I had my bloods checked by my gp. Everything was mid range except tsh @13.41.
What did your GP say about this high TSH? Did he arrange a second test for a few weeks later which is what he should have done?
We always need reference ranges when posting results, this is because they vary from lab to lab and we can only use the ranges specific to the lab which did your test. However, I use Medichecks so know the ranges so can comment.
Inflammation 0.54
This is good, the lower the better with CRP.
Ferritin 144
I think the male range is something like 30-400.
It's generally recommended that ferritin is half way through range, although some experts say the optimal level for thyroid function is 90-110ug/L although it's not specified whether there is any difference between male and female.
Folate 9.94
The range for Medichecks usually shows a >3.89 whereas in fact the full range is 3.89-19.45. Folate is recommended to be at least half way through it's range so that would be about 12 plus with that range.
B12 143
Medichecks measures Active B12 (as opposed to Total B12) and the range is generally 37.5-188. Anything over 100 is classed as good with Active B12 and this range.
D 91
The unit of measurement should be nmol/L and the Vit D Council, the Vit D Society and Grassroots Health recommend a level of 100-150nmol/L, with a recent blog post on Grassroots Health mentioning a study which recommends over 125nmol/L. So your result is just about reaching that range and with summer being here you might be able to improve this if you make Vit D naturally from the sun. It would be a good idea to retest end October/beginning November to see whether you need to supplement throughout the winter months.
Tsh 17.8 (0.27-4.20)
T3 4.49 (3.1-6.8)
Free thyroxine 13.2 (12-22)
Thyroglobulin antibodies 532 (<34)
Thyroid peroxidase antibodies 176 (<115)
Your raised antibodies confirm autoimmune thyroid disease (known to patients as Hashimoto's). Your TSH is well over range and your FT4 (free thyroxine) is at the bottom of the range. You now have two over range TSH results so your GP should start you on Levo based on your TSH alone.
Next steps for me are to find an endocrinologist and try to get to the root cause of the raised levels.
I don't know if that will help and if you are thinking of going private it could well be a waste of money. You have hypothyroidism, the cause of it is autoimmune. It's not going to go away and antibodies have a job to do.
Hashimoto's which is where the immune system attacks the thyroid and gradually destroys it.
Fluctuations in symptoms and test results are common with Hashi's.
Most doctors dismiss antibodies as being of no importance and know little or nothing about Hashi's and how it affects the patient, test results and symptoms. You need to read, learn, understand and help yourself where Hashi's is concerned.
Some members have found that adopting a strict gluten free diet can help, although there is no guarantee.
Gluten contains gliadin (a protein) which is thought to trigger autoimmune attacks so eliminating gluten can help reduce these attacks.
You don't need to be gluten sensitive or have Coeliac disease for a gluten free diet to help.
My gp tested blood count, liver function etc which were all ok. I highlighted the raised tsh and asked for thyroid specific tests but was told I’m sub clinical and to politely go away hence me taking the medichecks tests and looking at private options.
I am very keen to try and naturally reduce my inflammation and see if my tsh levels follow.
Subclinical?! With TSH at 13?! Your doctor is negligent. I'd be making a formal complaint I'd I we're you.
Shocking.
Guidelines say that if results come back over range another test should be done. Do that and your GP should start you on levo.
Your thyroid has been attacked to the point of failure. No amount of reducing inflammation will repair that damage I'm afraid. You need to be on hormone replacement. Make a fuss with your GP and take charge of your health.
I highlighted the raised tsh and asked for thyroid specific tests but was told I’m sub clinical and to politely go away hence
TSH over 10 is not subclinical, it is overt hypothyroidism (confirmed twice) and the cause of it is autoimmune as confirmed by your raised antibodies. Your FT4 is close to the bottom of the range. You need to be on thyroid hormone replacement. Even if you manage to "reduce the inflammation" you will still have Hashi's and it will still eventually destroy your thyroid so you would possibly be delaying the inevitable. If you are symptomatic what's the point of prolonging the agony?
In the majority of patients 50-100 μg thyroxine can be used as the starting dose. Alterations in dose are achieved by using 25-50 μg increments and adequacy of the new dose can be confirmed by repeat measurement of TSH after 2-3 months.
