I've paid for private blood tests over the years and had some NHS blood tests and the only red flag has been very low vitamin D which has been ongoing for 10 years. It'd got better over the years but is currently low normal, not optimal. Right now its the best it's ever been at 53 (50-200)Most other results have always been in the 'optimal' range, I've had kidneys/cholesterol/thyroid antibodies and pretty much everything else I'm fit as a fiddle. Even t3 and t4 were good and in the middle of the range.
I have a strong family history of an underactive thyroid, my mum/sister/gran. I also have the symptoms (fatigue, thinning eyebrows, dry skin, struggle to lose weight, feeling cold while its warm, anxiety and heavy menstrual cycles)
I'm not looking for help with a diagnosis because my results don't indicate this but I've read that a TSH over 2 can cause symptoms. My TSH in 2011 was 4.1, my TSH in 2015 was 5.2, my TSH in 2022 is 4.0. Has anyone experienced issues with normal blood results?
I'm in this alone but I know something isn't quite right, so maybe I should rule out thyroid and figure out what else it could be. I shouldn't feel tired like this at my age.
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HarrieM
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A TSH of over 4 is not 'normal' (euthyroid). A euthyroid TSH is around 1, never over 2, and when it reaches 3 you are technically hypo - and in some countries you would be treated at that level. So, yes, you could very well have symptoms with a TSH that high.
Interesting. So if a NHS GP isn't willing to help, is the answer to wait for the numbers to start changing? Or I guess paying for a private GP to help?
I was the one that pushed hard for the t3/T4/antibodies as he said they weren't needed and they all seem to be perfectly fine, it feels like the problems in my head but the TSH has mildly elevated for at least 10 years.
Even a private GP is likely to abide by the NICE guidelines, which say that there's no need to treat until the TSH reaches 10! They've only had the same training as the NHS GPs.
Problems are rarely in one's head, in my experience. That's just a doctor's way of avoiding having to actually do something. But, what exactly were the numbers for FT3/FT4/antibodies? Results and ranges? A GP that says these aren't needed is a very, very ignorant doctor with next to know understanding of how the thyroid works.
So it sounds like its a waiting game to see if anything changes. For now I can work on getting my vit D to a better level and trying other things (diet/exercise) to see if I can improve my energy levels. Thanks for the help.
Hardly the middle of the range! Your Frees are much too low. What's more, your TSH does not really correspond to the level of your Frees. With such a low FT4 one would expect the TSH to be higher.
So, what that suggests is that you don't have a thyroid problem, you have a pituitary/hypothalamus problem - i.e. the pituitary is not producing enough TSH to stimulate the thyroid to make enough thyroid hormone. We call this Central Hypo. And, if this is the case, waiting for the TSH to rise is not going to get you anywhere, because it won't. However, the Frees will gradually drop lower and lower, causing more and more symptoms. (NB it's not the TSH itself that causes symptoms, it's the T3, the active thyroid hormone needed by every single cell in your body.)
Doctors believe that Central Hypo is very rare (it isn't!) so they are not taught about it in med school, and are therefore incapable of recognising it when they see it. There are a few endos that understand it, and the need for further testing, but the average GP will just say he's never heard of it. So, you need to see an endo. But, first, do your research into the condition so that you know what you're talking about, because your GP might need a lot of persuasion!
Below is a graph of TSH levels in healthy people with no thyroid condition. You will see that the majority of people are around 1, some just under, some just over, with a very few being well with no thyroid problem when TSH is much higher, 4 or 5. So it's not set in stone. Considering that you have said
I'm fit as a fiddle. Even t3 and t4 were good and in the middle of the range.
then even though there is a familial connection perhaps you don't have a thyroid problem.
the only red flag has been very low vitamin D which has been ongoing for 10 years. It'd got better over the years but is currently low normal, not optimal. Right now its the best it's ever been at 53 (50-200)
What are you doing to optimise this? Are you taking D3 and it's important cofactors - magnesium and Vit K2-M K7?
The Vit D Council, the Vit D Society and Grassroots Health all recommend a level of 100-150nmol/L (40-60ng/ml), with a recent blog post on Grassroots Health mentioning a study which recommends over 125nmol/L (50ng/ml). To achieve this level you'd be looking at supplementing with 5,000iu D3 daily at the moment.
