New to forum

[auroracat]

Hi I have recently being diagnosed with Bowel cancer in June this year and last Thursday had a right hemicolectomy. Had to have a cardiopulmonary test before operation was scheduled for August. Found I had overactive thyroid, classed as Graves Disease and Atrial Fibrillation. No symptoms for any of these conditions. The cancer was found by the routine Bowel screening test. Any one else have these conditions? Would be pleased to hear from anyone. Have read that Graves is bought on by stress and AF is a symptom. Wondering if the Bowel cancer could have set the other two conditions off.

[humanbean]

If you had no symptoms for the Graves Disease or the AF I'm wondering how they were diagnosed?

It is not uncommon for doctors to see a below range level of TSH (Thyroid Stimulating Hormone) with a slightly over the range Free T4 and/or Free T3 and declare the patient has Graves Disease or hyperthyroidism. But that isn't the way that hyperthyroidism or Graves' Disease should be diagnosed.

There is more to getting a diagnosis than just those tests.

Have you been put on anti-thyroid drugs?

elaine-moore.com/Articles/G...

Welcome to the forum, and I'm sorry to hear about your cancer diagnosis.

Please note that surgery can really mess with your nutrient levels such as Vitamin B12, folate, ferritin, iron, and others. It would be a good idea to get hold of all the blood test results you had done by the hospital and your GP over the last few months, and check to see what they tested. For example, if you were close to being anaemic before surgery it may have worsened into outright anaemia now thanks to blood loss.

[auroracat in reply to humanbean]

Hi, the overactive thyroid was found in blood tests taken on the day of the cardiopulmonary test. I had previously had a blood test in 2015 which said my thyroid was overactive. Saw an endocrinologist at local hospital where we lived, he discharged me and said the figures were normal for me. Had ECG which showed AF, at the same time. Had pre op a month earlier with ECG and nothing found. The findings meant my cancer surgery, which should have been the following week was delayed by 5 weeks. Only have had bloods taken for the hospital. Moved 3 years ago only been to see GP at initial meeting and nurse before Covid for routine blood test.

[auroracat in reply to humanbean]

Thank you for your reply. Am on 40 mg of carbimazole and 5mg of bisoprolol, plus rivaroxaban for the AF. The rest of the questions I answered below. Just working out how to use this, sorry.

[humanbean in reply to auroracat]

If you're coping on a carbimazole dose of 40mg per day it would certainly suggest that you are hyperthyroid and/or have Graves' Disease because if that wasn't the case you would not be able to function.

I don't know if your condition was brought on by stress, but I have heard that hyperthyroidism and stress are often found together.

I had previously had a blood test in 2015 which said my thyroid was overactive. Saw an endocrinologist at local hospital where we lived, he discharged me and said the figures were normal for me.

I've read about doctors telling patients that such-and-such a result from a test is "normal for you", and I've always thought it was the most worrying comment a doctor could give. It implies that a test result is not "normal" for everyone, but it's good enough for the patient who has been tested. And I don't understand that logic at all.

[mistydog in reply to humanbean]

On the other hand it shows that ranges are often nonsense?

[humanbean in reply to mistydog]

True.

[PurpleNails Administrator]

Welcome to the forum

Sorry to hear of your bowel cancer diagnosis, AF and thyroid issue.

I think you need to get a hold of your historical results & see what’s been tested before and how your levels are being managed.

With Graves the thyroid hormone the FT4 (the free thyroxine) and FT3 (the free triiodothyronine) go very high and you would have very obvious symptoms.

The high levels causes the (TSH) Thyroid stimulating hormone, a hormone from the pituitary to reduce (it’s telling the thyroid the levels are high enough)

Usually the TSH is the main measurement doctors look at, (strangely - as it’s not the thyroid hormone) If this was low back 2015 but your levels were not high enough to worry an endocrinologist then something other than Graves is causing unusual readings.

40mg Carbimazole will bring down very high levels by inhibiting new hormone production. The medication needs regular adjustment to prevent both remaining too high or levels falling too low, and you must ensure this is judged but FT4 & FT3 as your TSH will not be reliable. Especially if you have had a low TSH for a long time.

Graves is confirmed by positive Thyroid Stimulating Immunoglobulin (TSI) or

TSH receptor antibodies (TRAb).

If these haven’t tested positive a Graves diagnosis is unconfirmed. & yes doctors do skip this step.

Thyroid Peroxidase (TPO) and Thyroglobulin antibodies(Tg or TGab ) confirm autoimmune thyroiditis (hashimotos) which can cause transient hyper but ultimately hypothyroid. They can be present in both Graves & Hashi autoimmune conditions.

Graves or uncontrolled hyper over a prolonged time can cause AF.

I had unnoticeable hyper from a nodule which caused levels to rise very gradually over years.

