Medichecks Result and a warning about testing & HRT

[FAB-jellybean]

Apologies for the long post (my first) and thank you if you manage to get to the end of it.

Bit of history first (there's more in my bio), after 7 years of being bedbound with a diagnosis of fibromyalgia, I was finally prescribed combination T3/T4 in 2018. I hadn't had my bloods checked since 2019 (will need to get a copy of my medical records to check those results and everything else) between Covid and my worry about them withdrawing the T3 after it making such a difference to me. Stupid, I know!! However, I now believe that I was slightly under-medicated as I've gradually had an increase of symptoms but mostly since starting HRT. Just over a year ago, I was having symptoms of menopause - mood changes, night sweats, general aches (or so we both thought), spoke to GP on the phone (they still wouldn't see anyone) and she agreed to give me a trial of HRT patches. I've got on ok with them but I now realise I should have had my bloods checked before starting this.

I had my thyroid tested by the GP on 6/6/22 and discovered I was quite badly under-medicated and it's no wonder I was feeling soooo bad. Results (24 hrs since both T4 and T3 - wrong I know):

TSH 4.76 (0.27-4.2)

fT4 9.1 (10-22)

fT3 2.9 (3.1-6.8) I realise this is falsely low and is around the same levels as it was when I took T4 alone. In Scotland, they'll test fT3 if you are prescribed T3.

My T4 was increased from 100mcg to 125mcg and T3 stayed the same at 20mcg.

I was away for a month over the summer and decided to stop taking my supplements so that I could get them checked when I returned. Prior to this I was taking Vit C, methylated B complex, D3, K2-MK7, magnesium malate, probiotic, glucosamine, iron, selenium and zinc and omega 3 fish oil. It's quite a lot so I was worried I was overdoing it, but it seems not. I eat a normal fairly balanced diet and weight train 3 times a week. I decided to do the advanced well-woman medichecks test to see what's going on with my general health and it's quite eye-opening. Most things were well within the normal range. I'll share the ones of concern.

Results 23/8/22 Bloods taken 8.45am fasting, 24 hrs since T4 and 12 hrs since last T3. No supplements for 8 weeks.

TSH 0.02 (0.27-4.2) -6.36%

fT4 14.9 (10-22) 29%

fT3 4.52 (3.1-6.8) 38.38%

MCV and MCH slightly above normal range and could apparently be macrocytic anaemia (common in thyroid disease) but needs to be considered along with B12 and folate.

Active B12 79.7 pmol/L (37.5-150)

Folate 17.47 ug/L (>3.89)

Vit D is flagged as low normal 69nmol/L (50-200)

Magnesium too low 0.67 mmol/L (0.7-1)

Female hormones (follicular stage)

LH too high 17.5 iu/L (2.4-12.6)

Oestradiol too high 1139 pmol/L (45.4-854)

Iron 20.1 umol/L (5.8-34.5) and Ferritin 72.1ug/L (13-150) but need to redo the TIBC and transferrin saturation as there was a problem with the sample.

Cholesterol also too high

Total 5.02 mmol/L (0-5)

LDL 3.05 mmol/L (<3)

Non HDL 3.54 mmol/L (<4)

HDL 1.48 mmol/L (>1.2)

Total: HDL ratio 3.39 (<4)

Trigylcerides 1.07 mmol/L (<1.7)

So I am still not feeling as well as I could/should be and would probably have increased my T4 again slightly (taking the cholesterol and vitamin levels into account) had I not had my female hormones checked. However, I will stop the HRT patches and start taking methylated B vitamins, Vit C, Vit D3, K2-MK7, magnesium glycinate and probably selenium/zinc again, keeping the thyroid hormones as they are for the next 3 months before re-testing.

If anyone has any other ideas and is happy to share their pearls of wisdom, I'd love to hear them.

[serenfach]

It was extremely negligent of your GP to give you HRT before testing blood, blood pressure and asking you a series of questions - it is a powerful drug with side effects and she should have known this. I am no expert but to me it looks like you had not quite reached the menopause and the patches were the wrong thing to have. You would think (and hope) a female doctor would be more clued up.

I had bloods taken at the height of covid - I drove to the surgery, wore a mask, stuck my arm through the door window and the nurse took the bloods.

Your cholestorol is not bad at all - most of us with thyroid problems have high readings.

Expect to get hot flushes after not using the patches - your body getting rid of the high levels - think of them as power surges!

I dont have any pearls of wisdom, but I do have a hug for you.

[FAB-jellybean in reply to serenfach]

Thank you serenfach, appreciate your reply. I had to take and report my own blood pressure before starting and then 2 monthly for the first 6 months. But no mention of a blood test at all. She was purely going by my age and symptoms. I'm wondering though if perimenopause is a bit like Hashi's in that the hormone levels fluctuate. Also wondering if being undermedicated could cause those fluctuations to swing more wildly or simply reduce the oestradiol that I was producing and this went back up when I increased my T4. It's only since I upped the T4 that my periods have become very light and shortlived which fits with the high LH and oestradiol. That's what my educated guess is anyway. Thanks again, hugs back.