Can anyone shed some light for me. I have had symptoms for 9 years of a thyroid issue. Fatigue, infertility, hair loss, recently aching joints, weight loss, occasional stomach issues. My blood results always come back normal I can never understand it!! Last year they found a nodule on my thyroid and I thought thank god finally a reason for my problems but my bloods are still normal!! The fatigue is debilitating and no one is listening to me. What can I do? My son has a thyroid issue and coeliac disease too
Symptoms but normal bloods: Can anyone shed some... - Thyroid UK
Symptoms but normal bloods
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Laralou36
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PurpleNailsAdministrator
Have you had nodule scanned? What was tested and what were results?
Hiya, I’ve had the scan and the fine needle aspiration done, it came back as not cancerous but they are going to check me again in 6 months to be safe?
What about blood test results?
My abnormal levels was missed as the nodule was biopsied and determined as benign but according to subsequent notes “patient did not return for thyroid function blood test” not true - I had attended for blood test & even phoned to specifically ask if was my thyroid ok. Was told “normal” - no further action. But the thyroid part hadn’t been processed. I didn’t know to insist on viewing my own results so it was missed for another 7 months….
Near 5 Years prior to that the hospital didn’t follow up abnormal levels either.
GPs often don’t do full thyroid test so first step obtain & view your results.
I just logged onto doctors and this was the recent blood result Serum TSH level (XaELV) 1.44 miu/L [0.35 - 5.5]
Erythrocyte sedimentation rate (XE2m7) 5 mm/hr [1 - 12]
Coded entry Serum free T4 level (XaERr) 16.8 pmol/L [10.5 - 21]
Serum thyroid peroxidase antibody concentration (XabCy) 33 kU/L [0 - 60]
TSH & FT4 are in range. TPO antibodies are also negative a positive level would suggest autoimmune thyroiditis. NHS do not test Thyroglobulin TG antibodies if TPO negative.
Nor do NHS do not test FT3 the active & powerful thyroid hormone if TSH & FT4 “euthyroid” normal, If FT3 is low this can cause hypothyroid symptoms but you would expect a higher TSH.
You can order a private test if you wanted to check FT3 and be sure.
Also important to test B12, Folate, ferritin & vitamin D. Have these been tested recently?
I think I will have to do that to be sure. I have recently had a private vitamin d test that came back low. The most recent of the others are from June 2021 and the results are Serum ferritin level (XE24r) 23.1 ng/ml [10 - 291] Information about this test
Serum folate level (42U5.) 17.31 ng/ml [> 5.38] Information about this test
Serum vitamin B12 level (XE2pf) 277 ng/L [211 - 911]
Was was your Vitamin D result? Was is treated? That Ferritin level is very low. GP should have investigated further if under 30. B12 Also low.
Trying to treat the vitamin d levels at then moment it came back as 24 I don’t know the reference ranges. I don’t understand the gp always tells me the levels are fine because my hemaglobin is fine?
How much vit D have you been supplementing? You likely need loading doses. Do you know about Vit D co factors K2 & magnesium.
Under 30 ferritin is iron deficiency without anaemia (if haemoglobin normal). But Dr should have done iron panel.
SlowDragonAdministrator
You need to test BOTH TPO and TG thyroid antibodies
Many autoimmune thyroid patients only have high TG antibodies, and 20% of autoimmune thyroid patients never have high thyroid antibodies
For full Thyroid evaluation you need TSH, FT4 and FT3 plus both TPO and TG thyroid antibodies tested.
Very important to test vitamin D, folate, ferritin and B12 at least once year minimum
Low vitamin levels are extremely common, especially with autoimmune thyroid disease (Hashimoto’s or Ord’s thyroiditis) usually diagnosed by high thyroid antibodies
Autoimmune thyroid disease with goitre is Hashimoto’s
Autoimmune thyroid disease without goitre is Ord’s thyroiditis.
Both are autoimmune and generally called Hashimoto’s.
In U.K. medics never call it Hashimoto’s, just autoimmune thyroid disease (and they usually ignore the autoimmune aspect)
Recommended on here that all thyroid blood tests early morning, ideally before 9am
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 and money off codes
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
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...
NHS easy postal kit vitamin D test £29 via
About 90% of all primary hypothyroidism in Uk is due to Hashimoto’s.
