Am I imaging things?: Please feel free to say if... - Thyroid UK

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Am I imaging things?

Karen234 profile image
17 Replies

Please feel free to say if you think I am imaging a problem that isn't there, I actually think my Doctors think I'm nuts.

About 3 years ago I went to see the Dr because I was not my usual self, constantly tired, miserable, losing my hair and brain fog. I was told I was depressed and to take Vitamin D.

I am in the process of gaining access to my medical records so I apologise if I am a little vague with my results. When I had blood tests done 3 years ago I was told my Ferritin level was high, vitamin D low and everything else ok, (I cannot remember time of day blood was taken).

Fast forward to this year, after gaining weight and hair still falling out, fatigue and brain fog still present I saw the Dr as I was having chest pains. This seemed to trigger some action, he actioned blood test, ECG, blood pressure monitor. The outcome was "borderline" hypothyroid but get re-tested in 6 months. One Dr wanted to refer me to the Cardiologist as I have a very low resting heart rate (Cardiologist said he wasn't worried based on the 24 hour monitoring), I was put on statins for high Cholesteral.

Medicheck July 2022

TSH 2.83 (0.27 - 4.2)

T3 4.02 (3.1 - 6.8)

T4 12.4 (12 - 22)

Ferritin 445 (13 - 150)

Folate 1.47 (<3.89)

Results for last NHS blood test (I will post complete report when I have it) Aug 2022 (I think)

TSH 4.3 (0.2 - 4.0)

T4 9.8 (11 - 22.6)

I have ordered another Medicheck kit.

Sorry it the information is a bit patchy but I would just like an honest opinion, as I said Dr thinks I am imaging things, husband bless him agrees with everything I say but could be for an easy life 🤣

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Karen234
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17 Replies

You are 100% NOT imagining things.

Your thyroid is failing; it's plainly obvious by your below range T4. Others will be along with practical support.

SarahJane1471 profile image
SarahJane1471

Oh my goodness 🤦‍♀️Your dr is an idiot . Your TSH is overrange and your FT4 is underrrange……… you are hypothyroid! Go and see another Dr in your practice. Tell all your symptoms and point out your results ( although shouldn’t have to if they were doing their job properly).

You MUST advocate for yourself if you want to get well

SlowDragon profile image
SlowDragonAdministrator

You are DEFINITELY not imagining it

Hopefully you are also testing vitamin D, folate, ferritin and B12 and thyroid antibodies via Medichecks

Test early Monday or Tuesday morning ideally just before 9am to get highest TSH

Starting levothyroxine - flow chart 

See box secondary hypothyroidism

Though TSH is creeping up….it’s not as high as should be for such low Ft4

gps.northcentrallondonccg.n...

With below range Ft4 you should have been started on levothyroxine or at least referred to endocrinologist

Standard starter dose of levothyroxine is 50mcg

They might start you on 25mcg initially as over 60

vast majority of endocrinologists are diabetes specialists and useless for thyroid

Email Thyroid U.K. for list of recommended thyroid specialist endocrinologist and doctors 

tukadmin@thyroiduk.org

Link about thyroid blood tests

thyroiduk.org/getting-a-dia...

Link about Hashimoto’s

thyroiduk.org/hypothyroid-b...

Symptoms of hypothyroidism 

thyroiduk.org/wp-content/up...

Come back with new post once you get results

Karen234 profile image
Karen234 in reply to SlowDragon

 have just received my latest Medicheck results, I would appreciate any comments please. I have a GP test booked in 10 days which will hopefully lead to a GP telephone appointment. I expect the results will be similar so if anyone can please give me any pointers please I will be so grateful.Blood sample taken at 8.30 am and I am not on any medication - apart from Statins.

CRP HS 2.14 mg/L (Range: < 3)

Ferritin 435 ug/L (Range: 30 - 650)

Folate - Serum 9.3 nmol/L (Range: 8.83 - 60.8)

Vitamin B12 - Active 142 pmol/L (Range: 37.5 - 188)

Vitamin D 67 nmol/L

TSH X 4.28 mIU/L (Range: 0.27 - 4.2)Free T3 5.5 pmol/L (Range: 3.1 - 6.8)

Free Thyroxine 13.8 pmol/L (Range: 12 - 22)

Thyroglobulin Antibodies 11.8 kIU/L (Range: 0 - 115)

Thyroid Peroxidase Antibodies 7 kIU/L (Range: 0 - 34)

SlowDragon profile image
SlowDragonAdministrator in reply to Karen234

so

TSH is high….Ft4 low suggesting thyroid is struggling

Folate is low and vitamin D

What vitamin supplements are you currently taking

Ferritin probably fine as over 60…..but

GP should do full iron panel test to check iron isn’t high

healthunlocked.com/thyroidu...