See if the hospital where you had the tests has a webpage listing a contact for health records department / library. Often a person or department with email & address is listed. If not I would try the switchboard and ask it there’s a records department.

I found it straightforward to send back an application form, ID and a witness signature via email.

I did this last year for a single record from 2014, the results were emailed back to me. I was wondering what my levels were when I was healthy, only to discover I was at hyper level then. Then I requested my entire records in the similar manner. This being a stack of paper it was posted to me & took longer.

Also see if your Practice offer online access which is extremely useful. Set up if available and if not Obtain printouts of your blood test results via practice reception (don’t ask doctor).

Don’t accept verbal or hand scribbled notes you need a printed copy with ranges (ranges vary between labs so essential). They shouldn’t ask why but if they do try to resist just say they are for your records. You are legally entitled to them.

When the doctor says results are “ok, fine or normal” it usually means it’s in range, even if only just in range (or just out of range) It doesn’t mean optimal & it doesn’t show what normal or ideal for you.

[auroracat in reply to PurpleNails]

Thank you for all the useful information.

[SlowDragon Administrator]

How long have you been on Carbimazole

Bloods should be retested very regularly as levels can change quickly

Often Carbimazole needs fine adjustment

For full Thyroid evaluation you need TSH, FT4 and FT3

Thyroid antibodies

TSI or Trab antibodies tested to confirm Graves’ disease

plus both TPO and TG thyroid antibodies tested for autoimmune thyroid disease (Hashimoto’s)

Very important to test vitamin D, folate, ferritin and B12

Low vitamin levels are extremely common with Hashimoto’s and Graves

Low vitamin levels very common as we get older 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...

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

Link about Graves’ disease

thyroiduk.org/hyperthyroid-...

Graves Disease antibodies test

medichecks.com/products/tsh...

Good info on Graves’ disease

ncbi.nlm.nih.gov/pmc/articl...

[auroracat in reply to SlowDragon]

Thank you for all the useful information. Will look into this.

[auroracat in reply to auroracat]

I have been on carbimazole since August 11. Had to have originally Bowel cancer surgery delayed because of the Af and thyroid. It should have been 19 August and it happened on 23 September. Everything since my original cancer diagnosis at the end of June has just been so overwhelming.

[Marz]

Lots of good advice from others. Just wanted to add that now you have had a Hemi-colectomy you are without the Terminal Ileum. This is where B12 is metabolised before returning to the liver for storage.

I had the same surgery for Ileo-caecal TB when I was 27 - now 75 - and was not told about B12. So important to maintain a good level so injections may be needed. I inject weekly.

Also Low VitD is an issue with bowel cancer as it is with other cancers and conditions. A level of 125 is good if the measurement is pmol/L or 60 if it is ng/L

grassrootshealth.net

Low nutrients - iron, folate, B12 and VitD - can also be involved with AF.

Hope you soon feel stronger and make a good recovery 🌻

[jgelliss in reply to Marz]

I'm so sorry Marz that you went through this surgery . Thank you Marz for the great advice . Always very helpful.

[auroracat in reply to Marz]

Thank you for this. I am going to get some B12. I already take vitamin D. Was taking a vitamin tablet until I saw it had iodine in so stopped it straight away.

[Marz in reply to auroracat]

How much VitD are you taking ? What was your test result as dosing is based on the test result. Also taking Magnesium and K2-MK7 is important.

Have you had B12 - Folate - Ferritin and VitD tested ?

[auroracat in reply to Marz]

Had none tested as far as I know. I have been taking 1 capsule of vitamin D for ages. Not medically prescribed. We just started taking as a family.

[Marz in reply to auroracat]

I take 8000 iu's daily of VitD - so what measurement is your capsule ? How do you take it- it is fat soluble so needs to be taken with a meal containing good fats. On-line testing is available for vitamins and minerals through Thriva - testing kits sent to your home and results by email.

The importance of vitamins and minerals is under estimated by doctors - however having followed this site since 2011 I have learnt otherwise. Optimal levels can make a difference 🌻

[auroracat in reply to Marz]

I didn’t know until I just checked! It is Holland and Barrett high strength cod liver oil 100mg with omega 3 and vitamins A and D 240mg. Softgel capsules. VitayD 200 I.U. I just take it with my other tablets in the morning. Take one daily preferably with a meal.

[Marz in reply to auroracat]

VitD - is that 200 or 2000 iu's. 200 unlikely to raise levels. What was your test result ? Are you taking the co-factors I mentioned earlier ?

VitD is a steroidal anti-inflammatory pro-hormone so far more than a vitamin ....

[SlowDragon Administrator in reply to auroracat]

Test vitamin D twice year when supplementing

Very easy NHS postal test

vitamindtest.org.uk

[auroracat]

As far as I know have had no tests. There has been so much going on recently with tests for the cancer and AF as well.