Would anyone be able to help 🤗😀 : My tsh is 2.... - Thyroid UK

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Would anyone be able to help 🤗😀

Happyxx profile image
Happyxx
•30 Replies

My tsh is 2.8 doctor says that's normal

My iron is 09.09 mmol

Ferritin 40 ugl

Vitamin D 23

Tibc 23 umol

Doctor says all normal but had extreme tiredness for 2 months.

Does anyone know if TSH indicates underactive thyroid?

Any help be great thank you.

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Happyxx
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SeasideSusie profile image
SeasideSusieRemembering

Happyxx

Just testing TSH on it's own is not enough, we also need to test FT4 because one can have a normal TSH but low FT4 which would suggest Central Hypothyroidism (which is where the problem lies with the pituitary rather than the thyroid ).

Please add reference ranges for all your results so that we can interpret them, ranges vary from lab to lab .

Iron panel looks low, was saturation percentage also done?

Vit D is likely to be low, is the unit of measurement nmol/L or ng/ml?

Were B12 and Folate also tested ?

SlowDragon profile image
SlowDragonAdministrator• in reply toSeasideSusie

23nmol (35-120)

Told results normal……unbelievable

Do you understand very low TIBC …..but low iron and ferritin?

SlowDragon profile image
SlowDragonAdministrator

How long since these tests were done

Was test done early morning?

Ideally around 9am to get highest TSH?

Are you currently taking any medications or vitamin supplements?

Request GP retest thyroid 6 weeks after first test

Request including thyroid antibodies and Ft4 (very unlikely to get Ft3 so not worth asking )

Plus B12 and folate

Happyxx profile image
Happyxx• in reply toSlowDragon

Thank you 🤗

Tsh 2.9 range (0.2-4.2)

Iron 09.09 range (09.00-60)

Ferritin 45 ugl range ( 40-120)

Tibc 23 umol range ( 48-89)

Vitamin D 23 umol. ( range 35-120)

Tests were done early morning.

I've just started wellwomans vitamins to see if helps tiredness. Doctor said all results normal. On no medication except sertraline slowly cutting down.

My symptoms are tiredness dry eyes hair loss brain fog.

Thank you for reply.

SlowDragon profile image
SlowDragonAdministrator• in reply toHappyxx

Iron 09.09 range (09.00-60)

 Ferritin 45 ugl range ( 40-120)

Tibc 23 umol range ( 48-89) 

Vitamin D 23 umol. ( range 35-120)

Multivitamins are never recommended on here

Don’t take anything until seen different GP

TIBC very low

Iron low

Ferritin low

With ask radd and humanbean to comment

I think low TIBC might be possibly indicative of high iron

Hemochromatosis

So results are odd

radd profile image
radd• in reply toSlowDragon

   Happyxx

Iron 09.09 range (09.00-60)

Ferritin 45 ugl range ( 40-120)

Tibc 23 umol range ( 48-89)

Serum iron is bottom of range and ferritin at 6.25%. TIBC measures the transferrin proteins available for binding free iron in the body and is way under range. 

SlowDragon refers to the usual lab presentation where elevated TIBC may indicate iron deficiency anaemia (too many proteins available for iron to bind to) and low TIBC may indicate iron overload (too few proteins available for iron to bind to). However, when we are long term ill iron mechanisms can go askew and usual patterns don’t always follow through. Low iron and low TIBC could be due to conditions such as haemolytic anaemia where RBC are destroyed too quickly or protein levels become low through inflammation. 

Again a usual presentation of inflammation would be for ferritin to raise to secure iron from feeding pathogens but if you don’t have any iron or proteins are low due to other conditions, then ferritin isn’t going to raise. There are many forum members with high inflammation evidenced by swellings, aches & pains, elevated auto antibodies, etc but low ferritin.

There is also thought when iron behaviours are left long term as in the case of too little, then the amount of transferrin protein carriers will naturally reduce to correlate with the low level of iron and in which case you would end up with low iron and low transferrin.