We have received further information the lab about ferritin reference ranges. They confirm that they are sex dependent up to the age of 60, then beyond the age of 60 the reference range is the same for both sexes: 

Males 16-60: 30-400 ug/L

Female's: 16-60: 30-150

Both >60: 30-650 

The lower limit of 30 ug/L is in accordance with the updated NICE guidance and the upper limits are in accordance with guidance from the Association of Clinical Biochemists. ‘

Karen234 profile image
Karen234 in reply to SlowDragon

thank you so much for responding, I am not taking any vitamin supplements.

SlowDragon profile image
SlowDragonAdministrator in reply to Karen234

Folate - Serum 9.3 nmol/L (Range: 8.83 - 60.8)

Clearly right at bottom of range

Looking to improve folate to at least half way through range

supplementing a good quality daily vitamin B complex, one with folate in (not folic acid) 

This can help keep all B vitamins in balance

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 recommended vitamin B complex that contains folate, but they 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...

In week before blood test, when you stop vitamin B complex, you might want to consider taking a separate methyl folate supplement

 

SlowDragon profile image
SlowDragonAdministrator in reply to Karen234

Low vitamin D

GP will often only prescribe to bring vitamin D levels to 50nmol.

Some 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 with Hashimoto’s, 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 

vitamindtest.org.uk

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...

Another member recommended this one recently

Vitamin D with k2

amazon.co.uk/Strength-Subli...

It’s trial and error what dose we need, with thyroid issues we frequently need higher dose than average

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 (once you get prescribed)

betterbones.com/bone-nutrit...

medicalnewstoday.com/articl...

livescience.com/61866-magne...

sciencedaily.com/releases/2...

Vitamin K2 mk7

betterbones.com/bone-nutrit...

healthline.com/nutrition/vi...

Government recommends everyone supplement October to April

gov.uk/government/news/phe-...

Thyroid patients frequently need higher dose than average

Only add one supplement at a time then wait at least 2-3 weeks before adding another

Suggest you start with vitamin D first

Then vitamin B complex

DippyDame profile image
DippyDame

Worry not!

The person who is nuts is your doctor !

You are experiencing the clear symptoms of undermedicated hypothyroidism.

SlowDragon has already given you good advice about testing

Doctors tend to be fixated on TSH which science proves is wrong....it is not a reliable marker so don't be persuaded by a TSH result alone as a diagnosis

Your FT4 and FT3 are abysmally low.....your doctor would realise this if he had results like you!!

thyroidpatients.ca/2021/07/...

Well done your husband, he is correct. My husband supported me too when doctors didn't ....that kept me believing in myself.

These tests speak for themselves but it is also vital to optimise the nutrients that support thyroid function.....vit D, vit B12, folate and ferritin.

And... to test thyroid antibodies TPO and TG to test for thyroid autoimmune disease/ Hashimoto's

My honest opinion....ditch this dolt and find a discerning doctor!

Good luck!

SeasideSusie profile image
SeasideSusieRemembering

Karen234

I was put on statins for high Cholesteral.

You absolutely should not be on statins - see

nhs.uk/conditions/statins/c...

If you have an underactive thyroid (hypothyroidism), treatment may be delayed until this problem is treated. This is because having an underactive thyroid can lead to an increased cholesterol level, and treating hypothyroidism may cause your cholesterol level to decrease, without the need for statins. Statins are also more likely to cause muscle damage in people with an underactive thyroid.

TSH 4.3 (0.2 - 4.0)

T4 9.8 (11 - 22.6)

Your NHS results confirm hypothyroidism. Some doctors will wait until TSH reaches 10 before diagnosing/prescribing Levo; however, you have an over range TSH with a below range FT4 which should give you the diagnosis and prescription, there will be no advantage waiting for a repeat test considering your Medichecks results were also suggesting hypothyroidism with the low FT4

Karen234 profile image
Karen234

Hi Everyone, just a quick update. I have had a GP blood test that reported:

TSH 4.3 (0.2 - 4.0)

T4 12.8 (11 - 22.6)

I decided enough is enough and I am not continuing feeling rubbish, existing not living. I have just put the phone down from a GP telephone appointment who has agreed to issue me a repeat prescription for 50 mg (I assume of Levothyroxine) although she said I don't think it will help as I've done it with other people. I will get re-tested in 3 months. I actually feel giddy that I am getting somewhere! Thank you all for your kind advice and giving me the confidence to get to this stage.

Merry Christmas everyone.

tattybogle profile image
tattybogle in reply to Karen234

Well done .. good feeling isn't it.

presumaby she has also prescribed antidepressants (and statins !) to 'lots of people who it didn't help' .. but doesn't let that stop her offering them to every tom, dick and harry who 'might' benefit ? .

And, given her rather negative attitude to prescribing Levo to someone for whom she's had clear evidence of below range/ low fT4 with steadily rising TSH , you do have to wonder if she just gave these other people 50mcg Levo and then took it away when they didn't immediately feel better on that dose .... or did she increase it carefully to optimise their dose ?

be aware that 50mcg may only make you feel better for a few weeks and then tail off again .. this is quite usual .. the same pattern is likely to be repeated with further increases, but hopefully feeling better for longer with less of a drop off each time.. until best dose for you is found .. starting levo is a bit '2 steps forward ,one step back'.. (with an occasional game of 'snakes and ladders' thrown in just to keep it interesting)

let us know how you get on over the next few weeks .

