and do an iron panel every few months.
If your daughter was to get an iron panel done (Medichecks do the best one I know of), she could treat her own iron levels. You could post the results on here and ask for help. Prescription-strength iron supplements in the UK can be bought from pharmacies without a prescription - you just need the pharmacist's permission.
Optimal for iron and iron-related levels are given here :
1) Always take vitamin D3 not vitamin D2. The best form of vitamin D3 supplement is in gel capsules containing only oil and vitamin D3. Some people like vitamin D sprays but they do have a lot more ingredients in them.
2) Vitamin D3 raises the absorption of calcium from the diet. This calcium needs to go into the bones and teeth, not end up lining the arteries. To do this the body needs sufficient magnesium and vitamin K2. You'll find lots of posts on the forum on these co-factors, and SeasideSusie 's posts on the subject come strongly recommended, so please search the forum for magnesium and vitamin K2.
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