Haemolytic anaemia presents as primary, secondary and autoimmune with the cold temps common in hypothyroidism impairing the production of RBC’s (as explained by Dr P in his book). 

Definitely no haemochromotosis as you are deficient in iron. Have you had a FBC to assess RBC health and haemoglobin levels?

Also a WellWomen multivitamin will not address deficiencies. As you are low in iron and Vit D it would be prudent to assume malabsorption issues and a need for further nutrient testing/monitoring.

Happyxx profile image
Happyxx• in reply toradd

What is FBC? The doctor suggested wellwomans vitamins 🙈😬 I've tried two months now with doctor so tricky when they keep saying all ok x

tattybogle profile image
tattybogle• in reply toHappyxx

FBC= "Full Blood Count ",, it's the name for a standard bunch of blood tests GP's run together .

humanbean profile image
humanbean• in reply toradd

Low iron and low TIBC could be due to conditions such as haemolytic anaemia where RBC are destroyed too quickly or protein levels become low through inflammation. 

Another possible cause for low iron and low TIBC in the same person is internal or GI bleeding. My iron and TIBC ended up below range thanks to a bleeding polyp.

radd profile image
radd• in reply tohumanbean

Absolutely, and sorry you experienced this hb.

SlowDragon profile image
SlowDragonAdministrator

vitamin D is deficient

GP should prescribe LOADING Dose on NHS

That’s total of 300,000iu over 6-8 weeks

Not acceptable to say it’s fine

NHS Guidelines on dose vitamin D required - see here

ouh.nhs.uk/osteoporosis/use...

Vitamin D levels should be retested again at end of the vitamin D prescription

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 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

betterbones.com/bone-nutrit...

medicalnewstoday.com/articl...

livescience.com/61866-magne...

sciencedaily.com/releases/2...

Interesting article by Dr Malcolm Kendrick on magnesium 

drmalcolmkendrick.org/categ...

Vitamin K2 mk7

betterbones.com/bone-nutrit...

healthline.com/nutrition/vi...

Happyxx profile image
Happyxx• in reply toSlowDragon

Thank you for reply. I've got autoimmune diesese in the family.

My main symptoms are extreme tiredness dry eyes look pale tiny bit hair loss x

SlowDragon profile image
SlowDragonAdministrator

politely request that B12, folate and thyroid antibodies are also tested including TSH, Ft4 and Ft3

Happyxx profile image
Happyxx• in reply toSlowDragon

Yes will do it's so hard isn't it doctor tends keep saying all ok so hard keep bothering them.Do you know is my tsh seemed high 2.8 x

SeasideSusie profile image
SeasideSusieRemembering

Happyxx

Vitamin D 23 umol. ( range 35-120)

Please double check this. As far as I know there are two units of measurement for Vit D

ng/ml and the range is often given as 30-100 and the recommended level 40-60ng/ml

nmol/L and the range is usually something like >50 or >75 = adequate and the recommended level is 100-150nmol/L

Happyxx profile image
Happyxx• in reply toSeasideSusie

Sorry yes 23 nmol xx

SlowDragon profile image
SlowDragonAdministrator• in reply toHappyxx

So vitamin D is deficient at under 25nmol

GP should prescribe LOADING dose vitamin D on prescription for 6-8 weeks and retest vitamin D at end of the course

That’s 300,000iu in total over the prescription

Print out these NHS Guidelines on dose vitamin D required and be ready to quote them

ouh.nhs.uk/osteoporosis/use...

You will then require ongoing daily vitamin D

Trail and error what that dose is

Likely at least 2000iu per day minimum

Test twice yearly via NHS private testing service when supplementing 

vitamindtest.org.uk

Happyxx profile image
Happyxx• in reply toSlowDragon

Thank you x

meme profile image
meme

hello Happy

Your results show you need further investigation.