Low vitamin levels are particularly common with Hashimoto’s.
Gluten intolerance is often a hidden issue too. Request coeliac blood test BEFORE considering trial on strictly gluten free diet
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...
I’ve just found a blood result from 2018 free t4 was 4.92 (3.10-6.80) range. I will try having more bloods early in morning then
free t4 was 4.92 (3.10-6.80)
That’s a typical FT3 range (FT4 is usually higher range eg 12 - 22 - so Suspect that’s a typo) the result is 49% or range so wouldn’t indicate a thyroid issue, (at that time)
I still think it’s worthwhile doing to current level, and especially as nutrients have been so low. Very important to retest them.
Yes definately going to get the whole lot re done Thankyou. Will post again with results
I'm confused are you taking about fT3 or fT4. You've written fT4 but the range seems to be for fT3
No ,[3.1-6.8] IS a typical fT3 range. (very common on NHS and private tests posted on the forum)Typical fT4 ranges might be anything from [7-14] to [12 -22], [9-25] ish ... but you wouldn't get an fT4 range of [3-6] ish
I Suspect there was a typo/ misreading of results in the original comment.
SlowDragonAdministrator
You should have been tested for coeliac disease when your son was diagnosed
Did that happen
nice.org.uk/guidance/ng20/c...
1.1.1 Offer serological testing for coeliac disease to:
people with any of the following:
persistent unexplained abdominal or gastrointestinal symptoms
faltering growth
prolonged fatigue
unexpected weight loss
severe or persistent mouth ulcers
unexplained iron, vitamin B12 or folate deficiency
type 1 diabetes, at diagnosis
autoimmune thyroid disease, at diagnosis
irritable bowel syndrome (in adults)
first‑degree relatives of people with coeliac disease.
Fatigue, infertility, hair loss, recently aching joints, weight loss, occasional stomach issues.
Aching joints - low vitamin D
Hairloss - low iron/ferritin
What vitamin supplements are you currently taking
Your son should have vitamin levels tested annually too
Hiya. Thanks for all the really helpful info. I have also been tested for coeliac disease multiple times over the past 9 years since having my son but they also come back as normal
ALWAYS Worth trying strictly gluten free diet Only 5% of Hashimoto’s patients are coeliac but approx further 80% find strictly gluten free diet helps or is essential
I have tried before and felt a bit better but ended up losing a lot of weight which I can’t afford to do so went back to gluten. It’s a never ending cycle just want to feel better
Recommend getting full thyroid and vitamin testing
If you can afford it Blue horizon test includes cortisol, can be useful indicator if adrenals are trying to compensate for lack of thyroid hormones
Come back with new post once you get results
Ok will do thanks
Just seen you added vitamin results
Serum ferritin level 23.1 ng/ml [10 - 291]
Serum vitamin B12 level 277 ng/L [211 - 911]
Vitamin D 24nmol (assuming you are in U.K. )
Ferritin is deficient
Vitamin D deficient
B12 so low you need testing for Pernicious Anaemia before starting on B12 and vitamin B complex
All four vitamins need improving to OPTIMAL levels
Low vitamin levels, especially low ferritin tend to lower TSH making it difficult to get diagnosed
Are you vegetarian or vegan
How can I get doctors to listen? Not vegetarian or vegan no.
Hi I am in the same position as you, I have very low Vitamin D and Folate, high ferritin yet "normal thyroid " apart from high antibodies. because these were done privately my GP wont accept them, he tells me I am depressed. I feel so ill and have lost my job but getting nowhere, except more and more unwell. I hope you fare better than I have. Take care
So sorry you feel the same it’s horrible isn’t it. I’ve just signed up for private medical cover hope I can get somewhere
I was the same with low vitamin levels, ‘technically’ normal, within range thyroid results but horrible symptoms and positive antibodies. I went privately in the end and luckily went to an incredible endo who treated me based on my symptoms and I feel like a brand new person compared to how I felt before. I hope you find a decent endo to help you too.
Sorry to be dumb what does positive antibodies mean?
Antibodies have for example a 0-60 range or >60. Within the range or limit is normal (negative for signs of autoimmune) above the limit is positive.
What thyroid issue does your son have?
