private test results

[Jsmountain]

this are my private test results I have not had a call for thyroid blood test for 2 year my health is get worse and GP have said I am stressed and that is the problem , also At 72 I should except I am getting older and slowing down

I was diagnosed with hypothyroidism 40yr ago I have never seen an endocrinologist

Thyroglobulin 783.3 Thyroid Perovides ants134.1 TSH 3.5 freeT33.5 Free thyroxine 16.3

Some of my symptoms are new to me in the last year l

More body pain

,balance not good

,bad sleep waking up very hot But body temp at time as low as 34:5 but at night and in the day never above 36.1 most often 35/6 I have to lay down as I feel so bad

Any idea what I can do to help myself

[1tuppence]

Firstly, why would a GP assume that age equals feeling unwell? How old is your GP? Why hasn't your GP done recent blood tests? How much levothyroxine are you taking? Has the dose been adjusted at all? Has the brand of levothyroxine remained the same or has it been changed?

[Jsmountain in reply to 1tuppence]

I think the gp was a stand in he was not young.

I take 100m one day and 125 the next it not been changed for years sometime I get another brand.

I do not know why they have not done a blood test but I have not been call for one since covid started

Because I have been feeling unwell since before covid I also paid for a cholesterol test which came back high and the private firm advised that I check my diet

I have also had covid that was back in the summer I was in bed for a week I think that has not help with some of the symptoms

[1tuppence in reply to Jsmountain]

Sorry I bombarded you with lots of questions.... I was taken aback by the assumption that at 71 you "should accept getting older and slowing down"..... and the way you feel is simply that, and stress. "Stress" is such a "catch-all" as an excuse from any GP. (It was "suggested" to me by a DR when I was much younger, that my utter weariness was due to being a "mother of two young boys and working as a teacher"...in fact I had bronchitis!!)

Buddy195 has given you good advice, and a friendly welcome to the forum. Apologies for not doing that....see above

If I were you I'd make another appointment to see a GP who hopefully knows at least a little about you, and discuss your hypothyroid condition, how you are feeling and what treatment needs to be in place to help make you feel better asap. .... and that would include blood tests for thyroid hormones and necessary vitamins etc as Buddy195 says.

Cholesterol seems to be affected by hypothyroid problems, so it's worth getting your treatment optimal. I found that one brand of levothyroxine suits me and that having differing brands made me ill...so much so that I fell over badly. Now my prescription states the brand that suits me only.

[Buddy195 Administrator]

A big welcome to the forum Jsmountain,

Can you let us know the ranges for your blood tests, as these vary between laboratories. Also what dose of Levothyroxine are you taking?

It does look as if you are undermedicated as TSH should be under 2, with most members here reporting feeling best with TSH significantly under 1

Have you tested key thyroid vitamins; ferritin, folate, B12 and vitamin D? Having these optimal is very important to improving symptoms. Please don’t consider supplementing until you have tested levels first.

We are a very friendly forum and are here to help and support 🦋

[SlowDragon Administrator]

High thyroid antibodies confirms autoimmune thyroid disease also called Hashimoto’s

About 90% of primary hypothyroidism is autoimmune thyroid disease, usually diagnosed by high thyroid antibodies 

Autoimmune thyroid disease with goitre is Hashimoto’s

Autoimmune thyroid disease without goitre is Ord’s thyroiditis. 

Both are autoimmune and generally called Hashimoto’s.

Low vitamin levels are extremely common when hypothyroid, especially with autoimmune thyroid disease (Hashimoto’s or Ord’s thyroiditis)

Did you know you have Hashimoto’s

Request GP test vitamin D, folate, ferritin and B12 now

Likely to need to improve low levels

[SmallBlueThing]

There was a vacutainer shortage, leading to limiting of thyroid tests to one per year for those of us considered stable. I should've had a follow-up test last year, following a change of dose after having COVID-19. The surgery knew I'd double-checked with a private test, and maybe think they can offload thyroid testing on me?

Most GPs see TSH in-range and think their job's been done. I wouldn't be happy with mine at 3.5, and your free T3 and free T4 look correspondingly low. As we get older, medics get more concerned about the effect of thyroid hormones on our hearts, so you may have a task ahead of you, requesting a higher dose, while keeping free T3 and T4 in-range. In my area, fT4 is only tested when TSH is under 1, and fT3 only by special request, leaving the patient in the dark (as the GP is seldom interested in the "frees"). Try and get tested fairly early e.g. 9:00am and roughly 24 hours after your last dose, and before eating.

[anniec11 in reply to SmallBlueThing]

Glad to see you mention the reason a lot of GPs believe that when you get older (like myself) the less Levo you take the better it is for your heart. Hence they insisted on reducing it. I most certainly do not feel dog on my current dose. Has there been anymore news about the Heart vs. Levothyroxine debate.

[anniec11 in reply to anniec11]

Forgive the underline for certain words. Completely unintentional. Need to figure out why that is suddenly happening 🙄

[Jsmountain in reply to anniec11]

I was did not know that as we get older the GP likes to reduce the dose but I have been on the does now for about 6 years but they are of no help and say all my symptoms are stress and age which leaves me with no help I am thinking of going to a specialist privately but it’s the cost and whom do you trust to really help you

[SmallBlueThing in reply to anniec11]

Atrial fibrillation is a real risk, but it's also said that as the thyroid gland atrophies it contributes less and less free T3 (partly by conversion from free T4), and having high free T4 and comparatively low free T3 isn't good for the heart.