What is your diet like?

Do you have any stomach / bowel issues?

Happyxx profile image
Happyxx• in reply tomeme

My diet is mixture of things have meat twice a week. Tend to skip breakfast 🙈 sometimes bowels go from one extreme to another but not too bad.Do get bloating.

My main symptoms are tiredness, dry eyes, brain fog. It's so hard isn't it when doctor says all ok. But hard to keep going back x

meme profile image
meme• in reply toHappyxx

you must keep going back until you are satisfied.

Happyxx profile image
Happyxx• in reply tomeme

Thank you 🙂

SlowDragon profile image
SlowDragonAdministrator• in reply toHappyxx

bowels go from one extreme to another but not too bad.

Do get bloating.

Very common with autoimmune thyroid disease

Come back with new post once you get Thyroid antibodies, B12 and folate results

Happyxx profile image
Happyxx• in reply toSlowDragon

Thank you 🤗😊

SlowDragon profile image
SlowDragonAdministrator

Push GP to test…..but if they won’t …..private testing here

Used by 1000’s of U.K. patients, either for diagnosis or ongoing management

all thyroid blood tests should be early morning, ideally just before 9am

This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip)

Private tests are available as NHS currently rarely tests BOTH thyroid antibodies, Ft3 or all relevant vitamins

List of private testing options and money off codes

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

Medichecks Thyroid plus antibodies and vitamins

medichecks.com/products/adv...

Blue Horizon Thyroid Premium Gold includes antibodies, cortisol and vitamins

bluehorizonbloodtests.co.uk...

Only do private testing early Monday or Tuesday morning. 

Watch out for postal strikes, probably want to pay for guaranteed 24 hours delivery 

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...

If doing private testing……suggest you wait until completed vitamin D loading dose in 6-8 weeks time

Happyxx profile image
Happyxx• in reply toSlowDragon

Do you know roughly how much private blood tests are for thyroid?Be so great to get to the bottom of it so hard to know if vitamin D causing tiredness or iron or autoimmune diesese 😬 so hard keep ringing doctor especially when says all normal x

SlowDragon profile image
SlowDragonAdministrator• in reply toHappyxx

prices are on the links

Thyroid U.K. has general money off codes here

thyroiduk.org/help-and-supp...

Often extra money off on Thyroid Thursdays via Medichecks

Medichecks £86

medichecks.com/products/adv...

Only do private testing early Monday or Tuesday morning

Double check when postal strikes are

Ideally…….Get vitamin D sorted and improved FIRST

Low vitamin levels tend to lower TSH

Low vitamin D tends to lower B vitamins too

Happyxx profile image
Happyxx• in reply toSlowDragon

Thanks for all your help. Do you know if thyroid can cause low vitamin D.

SlowDragon profile image
SlowDragonAdministrator• in reply toHappyxx

Low vitamin D common with all autoimmune diseases, but especially thyroid disease

pubmed.ncbi.nlm.nih.gov/286...

Vitamin D deficiency is frequent in Hashimoto's thyroiditis and treatment of patients with this condition with Vitamin D may slow down the course of development of hypothyroidism and also decrease cardiovascular risks in these patients. Vitamin D measurement and replacement may be critical in these patients.

pubmed.ncbi.nlm.nih.gov/273...

Vitamin D insufficiency was associated with AITD and HT, especially overt hypothyroidism. Low serum vitamin D levels were independently associated with high serum TSH levels.

pubmed.ncbi.nlm.nih.gov/300...

The thyroid hormone status would play a role in the maintenance of vitamin D sufficiency, and its immunomodulatory role would influence the presence of autoimmune thyroid disease. The positive correlation between free T4 and vitamin D concentrations suggests that adequate levothyroxine replacement in HT would be an essential factor in maintaining vitamin D at sufficient levels.

Happyxx profile image
Happyxx• in reply toSlowDragon

That's so much for all the information 😃 x

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