He has an under active thyroid I think. They do bloods on him yearly because he has coeliac disease and then tsh kept creeping up so they started to treat him with thyroxine
Positive antibodies means your body is attacking your thyroid. Giving up gluten can help slow the attack.
It’s the immune system which attacks the thyroid, antibodies come along and clean up the debris from the damage which is left as a result of them.
So antibodies are part of the process but aren’t a measure of what’s attacking the thyroid.
SlowDragonAdministrator
NHS Guidelines on dose vitamin D required
Vitamin D under 25nmol
GP obligated to prescribe LOADING Dose of 300,000iu vitamin D over 6-8 weeks and retest at end of prescription
ouh.nhs.uk/osteoporosis/use...
GP will often only prescribe to bring vitamin D levels to 50nmol. Some CCG areas will prescribe to bring levels to 75nmol or even 80nmol
leedsformulary.nhs.uk/docs/...
GP should advise on self supplementing if over 50nmol, but under 75nmol (but they rarely do)
mm.wirral.nhs.uk/document_u...
But improving to around 80nmol or 100nmol by self supplementing may be better
pubmed.ncbi.nlm.nih.gov/218...
vitamindsociety.org/pdf/Vit...
Once you Improve level, very likely you will need on going maintenance dose to keep it there.
Test twice yearly via NHS private testing service when supplementing
Vitamin D mouth spray by Better You is very effective as it avoids poor gut function.
There’s a version made that also contains vitamin K2 Mk7. One spray = 1000iu
amazon.co.uk/BetterYou-Dlux...
It’s trial and error what dose we need,
Vitamin D and thyroid disease
grassrootshealth.net/blog/t...
Vitamin D may prevent Autoimmune disease
newscientist.com/article/23...
Web links about taking important cofactors - magnesium and Vit K2-MK7
Magnesium best taken in the afternoon or evening, but must be four hours away from levothyroxine
betterbones.com/bone-nutrit...
medicalnewstoday.com/articl...
livescience.com/61866-magne...
sciencedaily.com/releases/2...
Vitamin K2 mk7
SlowDragonAdministrator
cks.nice.org.uk/topics/anae...
In all people, a serum ferritin level of less than 30 micrograms/L confirms the diagnosis of iron deficiency
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
List of iron rich foods
Links about iron and ferritin
An article that explains why Low ferritin and low thyroid levels are often linked
preventmiscarriage.com/iron...
irondisorders.org/too-littl...
davidg170.sg-host.com/wp-co...
Great in-depth article on low ferritin
oatext.com/iron-deficiency-...
drhedberg.com/ferritin-hypo...
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.
Thyroid disease is as much about optimising vitamins as thyroid hormones
healthunlocked.com/thyroidu...
restartmed.com/hypothyroidi...
Post discussing just how long it can take to raise low ferritin
healthunlocked.com/thyroidu...
Never supplement iron without doing full iron panel test for anaemia first and retest 3-4 times a year if self supplementing.
It’s possible to have low ferritin but high iron
Medichecks iron panel test
medichecks.com/products/iro...
Iron and thyroid link
healthunlocked.com/thyroidu...
Posts discussing why important to do full iron panel test
healthunlocked.com/thyroidu...
healthunlocked.com/thyroidu...
Chicken livers if iron is good, but ferritin low
healthunlocked.com/thyroidu...
Good explanations of iron
theironclinic.com/iron-defi...
theironclinic.com/ironc/wp/...
Why low ferritin needs improving
SlowDragonAdministrator
Low B12
What vitamin supplements are you currently taking
Are you taking any folic acid or folate supplements
Only on vitamin d and folate supplants at the moment
So is that a folate supplement you have bought or folic acid prescribed by GP?
GP should have tested for Pernicious Anaemia before starting any folate/folic acid supplements as they can mask B12 deficiency
If GP won’t test…..you will just need to start supplementing yourself
supplementing a good quality daily vitamin B complex, one with folate in (not folic acid) may be beneficial. This can help keep all B vitamins in balance and will help improve B12 levels too
Difference between folate and folic acid
chriskresser.com/folate-vs-...
Many Hashimoto’s patients have MTHFR gene variation and can have trouble processing folic acid.
thyroidpharmacist.com/artic...
