I've been struggling for the last year feeling exhausted all the time, very low in mood, really irritable and the last few months I've been trying to lose weight and can't, even with my usual routine which tones me up, I haven't lost a pound. I initially asked for my B12 levels to be checked because I was so tired, they came back fine. I then found a lump on my thyroid and got sent for a 2 week urgent referral. After weeks of waiting it turned out to be a cyst thankfully. But whilst waiting I looked into posts on this forum and became convinced that I had an underactive thyroid.
I ordered the private blood test convinced it would show I was under active and the Gp would have to sort me out. But it's all come back normal. I don't feel myself at all. I just don't know what is wrong with me?!
On the same blood test as the B12, my folate was tested. I was told by the GP receptionist that it was fine but the endo at the hospital said folate was low and I should supplement. This could be causing the tiredness I guess.
If anyone has any ideas please let me know!
Thanks for reading xx
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Did you do the test no later than 9am with nothing to eat or drink before except water?
If you did your test before 10am (please confirm time) then your cortisol appears to be rather low. I will ask Hidden if she can comment when she's around.
A normal, healthy person would have TSH no more than 2, often nearer 1, with FT4 around mid-range-ish. Your FT4 is on the lowish side at 37% through it's range but as none of us are tested in health we don't know what our normal levels are.
Your low antibodies don't suggest any sign of autoimmune thyroid disease.
On the same blood test as the B12, my folate was tested. I was told by the GP receptionist that it was fine but the endo at the hospital said folate was low and I should supplement.
What were these results, can you please post them along with their reference ranges and the units of measurement for B12.
Did you also have vitamins tested with your Blue Horizon test?
You really need Vit D and Ferritin tested. Symptoms of low ferritin or iron can mirror or coincide with those in thyroid disease so as you've mentioned tiredness I think it's essential to get these tested.
I actually had the blood taken at 2pm, not fasted. The kit said I did not need to fast. Also, I'm a whimp with blood so asked my nurse friend to help me and that was the only time she was free. Does that mean all my results are unreliable?
I wasn't given the results. I will ask for a print out from the GP surgery. It took me 50 mins to get through on the phone last week, I have an appointment next week so will ask GP if she is happy to do vitamin level tests and ask reception for a print out.
Sounds like it's worth me trying the gold Blue Horizon test. Or shall I just take a multivitamin and see how I feel in a couple of months?! Just begging the gp to help me feels like more energy than I have.
I actually had the blood taken at 2pm, not fasted.
OK, so your cortisol result may not be as bad as it first seemed then. Cortisol is best done before 9am I believe. But let's see what Hidden says if she is around.
The reason we say no later than 9am for a thyroid test is because TSH is highest at midnight then lowers throughout the day, see first graph here:
Also, certain foods and drinks can affect TSH so it's best to have water only before the blood draw.
As we need the highest possible TSH for a diagnosis of hypothyroism, it's best to make sure the test is done when TSH is at it's highest and nothing can affect it.
It's only TSH that will be affected this way, your FT4 is unlikely to alter very much but as it's TSH that is used for diagnosis this is the important one we need to get right.
Sounds like it's worth me trying the gold Blue Horizon test. Or shall I just take a multivitamin and see how I feel in a couple of months?!
No, don't take a multivitamin, they are not recommended for many reasons. They contain too little of anything to help low levels or deficiencies, they tend to use the cheapest, wrong form and least absorbable of active ingredients, and they usualy contain things we need to test before supplementing, eg iron, calcium, Vit D, iron, iodine. If they contain iron then that affects the absorption of everything else as iron needs to be taken 2 hours away from all other supplements (and medication).
If you can't get GP to test Vit D and Ferritin then I'd do the Blue Horizon Gold test.
Ahhh that explains the time ranges put next to the levels..I wondered what that meant!
OK, so I will request this from the Dr next week. But I may do the gold either way so I can re test TSH at the right time, fasted, and see what it comes out as.
So low T4 can mean hypothyroidism? Or is that only if TSH is high too?
That's really interesting about the multivitamins. Thanks for all the info.
Yes, basically low FT4 means hypothyroidism but diagnosis is made on TSH.
Primary Hypothyroidism requires a TSH over 10 for diagnosis but over range with FT4 below range should also give a diagnosis.
There is one form of hypothyroidism called Central Hypothyroidism where the TSH may not rise because there is a fault with the pituitary or the hypothalamus and the TSH can be low, normal or minimally elevated with a low/below range FT4. Central Hypothyroidism is not as common as Primary Hypothyroidism and most doctors have never heard of this so if only TSH is tested this Central Hypothyroidism is missed.
I have inhalers with steroids in - can this affect the TSH? I do take tablet steroids when I get chest infections, I haven't had so many since covid came along. The last ones I had were in March/April.
I remember you saying to test before food or water now. I really struggle to retain information at the moment, again, because of the tiredness.
I was expecting cortisol to be high as I've been so stressed as I have so much on my plate and not enough brain power or physical energy to do it all. I do wonder if this is maybe causing my symptoms but not sure.
OK thank you, I will repost when I have the other results. xx
Your cortisol isn't too bad for a 2pm reading, it's best done between 8-9am in the morning, for cortisol you don't need to fast. Long term steroids can actually stop your adrenal glands producing enough cortisol so be aware of that. If your thyroid is not in balance then that can affect cortisol levels. This chart shows what normal cortisol should be through the day.
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