Ultrasound result not sure what's next

[Lanny2010]

Hi I just got my results from thyroid ultrasound (refererred as have goitre which i noticed for the first time a few months ago but think i've had for ages). the letter reads: "I'm glad to say that there were no suspicious findings on your recent thyroid ultrasound. There were benign-looking nodules which typically do not require routine surveillance acans. Thyroid nodules are very common in the general population and it is very unusual for them to cause problems"

Reassuring but wondering what to do now.

While waiting for scan (7 week wait) I had medichecks thyroid test and results were:

TSH

(0.27 - 4.2 R)

3.06

mIU/L

FREE T3

(3.1 - 6.8 R)

4.1

pmol/L

FREE THYROXINE

(12 - 22 R)

14.2

pmol/L

THYROGLOBULIN ANTIBODIES

(0 - 115 R)

312.8

kIU/L

THYROID PEROXIDASE ANTIBODIES

(0 - 34 R)

106.1

kIU/L

Vit D, B12, folate and ferritin were all in range bit less than half way through normal range.

I phoned Dr and asked her about my antibodies as clearly high and she said they wouldn't register unless my thyroid hormones out of range but would email medichecks results to endocrinology anyway.

I was hoping I might have a phone appointment with Endocrinology to discuss ultrasound etc but does the letter (top of message) sound like I'm being discharged with no further surveillance?

Basically I've not felt myself for 3 years, was diagnosed coeliac then (with atypical symptoms) assumed I'd feel better with gf diet but have not. I'm 45 and perimenopausal too so list of symptoms (which tick lots of hypothyroid) are probably all mixed up with that too. Should I just treat myself with diet, lifestyle and supplements etc and test myself every year with medichecks or speak again to the dr? No idea what to ask for or if better to avoid any potential medication until symptoms worsen if they do?

Also considering chatting it through with a private consulation but no idea how this works or if worth it. Is one consultation enough to think things through usually as couldn't afford regular private. I'm in Edinburgh...

thanks so much sorry very long message x

[SlowDragon Administrator]

Please add actual vitamin results and ranges

What vitamin supplements are you currently taking, if any

Low vitamin levels tend to lower TSH

Difficult to get any medic to prescribe levothyroxine until TSH is over 5

Though with high thyroid antibodies, symptoms, low Ft4 and coeliac disease a thyroid specialist endocrinologist might agree to start you on levothyroxine

Suggest you work on improving all four vitamins to OPTIMAL Levels and retest thyroid levels again in 6-9 weeks

You might hopefully see TSH increase high enough to get prescribed levothyroxine

Optimal vitamin levels are

Vitamin D at least over 80nmol and around 100nmol maybe better

Serum B12 at least over 500

Active B12 at least over 70

Folate and ferritin at least half way through range

[Lanny2010 in reply to SlowDragon]

Thank you so much 🙏 vitamins are VITAMIN B12 - ACTIVE37.5 - 188 R

117

pmol/L

VITAMIN D

50 - 250 R

99

nmol/L

FERRITIN

30 - 150 R

61

ug/L

FOLATE - SERUM

8.83 - 60.8 R

26.2

nmol/L

I've been taking better you spray for b12 and vitamin D. Got a bit muddled with which other supplements to take and I've only really just started. I've been eating liver as you suggested previously thanks so much

[Lanny2010 in reply to SlowDragon]

Hi what is the difference between serum b12 and active b12? Results below thank you so much

[SlowDragon Administrator in reply to Lanny2010]

NHS only tests serum B12 - range usually 180-760 approx

forthwithlife.co.uk/blog/wh...

Rather than a separate B12

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

This can help keep all B vitamins in balance and will help improve B12 levels too

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) 

Or Igennus B complex. Small tablets.

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

 

Now your serum B12 is over 500 (or Active B12 level has reached 70), just carry on with the B Complex.

[Lanny2010 in reply to SlowDragon]

Thanks so much for your help, really appreciated 🙏

[SlowDragon Administrator]

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

There’s private one in Edinburgh

[e-mail]

[Lanny2010 in reply to SlowDragon]

Thank you yes I think I might book an appointment as would be interested to talk it all through and understand myself a bit more! 😊