Looks like Central Hypothyroidism - advice for ... - Thyroid UK

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Looks like Central Hypothyroidism - advice for approaching the GP...

MrsButler profile image
31 Replies

Hi - I've been away from here for a year or so, I needed to stop obsessing over blood test results. My results were never "bad enough" to make a trip to the GP worthwhile - anyway, after suffering with rib pain, my Chiropractor advised me to check my thyroid:

2/02/2022

TSH 1.5 (0.27-4.2)

T4 11.7 (12-22)

T3 3.8 (3.1-6.8)

Knowing that any GP would advise re-testing in a few weeks, I tested again:

01/04/2022

TSH 1.74

T4 11

T3 4.17

and then to be really sure - again:

04/05/2022

TSH 0.96

T4 13.3

T3 4.2

my Vit D and B12 are mid range - but my ferritin and folate are very low in range - as they have been for last 3 years, despite my best efforts to improve them (iron panel showed no anemia)

I've also recently had a cortisol test with regenerus - DHEA 315 (106-300)

9am 11 (optimal14-25) (standard 7-30)

12pm 6 (optimal 5-10) (standard 2.1-14)

5pm 2.1 (optimal2-5) (standard 1.5-8)

10pm 0.8 (optimal1-4) (standard 0.33-7)

I'm really dreading going to the GP - I always make a hash of it - any advice on how to approach them would be great. Thank you

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MrsButler
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31 Replies
diogenes profile image
diogenesRemembering

Where on earth do chiropractors gain any knowledge of thyroid treatment? All the figures you've given do not support thyroid problems. If you have problems, they are very likely somewhere else.

MrsButler profile image
MrsButler in reply to diogenes

So does below range T4 not indicate a thyroid issue? Or do you mean the the problem is maybe with the pituitary?

PixieElv profile image
PixieElv in reply to MrsButler

Yes your results do support your inclination that it could be central hypothyroidism. I had similar results and got a diagnosis of CH. A lot of people, including GPs do not understand it and tell you there’s nothing wrong with you. Do you have symptoms?

Are you in any Levothyroxine? I had to stop it for 2 weeks and then test.

I’m now on NDT and feeling so much better.

Getting you vitamins & minerals right is also important.

SlowDragon profile image
SlowDragonAdministrator

Please add vitamin results and ranges

Exactly what vitamin supplements are you currently taking

Were thyroid tests all done early morning, ideally before 9am

Your morning cortisol is very low

MrsButler profile image
MrsButler in reply to SlowDragon

Thanks, I've added those details in a reply

MrsButler profile image
MrsButler

ferritin 20.5 (13-150)Folate 4.84 (3.89-19.45)

B12 63.7 (37.5-150)

Vit D 107 (50-200)

I take a vit d oral spray.

That's it at the moment. Have tried b complexes in the past and didn't seem to help

First 2 tests were pre 9am. Last test more like mid day.

SlowDragon profile image
SlowDragonAdministrator in reply to MrsButler

For thyroid to work well we must have GOOD vitamin levels

Serum B12 at least over 500

Active B12 at least over 70

Folate at least half way through range

Ferritin at least over 70

Are you vegetarian or vegan?

Ferritin is deficient

Request/insist GP should do full iron panel test for anaemia

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

dailyiron.net

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-...

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/...

SlowDragon profile image
SlowDragonAdministrator

Folate and B12 both too low

Request GP test folate and B12 on NHS BEFORE starting any B vitamins

SlowDragon profile image
SlowDragonAdministrator

Looking at previous posts

You have goitre and a large lump in thyroid

MrsButler profile image
MrsButler in reply to SlowDragon

It wasn't a goitre in the end, it was a thyroglossal duct cyst, higher up in neck. I do have some nodules on thyroid.

So, is it more likely my t4 is low due to low ferritin etc than central hypothyroidism.

I really have tried to raise the ferritin in the past through diet. I couldn't get it up at all. I gave up. Not vegan or vegetarian.

