Advice Please

[Katherine0121]

Hello,

Could anyone possibly provide an explanation as to what these results are saying?

Many Thanks

[Jaydee1507 Administrator]

It's not clear from your profile why you had the scan done but it looks routine and that the scan confirmed Hashimoto's. Looking back at your posts you have had raised antibodies before.

[Katherine0121 in reply to Jaydee1507]

Thank you for your reply. Sorry I posted rather hastily.

Long story short. Over the last 13months my symptoms have not improved, they have got significantly worse. I’ve had an ongoing battle with my GP, who constantly advises me “I’m in range”, and discards the ever growing list of symptoms.

He referred me to an endocrinologist, who during my initial appointment actually made me feel like I was been listened too. He wrote a detailed letter to my Gp, he arranged a scan of my thyroid as I have persistent sore throats, voice issues and he could feel a swelling/lump. There is also a history of thyroid issues/surgery requirements within my family. He requested further bloods be done and agreed he would meet with me to discuss the outcome of my scan, blood results and what steps we would take next. It was only during the appointment today ( at my Gp surgery ) to have the requested bloods done that I was advised he has discharged me.

I have no understanding of what the above means and I’m extremely disappointed to learn he has not kept his word and discharged me. I honestly feel like I am constantly getting passed from pillar to post and making no improvement at all. Th

[Jaydee1507 Administrator in reply to Katherine0121]

What were your latest blood results? Are you on any treatment?

[Katherine0121 in reply to Jaydee1507]

My most recent bloods are listed in my profile, along with current medications. I shall be able to update these once yesterdays results come in. Again, thank you for responding 😊

[PurpleNails Administrator]

Hypoechoic mean less sound wave & therefore more dense area.  This may be from swelling or scaring damage.

heterogeneous means it’s variable throughout thyroid - not uniform. So likely patchy areas.

Greater vascularity is seen with autoimmune (both over & under).  It likely the thyroid is working harder & being stimulated which causes greater blood flow.

Confirm Hashimoto’s.

[Katherine0121 in reply to PurpleNails]

Thank you for your reply and taking the time to provide an explanation.

[SlowDragon Administrator]

08/11/2022

TSH 26 mu/l (0.35-4.7)

T3 4.3pmol/L (3.8-6.0)

T4 7.2pmol/L (7.8-21.0)

Thyroid Antibody >1000u/ml(0.00-75.00)

Currently taking Levo 150/175 alternative days.

Fultium-D3 800unit and Strivit-D3 3,200unit Daily.

Vegetarian and strict gluten free diet since July 2022.

Results from your helpful profile

When were vitamin D, folate, ferritin and B12 last tested

What vitamin supplements are you currently taking

As vegetarian you will need daily B12 supplement

And separate daily vitamin B complex

and likely to need iron supplement

But essential to do full iron panel test for anaemia including ferritin BEFORE considering iron supplement

Have you tried dairy free diet.

May take 2-3 months to have noticeable results

[Katherine0121 in reply to SlowDragon]

I had bloods done yesterday, including a full vitamin panel, so I will be able to update with those once they are available.

I would have to go through all my previous results, last time my B12 was checked it was elevated.

I have not tried a diary free diet. Would I be right to assume it has the same benefits as a GF diet?

Once again thank you for your reply

[SlowDragon Administrator in reply to Katherine0121]

You won’t know if dairy free helps unless you try it

[DippyDame]

Your thyroid labs of 18/11/22 indicate hypothyroidism and high thyroid antibodies indicate thyroid autoimmune disease/ Hashimoto's.....but you already know this and your current dose is 150/175mcg levo on alternating days!

Hashi's can cause thyroid levels to fluctuate

Many people find that grains (specifically gluten -containing grains, like wheat, barley, or rye), high sodium intake, as well as high iodine intake are common triggers for a Hashimoto's flare-up.

You would likely benefit from a gluten free diet

Your TSH has shot up....A Hashimoto's disease flare-up may cause the pituitary gland to produce more TSH to rebalance hormone levels. Continued overproduction of TSH causes the thyroid to become enlarged, leading to a painless but uncomfortable condition called goiter.

You say you swelling or throat problems which appears consistent with the above

The flare is likely to be transient, though it may take some time to settle...

restartmed.com/hashimotos-f...

I guess the consultant lacks communication skills and didn't explain this when he discharged you!

Meantime continue to strictly adhere to a GF diet and work to optimise vit D, vit B12, folate and ferritin.

You may need to increase your levo dose until things settle down again

Labs "in range" do not mean you are euthyroid....we aim to find the specific point within the ref range where you feel well.

I tend to rant that, unlike machines that can be calibrated to a specific set point ( number), we are humans and therefore all different with different needs.... and don't respond to a standard hormone level that appears on a surgery computer screen!! Medics seem to assume that any result within the range is fine....it absolutely is not!!

Just a few thoughts...hope they help.

[Katherine0121 in reply to DippyDame]

Thank you so much.

I have lost count of the number of conversations I have had with GP’s about “in range”. It really does just go in one ear and out the other!

Don’t get me wrong, it was a massive relief that the thyroid scan showed nothing untoward, given my family history. I think I am just incredibly disappointed that the endocrinologist has just discharged me, without even looking at the blood results he requested. I honestly felt like he was the first person (aside from this forum), to sit and actually listen to what I was saying and how this impacts my daily life, for the first time I thought I may finally be on track to stabilising things and having a better quality life.

It infuriates me so much that we all have to fight so hard to be heard.

Again, Thank you 😊

[Katherine0121]

I have now updated with my most recent blood results. Prescription has been issued for iron tablets. Now awaiting a further call from GP which is scheduled for 01/02/2023 to discuss thyroid results. I have also requested a copy of these be sent to the endocrinologist, given he requested them in the first place.