Karen234 profile image
Karen234 in reply to tattybogle

A quick update. After being on 50mcg of Levothyroxine for 3 months I had an NHS blood test, of course they only did TSH which came back at 1.1 (0.2 - 4). I still have a lot of the original problems, the usual suspects - brain fog, no energy, hair loss, weight gain (if only the hair and weight were the other way round 😀. So today I had a telephone appointment with the GP who insisted that my problems were more likely to be menopausal rather than thyroid! When I explained I did feel slightly better since taking thyroxine she stated it could be placebo effect. Upshot is I must be feeling better because I stood my ground and got my prescription increased to 75 mcg. Thanks to everyone on here for all your help, I keep hearing "you must advocate for yourself to feel better".

One question if anyone can help, the Dr said that my antibodies were low so it most likely wasn't a problem with my thyroid. I asked isn't this just Hashimoto's (trying to sound informed) but she shot me down and said no.

PurpleNails profile image
PurpleNailsAdministrator in reply to Karen234

Your TPO & TG antibody level were negative at the time you tested. 

A positive level is proof the immune system it attacking thyroid.  A negative level just shows there are currently no antibodies.  

Antibodies can fluctuate. 

 So you may of may not have autoimmune thyroiditis, but your doctor can’t conclude there’s nothing wrong with thyroid because you’re low levels required replacement.

tattybogle profile image
tattybogle in reply to Karen234

Good see how 75 goes .. as for the antibodies .. in research , apparently autoimmune /hashimoto's damage has sometimes been found in the thyroid glands of people who never found raised TPOab / or TGab.. so a negative antibodies test does not 100% rule out having autoimmune thyroid disease.

if they chuck that one at you again ~ ask them to arrange a thyroid ultrasound to look at your thyroid .

These references recommend GP's to keep TSh between 0.4/0.5 and 2.0/2.5 in patients on levo ... so you can use them to push for increases as long as TSH is over 0.4

healthunlocked.com/thyroidu.... -list-of-references-recommending-gps-keep-tsh-lower-

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

This explains why you may still need increases when TSH /fT4 are in 'normal' range:

healthunlocked.com/thyroidu... the-shoe-size-analogy.

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

This may come in useful if TSH goes below range : healthunlocked.com/thyroidu.... useful-evidence-that-tsh-between-0.04-0.4-has-no-increased-risk-to-patients-on-levothyroxine-as-long-as-ft4-and-ft3-are-in-range-.

SeasideSusie profile image
SeasideSusieRemembering in reply to Karen234

Dr said that my antibodies were low so it most likely wasn't a problem with my thyroid. I asked isn't this just Hashimoto's (trying to sound informed) but she shot me down and said no.

Your doctor is very ignorant, you are correct. I have been diagnosed/treated since 1975, my antibodies have been tested several times over the years and always low but I am definitely hypothyroid .

arTistapple profile image
arTistapple

OK Karen234 this is the closest thing I have ever read to my own story. Even your blood tests are similar. Why your doctor (and mine) think they have the right to use their extremely limited knowledge to ‘treat’ us, God alone knows. They could study up on it but they don’t. This happened to me 25 years ago. I was eventually diagnosed with a heart condition that did not even have a name. However even then it was routine to do blood tests to establish thyroid issues with heart symptoms as it was well understood in circles of medics that thyroid and heart are closely connected - and then to (in my case) ignore them. Both GP and Cardiologist ignored them. I only found the blood test results recently, when eventually diagnosed with hypothyroidism. It seems I have spent most of the last 25 years ‘subclinical’ without treatment. So by the time I have finally been diagnosed (two years ago) I have struggled for at least those 25 years. Probably much longer. No idea how or why it has progressed so slowly or at least taken them so long to discover it.

There is enough collated knowledge for medics to know about the connection. However they do not understand the blood test results. They only pay attention to TSH which appears to only have any accuracy before medication is attempted. They do not understand ‘subclinical’ and they certainly do not make the connection between heart symptoms and thyroid - even although it is well researched.

It’s a difficult battle with medics for a whole host of reasons. I have had the hypothyroidism for so long untreated, it’s really caused problems with my muscles (heart is a muscle too) and these muscle problems are very similar to what can be caused by taking statins. I did take statins for a very short while. Are they the cause? I cannot honestly answer that. However I will never take them again and even NICE recommend that for people who are hypothyroid they should be avoided and that cholesterol levels sort themselves out with correct thyroid meds. My cholesterol level has dropped from 9.9 to 6.8 with no other changes to my regime but thyroid meds. In my opinion it’s not important in any case, from everything I have read.

All I can recommend is keeping in touch with the forum. You get good advice here and knowledge way beyond your doctors. I am not yet at a ‘sweet spot’ myself. It’s been a difficult journey, just like the rest of the people on the forum. However each journey is in itself unique, even when similar symptom pictures are shared.

Sounds like you are tackling it. Good on you!

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