Hi, recently been told I am border line underactive, doctor said my levels arent high enough yet for medication, especially as I don't yet have many symptoms apart from weight gain, constipation (was told it was ibs years ago), loss of libido (blamed the hysterectomy and hrt).
What should I expect to happen in the long term?
I've posted my most recent blood test results. Doctor seems reluctant to discuss it until I need to start medication.
Welcome to the forum
Just testing TSH and Ft4 is completely inadequate
Can’t quite read TSH …..is that 5.25 or 6.25
Ft4 is very low
With TSH over 5 bloods should be retested in 6-8 weeks time
With 2 tests with TSH over 5, and hypothyroid symptoms you should be started on levothyroxine
See flow charts on here
gp-update.co.uk/Latest-Upda...
Meanwhile recommend getting GP to test vitamin levels and thyroid antibodies NOW …..or test privately
For full Thyroid evaluation you need TSH, FT4 and FT3 plus both TPO and TG thyroid antibodies tested.
EXTREMELY important to test vitamin D, folate, ferritin and B12
Low vitamin levels are extremely common, especially with autoimmune thyroid disease (Hashimoto’s or Ord’s thyroiditis)
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.
Low vitamin levels tend to lower TSH
Gluten intolerance is often a hidden issue too
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 all relevant vitamins
List of private testing options
thyroiduk.org/getting-a-dia...
Medichecks Thyroid plus antibodies and vitamins
medichecks.com/products/adv...
Blue Horizon Thyroid Premium Gold includes antibodies, cortisol and vitamins by DIY fingerprick test
bluehorizonbloodtests.co.uk...
Thriva Thyroid plus antibodies and vitamins By DIY fingerpick test
Thriva also offer just vitamin testing
NHS easy postal kit vitamin D test £29 via
Link about thyroid blood tests
thyroiduk.org/getting-a-dia...
Link about Hashimoto’s
thyroiduk.org/hypothyroid-b...
List of hypothyroid symptoms
thyroiduk.org/if-you-are-un...
Tsh is second test was 6.26. On previous test 6 weeks earlier it was 4.25.He did a full blood test back in April and it came back as vit levels were OK.
Please add actual vitamin results
Within range is not necessarily optimal
NHS only tests and treats vitamin deficiencies
Eg vitamin D they will prescribe if under 50nmol
But vitamin D should be at least around 80nmol and around 100nmol-150nmol is likely better
Folate and ferritin at least half way through range
Serum B12 over 500
50andnotfeelingfab
It looks like your report says "in view of TPO +ve status" so you have positive TPO antibodies with over range TSH and this should give you a diagnosis of autoimmune thyroid disease (aka Hashimoto's) and you should be started on Levo.
SlowDragon - do you have a link, I am on my tablet and have no links stored on it.
I think you still need 2 tests with TSH over 5
But push for testing 6-8 weeks time …..NOT 6-12 months as listed on the results
It says "TSH remains moderately raised" so it must have tested over range at least twice. 50andnotfeelingfab can you confirm?
Well spotted
Yes if this is second test with TSH over 5, high thyroid antibodies and hypothyroid symptoms patients should be started on levothyroxine
On previous blood test 6 weeks, earlier it was 4.25
Were both tests done as early as possible in morning before eating or drinking anything other than water
As you have high thyroid antibodies request coeliac blood test
high antibodies confirms autoimmune thyroid disease. Technically it’s Hashimoto's (with goitre) or Ord’s thyroiditis (no goitre). Both variants are autoimmune and more commonly just called Hashimoto’s
Hashimoto's frequently affects the gut and leads to low stomach acid and then low vitamin levels
Low vitamin levels affect Thyroid hormone working
Poor gut function with Hashimoto’s can lead leaky gut (literally holes in gut wall) this can cause food intolerances. Most common by far is gluten. Dairy is second most common.