The majority of patients will be clinically euthyroid with a ‘normal’ TSH and having thyroxine replacement in the range 75-150 μg/day (1.6ug/Kg on average).
The recommended approach is to titrate thyroxine therapy against the TSH concentration whilst assessing clinical well-being. The target is a serum TSH within the reference range.
……The primary target of thyroxine replacement therapy is to make the patient feel well and to achieve a serum TSH that is within the reference range. The corresponding FT4 will be within or slightly above its reference range.
The minimum period to achieve stable concentrations after a change in dose of thyroxine is two months and thyroid function tests should not normally be requested before this period has elapsed.
Are you currently taking any vitamin supplements……if yes ….what exactly
Autoimmune thyroid disease is usually managed by GP, not endocrinologist.
Endocrinologist unlikely to be interested in finding root cause. A functional doctor might….but they are extremely expensive
Im not aware of any direct family with autoimmune issues.
I did have covid last September but thinking back my symptoms started before that.
I supplement with multi vitamin, vitamin D + sun, zinc, magnesium and fish oil daily.
I also recently started taking betaine and pepsin after reading about the connection between stomach acid and thyroid issues. I feel my sleep quality has improved since taking these.
Maybe a functional doctor is a better option for me?
Multivitamins are never recommended on here, most contain iodine not recommended for anyone with autoimmune thyroid disease, unless tested, found deficient and even then endocrinologist tend to avoid iodine supplements
Best to supplement vitamin D and good quality vitamin B complex rather than multivitamin
I went back to my GP on Friday to question their approach armed with my medichecks results. After some discussion it transpired that the nurse practitioner had looked at my previous results (high tsh) and deemed no further action was necessary. I reviewed my latest results with my regular gp who admitted she wasn’t familiar with the autoimmune levels and spoke to another gp for guidance. The end result was a prescription for 25mcg levothyroxine daily with further blood tests in 2 months.
I’ve stopped taking multivitamins and added selenium.
Fingers crossed things will start to improve over the coming weeks.
unfortunately your GP is still being rubbish i'm afraid . 25mcg is a tiny dose , That dose is only intended to be given to people over 65yrs old , or people with heart problems ... (as a more gentle introduction for the heart to having more T4 again when it's got used to going slowly when the person was hypothyroid)
if you get stuck on 25mcg for too long it may make you feel worse rather than better .
the NHS ( NICE ) guidelines for treating hypothyroidism advise GP's to start people under 65yrs old on 50mcg.
The settled dose that most people will end up needing is usually somewhere between 75mcg and 150mcg , but it takes time to adjust the dose carefully to get it right. hence starting at 50mcg and then building up with testing at intervals.
your TSH is fairly high and your fT4 is fairly low and so you will need more than 25mcg quite quickly , (and there was no reason for starting you on such a piddling little dose anyway)..... so telling you to stay on that for 8 weeks before testing might leave you feeling pretty rubbish for several weeks.
T4 from levo doesn't 'top up' your own low T4.... it 'replaces' it.
eg ~ you take it.... so your blood level of T4 goes up ..... in response to the higher T4 your TSH lowers a bit ,and in response to the lower TSH , your own thyroid then makes a bit less T4 than it was doing at the start.. so then the dose of levo need's increasing to compensate. this adjustment continues until the right balance is found and you are stable with more T4 than you started with , your symptoms get better, and your TSH hopefully stays about 1 ish where it should be.
when you start levo it is usual to feel a bit better after about a week(ish) . and for this 'better' to last for another week or so , and then to feel less good again .. this is probably the process described above happening. The TSH can then be retested after 6 /8 weeks ~it take that long to settle after a dose change. then the dose is adjusted .
As you get closer to the right dose fro you , hopefully the 'better' bit lasts longer ,and the 'less good again' is not so bad... until you are on a stable dose and feel well.
Starting people on 25mcg when they could be on 50mcg straight away just makes this whole process take months longer than it needs to, and leaves people feeling rubbish for longer.
(i hope the nurse practitioner has been given some more training on recognising /treating hypothyroidism ~ they should have followed up your previous high TSH result with a repeat test fairly soon and a prescription of levo ).
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Advice on latest blood results 
Advice on blood test results 
first blood results after adding t3 advice please. 
Looking for some advice on blood results which don’t correlate with symptoms please? 
Advice on blood results please!