B vitamins best taken after breakfast
Thorne Basic B or Jarrow B Right are recommended options that contains folate, but both are large capsules. (You can tip powder out if can’t swallow capsule)
IMPORTANT......If you are taking vitamin B complex, or any supplements containing biotin, remember to stop these 7 days before ALL BLOOD TESTS , as biotin can falsely affect test results
endo.confex.com/endo/2016en...
endocrinenews.endocrine.org...
Low B12 symptoms
b12deficiency.info/signs-an...
With serum B12 result below 500, (Or active B12 below 70) recommended to be taking a B12 supplement as well as a B Complex (to balance all the B vitamins) initially for first 2-4 months, then once your serum B12 is over 500 (or Active B12 level has reached 70), stop the B12 and just carry on with the B Complex.
B12 sublingual lozenges
amazon.co.uk/Jarrow-Methylc...
cytoplan.co.uk/shop-by-prod...
healthunlocked.com/thyroidu...
In week before blood test, while stopping vitamin B complex, you might want to take a separate folate supplement and separate B12 supplement. Eg Jarrow methyl folate and Jarrow B12
How much vitamin D
Is this prescribed by GP
Retest in 2-3 months
You will need ongoing maintenance dose vitamin D everyday
Hi Laralou36,
I have previously been very deficient in vitamin D and more recently ferritin. A lot of the symptoms that you describe are similar to what I experienced tiredness, infertility, hair loss and aching bones and joints. I also felt very unwell. Once I started supplementing properly most of my bone aches and pains lessened.
Although I'm still in the process of being diagnosed I'm working on improving my ferritin levels now as I've been having a lot of hairloss.
The forum and admin here are very knowledgeable and will give you brilliant advice.
Take care.
Hi, I'm not an expert but your blogs do look ok. I always thought that weight loss is more a symptom of hyper but fatigue is a symptom of hypo.Have you been checked for polycystic ovaries?
If your wit D is 24 this is very low as you should be at seeing 60-75 (at least what i was told by my Endo).
When my vit Dv levels were low, I had terrible joint and muscle aches, sleepless nights and all sort of symptoms. Since supplementing in feeling much better though I've been diagnosed with hypo and Chronic Fatigue Syndrome
I think you would benefit from full thyroid function testing incl T3, both antibodies, full iron testing, wit D, B12 but you already have some experts here taking about this. And yes, any other illness that goes together with thyroid issues in pair like celiac, insuline resistente, polycystic ovaries.
Good luck
Weight loss is, as you say, commonly associated with hyper. By everyone - doctors and the rest of us.
But a minority of hypo people actually lose weight. The reason appears to be loss of muscle mass. Which can be serious as the heart is almost all muscle.
(Similarly, some hypers put on weight despite most losing weight.)
Hiya thanks for your reply. I’ve had checks on my ovaries too. All ok. Will definately try and get my vit d levels up. Maybe the vitamin deficiencies are why I feel so rubbish
If there is no other issues and your blood really look ok thyroid wise then perhaps it's vitamins. I feel much better when supplementing vit D. But follow links of those who knows much more about vitamins which have already posted under your question. I know someone who ended up in hospital very such, coughing blood. All results were fine, no clear readings for it and get vit Dv was finally tested after weeks of illness. She had almost no vit D detected! That was the cause of her problems. In assuming your are not under Endocrinology care since your results are fine but consider private visit just in case. Good luck.
I have the same complaint! Take levotyroxine for 20 years. But still have symptoms...if you discover help share please.
Perhaps you have autoimmune of the thyroid (Hashimoto's Disease). Many Hypothyroid sufferer' have it and never get diagnosed. Hypothyroidism in the case of Hashimoto's Sufferer's is merely 1 symptom of many autoimmune symptoms. Fatigue, memory and brain fog, stiffness, muscle/joint/tendon issues, exercise intolerance, etc....get treated with thyroid but often don't get better, why? partly because many Dr's are lazy and don't think outside the box (or their paycheck), and partly because there are many autoimmune symptoms that are not getting treated. If Dr's told you that thyroid will not fix most of your autoimmune symptoms you might not have so many return visits, dose changes, and labs to keep their bank accounts filled to the brim. Many play the blood test game with us to see if we have the "correct" levels of thyroid, vitamins, etc.......but it's an error to think getting perfect blood levels will fix the other autoimmune symptoms that result from our bodies' attacking itself. -
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