Hello I wrote a couple of months ago about my symptoms and tests. I recently spoke to my Dr who said there is absolutely nothing wrong with my thyroid and this is backed up by "the best research in Western medicine". I just decided myself to do another test as recommended here (last medichecks test was in November). My results today are: TSH 4.58mu/L (range 0.27-4.2)
FT4 13.6pmol/L (range 12-22)
FT3 4.2pmol/L (range 3.1 - 6.8)
My results in November with Medichecks were (range then result):
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
I have symptoms, family history, coeliac disease, benign very visible nodules! Do I need to wait until I'm over TSH 10 to go back to the Dr or would folk recommend me sending these results in and asking for medication? I am working on vitamin levels etc. I can't really afford to go down the private route and pay for prescriptions. Just not sure if it's better to keep trying to treat myself with diet etc and hanging on for a while or do I actually need treatment and... will I get it? Thanks so much, confused! X
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Lanny2010
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Just to add the test results received today are with Monitor My Health and we're done yesterday at 8.30am. Should I send them in to the Dr? I feel she thinks I'm crazy!
Thank you so much, this is very helpful, I couldn't find the nice guidelines and now I get it. Do most people then just wait until they have TSH 5-10? Maybe I'm being overly dramatic! I keep reading about optimal levels and hearing about people being treated with much lower levels and fewer symptoms which adds to my confusion! As the Dr didn't take my symptoms seriously, I feel I should just wait until I am over 5 before I go back to see her! Many thanks
I had a 4.8 and a 5.5 TSH (same range as yours) with TPO antibodies at around 250. My GP accepts my private blood test results. You absolutely don’t need to wait till around TSH 10. We are all different but I was a barely functioning wreck of a shell of a human by the time I was diagnosed. Without this forum I’d still be on 25mcg, welcome to the Hashi club friend! Now it’s time to own your health, you will have to be pestery and pushy to get your meds and vits optimised but you can do it 🌱🦋🌱
Hi thanks for this, I thought I would wait until it's 5? Maybe I should ask to speak to a different Dr now and be pushy then? Ask for a 9am NHS test? (My antibody test was private, they only tested my tsh when I visited Dr with thyroid nodule in August so would be good to get that properly logged with NHS too even though they said they would only test for antibodies if over 5). I haven't felt myself for 3 years all a bit intertwined with perimenopause (also not taken seriously) will have another go! Thanks so much x
Definitely be pushy, I saw a string of locums after diagnosis and actually that helped.
Interesting you say about peri menopause, I was put on HRT at 45 only to discover at 48 I was having 2 periods a month and really struggling. Turns out I was hypothyroid all along (symptoms are very similar) and at 49 my ovaries are still in full swing, according to latest ultrasound. I hope you get it all sorted. 🌱
Thanks I'm going to try! Oh that is interesting about perimenopause I'm 45 and definitely some overlapping symptoms but sounds like it could be hypothyroid... Thanks again this has been so helpful x
Hi thanks I've been supplementing since full thyroid medichecks test results in November but haven't tested since. Did you say the best source of iron is in food or do you ever supplement? Thank you so much 🙏x
Hi SlowDragon hope you don't mind another quick question. So now I have been prescribed 25mg levothyroxine (Wockhardt) with a review in 7 weeks. Just checking is it just 30 minutes before food/drink that I take it? Also am I supposed to leave it a certain time before taking supplements? I'm sure I've read this on here but can't remember the timings. Thanks so so much again x
On empty stomach and then nothing apart from water for at least an hour
No supplements or medications within 2 hours
Some like iron, magnesium, calcium or vitamin D tablets at least 4 hours away from levothyroxine
Wockhart are very well tolerated. They only make 25mcg tablets. So when dose is increased will need to increase number of tablets (or try different brand)
Hi Lanny ,,,Assuming you are in UK? and it's NHS treatment we are talking about :
the good news is .. you don't have to wait until TSH is over 10
the bad new is you do have to show it's over the lab range on an NHS blood test ~ they can't officially accept your private results~ and then they have to wait another 3 months to confirm it's still over , and hasn't gone back down ... and then it depends on the GP .... they don't 'have to' treat it at that point ..they can 'consider' it.
Your over range TPOab thyroid peroxidase antibodies , show you have Autoimmune Hypothyroidism .. which is likely to get steadily worse,.. so the TPOab result ,AND any symptoms of hypothyroidism mean they are more likely to consider treating it before '10'
(* note 'subclinical hypothyroidism' means 'TSH over lab range, while fT4 is still in range' )
"1.5 Managing and monitoring subclinical hypothyroidism
Tests for people with confirmed subclinical hypothyroidism
Adults
1.5.1Consider measuring TPOAbs for adults with TSH levels above the reference range, but do not repeat TPOAbs testing.