[anniec11 in reply to SmallBlueThing]

Thank you for that explanation. I will fet my test done and come back on here to see how things are. Thanks all for your support.

[tattybogle in reply to anniec11]

anniec11 ..... in your case the circumstances leading to your dose reduction were very different to Jsmountain's current situation , and so the risk's were very different.

Your results DID show increased risks for your heart etc ,, it is not so much about 'age', its more about the TSh & fT4 & fT3 levels ..and so your dose was reduced because your fT4 was over-range and your TSH was totally supressed , not because of your age . they would have reduced the dose of a 30 yr old with those results too .

TSH <0.005 [0.27 - 4.20] Free T4 24.9 [12.0 - 22.0]

But Jsmountian has a TSH of over 3 (we still need to confirm the range for fT4 result).

So the same risks do not apply. and in fact there are also increased risks when TSH goes over 4 .

See my reply to Jsmountain lower down the page for more details on TSH / risk.

[anniec11 in reply to tattybogle]

Thank you for your response. I was given to understand that levo (unless excessive) does not affect one's heart? Also, I was going through difficult time at the time znd therefore feeling , what seemed to me, unreasonably anxious. When I reduced the dose, the anxiety did not improve and the liss and quality of hair got much worse.🙈

[tattybogle in reply to anniec11]

Levo ~ which is synthetic T4 ~ does not affect the heart any more or less than our own T4 (from our thyroid) does . It is all a matter of what level of T4 and T3 we have. It is the levels of T4 and T3 that actually affect the function of the body , not where the T4 comes from.

is that what you mean ? or have i misinterpreted the question .

[anniec11 in reply to tattybogle]

No, sorry, it isn't what I mean. Irrespective of where it comes from, I was told yo reduce my Levo because the GP thought it was causing my anxiety and that a lower level would be better for my heart anyway! But having reduced the Levo to 75 mcg( as she suggested) made no difference. I have since gone back up go 100 mcg. I used to be on 125 for years without problems I was aware of, but a blood test requested by GP returned TSH as too high so I was asked to change... for no other reason.

[tattybogle in reply to anniec11]

There may be reasons to avoid long term higher fT4 levels (from all sources) if possible. T4 interacts with a receptor that is associated with some (but not all) types of 'cancer cell proliferation' , (higher T4 more association), that is a fairly recent finding .

Studies used to back up the claim of "low TSH causing heart /bone problems" do show sharply increased risks (for several outcomes) in patients on levo when long term TSH goes below 0.04 (that study does not have any data on what the patients fT4 levels were)

However we have to balance those risks against quality of life . if we can't achieve good quality of life on a lower dose that avoids those risks, then so be it , we may choose to accept them .... as there is no point trying to protect your bones from crumbling or your heart from getting AF, on a lower dose IF that lower dose means you feel so naff you rarely leave the sofa ... "long term sofa dwellers " are also known to carry a very high risk profile for bone loss and heart health.

For a list of posts with more info on low TSH/Risk vs Quality of Life.. and also the post regarding T4 level /cancer cell proliferation ...please see my reply to this post (3rd reply down) : healthunlocked.com/thyroidu...

( feeling-fine-but-tsh-is-low)

[anniec11 in reply to tattybogle]

That is very interesting indeed. It makes sense too, except not quite how the GPs put it.... . I will read up on it further. Again, thank you.

[tattybogle]

Hi Jsmountain,

TSH over 3 is higher than is recommended for patients on Levothyroxine.

Is the lab range for that fT4 test 16.3 [12-22] ? or something different ?

(if it's different ,please let us know )

Assuming your fT4 is not over range. then :

(after following slowdragon/ buddy195's advice re. checking your vitamin levels.... as this may well improve how you feel without needing to increase your Levo dose)

Show this list of "recommendations for GP's to keep TSH below about 2/ 2.5" to your GP and ask then to ream them .. particularly the one that says:

" * NOTE this one also clearly states that raised cholesterol is caused by hypothyroidism * "

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

A small Levothyroxine dose increase (eg initially to 125mcg daily) may improve how you feel. ( and lower TSH a bit ) .

Your GP will need to do their own bloods to confirm yours, as they can't go off private ones. They may only test TSH ....... make sure your NHS blood test is done early a.m. to show highest TSH .

GP will warn you that "low TSH is associated with risks to heart and bones" . and may use this as a reason to say no to a dose increase ..but when looked at carefully , the research actually says that in patients on Levo, these risks do not increase until the TSH is below 0.04..and that TSH between 0.04 to0 0.4 has no greater risks than TSH 'in range' does.

Two papers to ask GP to read if they insist lower TSH causes heart / bone problems:

This one ~ shows long-term low TSH (with fT4 in range) does not increase bone loss healthunlocked.com/thyroidu... longterm-subclinical-hyperthyroidism-does-not-affect-bone-density-in-patients

This one ~ shows the risks for 'low but not supressed' TSH 0.04 -0.4 are no higher than the risks for 'in-range' TSH 0.4 - 4 academic.oup.com/jcem/artic... Serum Thyroid-Stimulating Hormone Concentration and Morbidity from Cardiovascular Disease and Fractures in Patients on Long-Term Thyroxine Therapy

Also for further reading ~ See my reply to this post (3rd reply down) for a list of useful discussions on the subject of low TSH/Risks vs Quality of life healthunlocked.com/thyroidu... feeling-fine-but-tsh-is-low