According to Izabella Wentz the Thyroid Pharmacist approx 5% with Hashimoto's are coeliac, but over 80% find gluten free diet helps, sometimes significantly. Either due to direct gluten intolerance (no test available) or due to leaky gut and gluten causing molecular mimicry (see Amy Myers link)
Changing to a strictly gluten free diet may help reduce symptoms, help gut heal
Before considering trial on gluten free diet get coeliac blood test done FIRST just to rule it out
lloydspharmacy.com/products...
If you test positive for coeliac, will need to remain on gluten rich diet until endoscopy (officially 6 weeks wait)
If result is negative can consider trialing strictly gluten free diet for 3-6 months. Likely to see benefits. Can take many months for brain fog to lift.
If no obvious improvement, reintroduce gluten see if symptoms get worse.
chriskresser.com/the-gluten...
amymyersmd.com/2018/04/3-re...
thyroidpharmacist.com/artic...
drknews.com/changing-your-d...
restartmed.com/hashimotos-g...
Non Coeliac Gluten sensitivity (NCGS) and autoimmune disease
ncbi.nlm.nih.gov/pubmed/296...
The predominance of Hashimoto thyroiditis represents an interesting finding, since it has been indirectly confirmed by an Italian study, showing that autoimmune thyroid disease is a risk factor for the evolution towards NCGS in a group of patients with minimal duodenal inflammation. On these bases, an autoimmune stigma in NCGS is strongly supported
ncbi.nlm.nih.gov/pubmed/300...
The obtained results suggest that the gluten-free diet may bring clinical benefits to women with autoimmune thyroid disease
nuclmed.gr/wp/wp-content/up...
In summary, whereas it is not yet clear whether a gluten free diet can prevent autoimmune diseases, it is worth mentioning that HT patients with or without CD benefit from a diet low in gluten as far as the progression and the potential disease complications are concerned
restartmed.com/hashimotos-g...
Despite the fact that 5-10% of patients have Celiac disease, in my experience and in the experience of many other physicians, at least 80% + of patients with Hashimoto's who go gluten-free notice a reduction in their symptoms almost immediately.
hypothyroidmom.com/how-to-l...
Eliminate Gluten. Even if you don’t have Hashimoto’s. Even if you have “no adverse reactions”. Eliminate gluten. There are no universal rules except this one.
Look at previous test results that you have had done
If a previous test was also over 5 you should be prescribed levothyroxine
Request GP test vitamin D, folate, ferritin and B12 too
Come back with new post once you get results
Previous was 4.25 but I am going to ask him to retest in 6-8 weeks.
So meanwhile get hold of vitamin results. Come back with new post once you get results
Get coeliac blood test done
Make sure you test thyroid early morning before eating or drinking anything other than water
Thank you I've been and got a copy of my blood tests and also asked for bloods to be retested in 6-8 weeks. I was unaware that I had to fast before blood test so will make sure I do this with the next set of tests.
Suggest you edit photo to remove old address
Folate, ferritin and B12 dropping and now borderline
No vitamin D result
NHS private testing service £29
What’s the range on folate and B12 results
I don't know what you mean about range,, I've only had those tested on first blood test.I don't know how to delete /edit my photo, when I click on it it doesn't give me options to do so?
Range is figures in brackets after each result
To edit post click down arrow on right of “more” on opening post
Thank you. The report doesn't show range.
You are not borderline, you likely have under active thyroid and you should be receiving treatment. Could you see another doctor?? You can have Thyroid Antibodies tested and that will tell you and the GP if you have Hashimotos disease which is the main cause of under active thyroid.
n.b Thyroid Peroxidase antibodies must have previously tested positive . (blurred image at top of post says "however ,in view of TPO +ve status ... " ) So Hashimotos's does seem to be the cause for reducing thyroid function.
As an aside because you said you are on HRT, oestrogen feeds an under active thyroid. I have avoided oestrogen completely and take progesterone only hormone.
Gaining weight and loss of libido may be menopause but also likely to be Hashis. Symptoms overlap and thyroid problems can get hidden by menopause.
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