Treating subclinical hypothyroidism
1.5.2When discussing whether or not to start treatment for subclinical hypothyroidism, take into account features that might suggest underlying thyroid disease, such as symptoms of hypothyroidism, previous radioactive iodine treatment or thyroid surgery, or raised levels of thyroid autoantibodies.
Adults
1.5.3Consider levothyroxine for adults with subclinical hypothyroidism who have a TSH of 10 mlU/litre or higher on 2 separate occasions 3 months apart. Follow the recommendations in section 1.4 on follow-up and monitoring of hypothyroidism.
1.5.4Consider a 6-month trial of levothyroxine for adults under 65 with subclinical hypothyroidism who have:
a TSH above the reference range but lower than 10 mlU/litre on 2 separate occasions 3 months apart, and
symptoms of hypothyroidism.
If symptoms do not improve after starting levothyroxine, re-measure TSH and if the level remains raised, adjust the dose. If symptoms persist when serum TSH is within the reference range, consider stopping levothyroxine and follow the recommendations on monitoring untreated subclinical hypothyroidism and monitoring after stopping treatment."
NOTE ... TSH falls naturally over the day until it's lowest around 1-3pm ish., so do NOT have your NHS blood tests after 9/ 9.30 am ish .. you TSH will be lower than it is on these 8 am tests .. and once they have a record of an 'in range' TSH they are not allowed to retest it for 3 months .
NHS won't accept you need a 9 am appointment for thyroid ,,, i am usually erm ... "unable to attend later than 9.30 due to work "
Thank you so much that's really helpful. Yes in the UK, Scotland and yes NHS. I guess I'll just wait a while and go back and ask to be tested. The Dr didn't take my symptoms or raised antibodies seriously so I'll just have to wait until they get worse! Bit depressing but I can't afford private prescriptions at the moment. Many thanks x
it's no bad thing that you have to get your initial diagnosis through NHS even if it means waiting 6 months ... they will always be highly dubious about a hypo diagnosis if Levo was already started on private prescription and this can create problems further down the line when they will keep suggesting you come of Levo every time you see them for anything... for the rest of your life .
see added Note on reply above re time of blood test . this will mean 'waiting' too ,, for an early a.m. slot for the blood test . but it's important
my gp accepts private test results as our labs won’t do more than TSH and she conceded I was doing the right thing for my health. She likes the official pdf though. Only takes my word for it when it’s Monitor my health (which is an nhs lab) 👍
. I recently spoke to my Dr who said there is absolutely nothing wrong with my thyroid and this is backed up by "the best research in Western medicine".
Well that's confidence for you! But it's somewhat misplaced!
It sounds as if she is diagnosing you on the basis that your labs are in range ...which they often wrongly refer to as "normal".
Instead what you are aiming for is the point within the range where you are relieved of your symptoms by correct medication.
You have symptoms so your labs are not sitting on the correct point!
As the others have said, you have Hashi's...apart from having the correct medication you should try a gluten free diet.....it helps many Hashi patients.
When diagnosing, medics are supposed to consider symptoms as well as labs....but they often do not and the patient suffers until the TSH reading is 5...or higher..
Your are NOT crazy, just in need of correct treatment.
Yes, take your latest MMH results to this GP and point out the test was done in an NHS lab....she can't argue with that!
I quote...
Monitor My Health private thyroid tests in the UK are carried out at the Royal Devon and Exeter NHS Foundation Trust laboratory.
MMH results today are:
TSH 4.58mu/L (range 0.27-4.2)
This is over range so hypothyroid
FT4 13.6pmol/L (range 12-22)
Result is 16% through the ref range
FT3 4.2pmol/L (range 3.1 - 6.8)
Result is 29.73% ditto
Both Frees should be approaching 75% through their respective ref ranges.....but with the caveat that we are all different so %age will vary a bit....but not as low as yours is!
Most people would feel under par with those results
Your GP will probably argue TSH is ( almost) fine so you must be fine....not so.
TSH is not a totally reliable marker....it can fluctuate especially if you have Hashi's
Use this link to help make your case for medication
FT3 followed by FT4 are the reliable markers and yours are both miserably low
You need to be prescribed 50mcg levothyroxine which you take daily away from food and drinks and after 6 weeks on that steady dose you need to be tested again
You will most likely need an increase to 75mcg.....repeat, wait and test
Those results will point the way forward....post them on this forum for advice
When you see this GP ( asap!) write down all you wish to ask and say in support of medication, use the info provided in replies here. I used to do this, it focussed my thoughts and stopped me sqawking like a demented parrot if I felt nervous!!
And yes, also work to optimise vit D, vit B12, folate and ferritin and cut out gluten... but absolutely no need to sit back and suffer until TSH rises
Hey thanks so much, that's incredibly helpful and generous of you. I'm going to take your advice and be very clear as per your words thanks I really needed that (I always lose my confidence with the Dr but will write it down). I am coeliac (diagnosed 3 years ago bizarrely with silent symptoms) and I suspect the two are connected (so completely carefully gluten free). Thank you 🙏😊x
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