Oh gosh nooo I'm not. The Dr recommended an over-the-counter vit D supplement as I pay for prescriptions. Its 10ug from holland and barrett. I wasn't informed about Vit K2-M and K7. This has been ongoing for ages and no one has ever mentioned this.
That's me on the research train later. Thanks for letting me know.
I think your doctor probably wants you to just waft the bottle of vitamin D under your nose. It would probably have much the same effect as a 400 iU tablet or capsule.
I'd go with SeasideSusie 's suggestions on dose if I were you.
It says 200% of daily allowance on the container. Plus I've been on 3 sunshine holidays this year. I probably should have researched this ages ago, I always assumed I was doing enough.
It says 200% of daily allowance on the container. Plus I've been on 3 sunshine holidays this year.
One of our members Marz lived in Crete for many years with her husband. They were active and spent a lot of time in the sun. They tested their vitamin D at some point and discovered they were both deficient (or very low).
Being in the sun might help vitamin D but it isn't a guarantee of adequate levels.
VitD is fat soluble so a gel capsule containing olive oil would be better - suggested by SeasideSusie. Your supplement needs are based on your test results so 4000 iu's looks more appropriate for you.
The Vit D Council, the Vit D Society and Grassroots Health all recommend a level of 100-150nmol/L (40-60ng/ml), with a recent blog post on Grassroots Health mentioning a study which recommends over 125nmol/L (50ng/ml).
So now you look at how much is needed to reach 50ng/ml and you'll see that they suggest 3,700iu per day.
Bearing in mind that your only 21.2ng/ml you could also look at the 2nd table for current level between 10-20ng/ml and you'll see that one suggests 4,900iu D3 daily.
You should be perfectly OK to supplement with either 4,000iu or 5,000iu D3 daily.
Retest after 3 months.
Once you've reached the recommended level then an ongoing maintenance dose will be needed to keep it there, which may be 2000iu daily, maybe more or less, maybe less in summer than winter, it's trial and error so it's recommended to retest once or twice a year to keep within the recommended range. This can be done with a private fingerprick blood spot test with an NHS lab which offers this test to the general public:
Doctors don't know, because they're not taught much about nutrients, but there are important cofactors needed when taking D3. You will have to buy these yourself.
D3 aids absorption of calcium from food and Vit K2-MK7 directs the calcium to bones and teeth where it is needed and away from arteries and soft tissues where it can be deposited and cause problems such as hardening of the arteries, kidney stones, etc. 90-100mcg K2-MK7 is enough for up to 10,000iu D3.
D3 and K2 are fat soluble so should be taken with the fattiest meal of the day, D3 four hours away from thyroid meds if taking D3 as tablets/capsules/softgels, no necessity if using an oral spray.
For D3 I like Doctor's Best D3 softgels, they are an oil based very small softgel which contains just two ingredients - D3 and extra virgin olive oil, a good quality, nice clean supplement which is budget friendly. Some people like BetterYou oral spray but this contains a lot of excipients and works out more expensive.
For Vit K2-MK7 my suggestions are Vitabay, Vegavero or Vitamaze brands which all contain the correct form of K2-MK7 - the "All Trans" form rather than the "Cis" form. The All Trans form is the bioactive form, a bit like methylfolate is the bioactive form of folic acid.
Vitabay and Vegavero are either tablets or capsules.
Vitabay does do an oil based liquid.
Vitamaze is an oil based liquid.
With the oil based liquids the are xx amount of K2-MK7 per drop so you just take the appropriate amount of drops.
They are all imported German brands, you can find them on Amazon although they do go out of stock from time to time. I get what I can when I need to restock. If the tablet or capsule form is only in 200mcg dose at the time I take those on alternate days.
If looking for a combined D3/K2 supplement, this one has 3,000iu D3 and 50mcg K2-MK7. The K2-MK7 is the All-Trans form
Don't take D3 and K2 at the same time unless both are oil based supplements, they both are fat soluble vitamins which require their own fat to be absorbed otherwise they will compete for the fat.
Don't start all supplements at once. Start with one, give it a week or two and if no adverse reaction then add the next one. Again, wait a week or two and if no adverse reaction add the next one. Continue like this. If you do have any adverse reaction then you will know what caused it.
The H&B D3 you are taking isn't much use. 10ug = 400iu which is a child's dose and wouldn't improve the Vit D level of a sunburnt flea. It's a tablet which is poorly absorbed unless taken with dietary fat and it contains lots of nasties. H&B and any high stree or supermarket supplements are generally pretty poor quality.
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