Also, last time I GP tested ferritin and folate they weren't bothered by low result as it was in range

SlowDragon profile image
SlowDragonAdministrator in reply to MrsButler

So, is it more likely my t4 is low due to low ferritin etc than central hypothyroidism.

You can’t tell …until vitamin levels are optimal

See many posts and replies by humanbean on how to increase ferritin

If GP won’t do full iron panel test, you will need to

Can take many months to improve low levels

If GP refuse to test folate and B12 ….you’ll have to start self supplementing vitamin B complex and separate B12

MrsButler profile image
MrsButler in reply to SlowDragon

Ok, thank you.

I'll read the information and try again.

Hedgeree profile image
Hedgeree

Hi Mrs butler,

Are you having any hair loss? My ferritin has been low similar to yours though not quite as low. My hair was coming out in large amounts and is now a bit thin on my scalp.

It is difficult. I've been trying Spatone gentle iron with a vitamin C drink on an empty stomach. My hair loss has definitely slowed down but I have yet to do a blood test to see if it's made much difference.

Hope you find something that works for you and get your ferritin levels much higher.

Best wishes.

MrsButler profile image
MrsButler in reply to Hedgeree

Thank you so much.

I have had some hair loss, more than is usual I think, but not excessive.

Alanna012 profile image
Alanna012

Are you menopausal at all?

MrsButler profile image
MrsButler in reply to Alanna012

Hi, I'm 42 so it's possible. Could be peri menopausal. But symptoms have been going on for 3 years now.

Periods are certainly irregular,.

PixieElv profile image
PixieElv in reply to MrsButler

That could also be a symptom of central hypothyroidism. Before my diagnosis, I was put on HRT aged 46. It made me very unwell, as it turned out I didn’t need it as it was a pituitary gland issue/CH. you may need an Endocrinologist to test, as GPs don’t know about this.

MrsButler profile image
MrsButler in reply to PixieElv

Thank you. I feel it is so easy for GP's to jump to menopause as a cause once you hit 40's. When I mentioned my adult onset acne, he basically just said, it happens at your age.

PixieElv profile image
PixieElv in reply to MrsButler

They do dismiss us so easily as middle aged women. They are so keen to give you antidepressants but not thyroxine. I could never fathom that…Stick to your guns. You know how you feel. And perhaps see an Endo? They know more. If you can afford it go private. Amazing the difference in the way you are treated.

Good luck

Ukie profile image
Ukie in reply to MrsButler

So on top of all your other health problems, you are expected to just live with the acne? Ask for Metronidazole gel, it’s a low dose antibiotic for acne rosacea, which I have had for years. If that doesn’t work, you can get it in tablet form.

MrsButler profile image
MrsButler in reply to Ukie

Thank you, I think an anti biotic is what I need. Nothing else has worked so far other than if I exfoliate a lot, like twice a day, I seem to get less cystic type spots. It's like I don't shed skin!

DippyDame profile image
DippyDame

uclahealth.org/endocrine-ce...

This may help....one way or another!

I used to make a list of all I wanted to say/ ask at appointments.....otherwise my foggy brain went awol!!

It helped jog my memory... and to focus

Don't anticipate "making a hash of it"....in that case you just might!!

I don't think it's necessarily you that is doing that!!

Good luck

MrsButler profile image
MrsButler in reply to DippyDame

Thank you. Really appreciate that.

humanbean profile image
humanbean

I've also recently had a cortisol test with regenerus - DHEA 315 (106-300)

9am 11 (14-25)

12pm 6 (5-10)

5pm 2.1 (2-5)

10pm 0.8 (1-4)

Are these the standard reference ranges supplied by Regenerus? I think they might be the "optimal" ranges rather than the standard ranges. I prefer to work from the standard ranges because Regenerus never tells people who decided what optimal is and what they based the numbers on.

MrsButler profile image
MrsButler in reply to humanbean

Yes, you are right. I didn't realise. I'll add the standard on

SlowDragon profile image
SlowDragonAdministrator

High DHEA suggests PCOS academic.oup.com/jcem/artic...

PCOS and acne strongly linked

medicalnewstoday.com/articl...

PCOS and hypothyroid linked

verywellhealth.com/hypothyr...

How to diagnose PCOS

nhs.uk/conditions/polycysti...

MrsButler profile image
MrsButler in reply to SlowDragon

This is something that been suggested to me before, but I don't have any of the other symptoms of it, I've had the bloods that check for it and it was fine,(they did show raised prolactin though which is another reason I'm thinking of it being pituitary related) and I've had ultrasounds which haven't shown PCOS.

SlowDragon profile image
SlowDragonAdministrator in reply to MrsButler

larabriden.com/you-might-no...PCOS cannot be ruled out by ultrasound because it’s possible to have normal-appearing ovaries on ultrasound and still have the hormonal condition PCOS.

cedars-sinai.org/blog/polyc...

Some women with PCOS may not have any cysts.

humanbean profile image
humanbean

I've also recently had a cortisol test with regenerus

9am 11 (optimal14-25) (standard 7-30)

12pm 6 (optimal 5-10) (standard 2.1-14)

5pm 2.1 (optimal2-5) (standard 1.5-8)

10pm 0.8 (optimal1-4) (standard 0.33-7)

DHEA 315 (106-300)

Using standard ranges :

Sample 1 : 11 (standard 7-30) 17.39% through the range

Sample 2 : 6 (standard 2.1-14) 32.77% through the range

Sample 3 : 2.1 (standard 1.5-8) 9.23% through the range

Sample 4 : 0.8 (standard 0.33-7) 7.05% through the range

DHEA : Over range

Optimal results according to this link (see example 1) :

rt3-adrenals.org/cortisol_t...

Optimal levels (using your standard ranges)

• Morning at the top of the range --- 30

• Noon approximately 75% of the range --- 11.025

• Evening close to 50% of the range --- 4.75

• Nighttime at the bottom of the range --- 0.44

...

Compare optimal results to your results.

Sample 1 : Optimal = 30 --- Yours = 11 --- You produce 36.7% of optimal

Sample 2 : Optimal = 11.025 --- Yours = 6 --- You produce 54% of optimal

Sample 3 : Optimal = 4.75 --- Yours = 2.1 --- You produce 44% of optimal

Sample 4 : Optimal = 0.44 --- Yours = 0.8 --- You produce 182% of optimal

Totals : Optimal = 46.215 --- Yours = 19.9 --- You produce 43% of optimal

Clearly you are not producing anywhere near enough Cortisol most of the day, nor in total throughout the day, but I doubt that you are suffering from Adrenal Insufficiency at the moment. (But please note I am not medically trained in any way whatsoever.)

This thread shows you results from a member who was diagnosed with Addison's Disease :

healthunlocked.com/thyroidu...

You might benefit from links and info in this thread:

healthunlocked.com/thyroidu...

I must admit I am puzzled about your DHEA result. In my study of member's saliva cortisol results high DHEA is often accompanied by cortisol results which are high and are getting higher. Low DHEA results are usually found when DHEA is low and getting lower. But your DHEA results don't fit that at all and I can't explain why, sorry.

MrsButler profile image
MrsButler

Thank you for that, really interesting to see it displayed as percentages. The DHEA is weird. I did read somewhere that it can be high if you've been under prolonged stress, which I have. But then maybe I do have PCOS.

I seem to be complicated

😅

MrsButler profile image
MrsButler

Little update: I spoke to GP, gave a history of all symptoms and results over past few years.

He felt that the two recent below range T4 results were likely in response to a temporary illness (I had no illnesses....)

He feels it's much more likely to be menopause than thyroid. I'm 42 and this has been happening for several years.

Anyway, he's ordering a raft of blood tests so I'll see what comes of that.

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