I'm in my mid 20s and have been feeling tired the last few weeks but have been busy with uni so didn't think too much of it until last week where I started feeling really off - weak, dizzy, and exhausted with a spacey/brain foggy feeling. I thought it might be anemia as I'm vegetarian (although have quite a good diet) and came home for a few days to try and feel better.
Over the weekend I started feeling worse and my brain fog became so bad I could barely think clearly and had to abandon all attempts at uni work. I got a doctors appointment for Monday as I couldn't shake this feeling something was 'wrong' in my body. I mainly mentioned anemia to the doctor but also asked if it could be my thyroid as my nan has a history of thyroid issues and so do some of my friends. She didn't seem sure but said she'd test for it anyway. My results came back today and everything she tested for was within range - B12, Foliate, Ferrin (although all these were right at the low end) and my serum TSH was 3.09.
I had thought if anything I might have a hyperactive thyroid as I was having heart palpitations as well but this result seems to suggest my range is closer to an underactive thyroid I think? It's still in range, however I read online that there is some debate that the range should be shifted for to 2.5 for the max for young women as 4.0 tends to be the upper range for men, is this right?
I've read a few posts here and it seems that doctors aren't always the best at diagnosing stuff like this - I have a history of anxiety and depression and I think my doctor was convinced this was the cause of what I'm feeling, especially as a uni student in my final year. Personally I don't think it is as it feels completely different to any anxiety/depression symptoms I've had before and I was in a fairly good place mentally before I felt ill.
I'd really appreciate any insight anyone might have regarding this - apologies for the long message!! Thank you 😊😊
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waterlover79
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Hi , and welcome waterlover .really sorry to hear how rubbish you feel .
you are correct ~ a TSH (Thyroid Stimulating Hormone) result of 3 is higher than most people, but not high enough to show a problem with hypothyroidism as far as the NHs is concerned.
shows the % of healthy people who have TSH at various levels .. as you can see 1 / 2 ish is by far the most common ... 3 is getting a bit unusual., and could be an early sign the the thyroid is beginning to struggle to make enough T4 for you .,, or it could be a result of rubbish vitamin levels , or something else that is just causing a temporary blip.
NHS wont usually test fT4 (the thyroid hormone) until TSH is over the lab range . (and they rarely test fT3 at all ).
Before they can consider treating hypothyroidism NHs need "2 consecutive over range TSH results, taken 3 months apart ,and symptoms of hypothyroidism.
What time of day was this TSH test taken ? (time of day affects result)
If you post the actual results you got for B12 /ferritin /folate and [lab ranges] people can help you see what to do to improve them.
Thank you so much for your reply, that is all really good to know! Time was just past 11am but I had not had any breakfast beforehand so had (unintentionally) fasted.
These are my vitamin levels - I was quite surprised to see my folate so low as I eat broccoli literally almost every day and have a pretty good diet with pulses, wholewheat pasta/rice etc. I don't eat eggs and am obviously veggie so thought maybe it was B12 but I do eat cheese, yoghurt, and have oat milk (which is B12 fortified).
I have been taking liquid iron which also has B12 and B9 since last week and have been eating as many iron rich foods as possible, and only had the blood test yesterday so not sure if this impacted results at all.
With serum B12 result below 500, (Or active B12 below 70) recommended to be taking a B12 supplement as well as a B Complex
Then once your serum B12 is over 500 (or Active B12 level has reached 70), you may be able to reduce then stop the B12 and just carry on with the B Complex.
If Vegetarian or vegan likely to need ongoing separate B12 few times a week
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)
Thorne currently difficult to find at reasonable price, should be around £25. Try iherb.com
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
In week before blood test, when you stop vitamin B complex, you might want to consider taking a separate methyl folate supplement and continue separate B12
Very common for doctors to assume anxiety / depression related.
Low ferritin can cause palpitations.
Many doctors are taught thyroid doesn’t need treating until TSH reaches 10 or there are 2 over range TSH results.
Unfortunately the TSH doesn’t tell you much. The TSH - thyroid stimulating hormone is a pituitary hormone which signal thyroid to reduce / increase production. It’s an assumption that thyroid hormones are at right level because TSH is in range.
Most have a TSH around 1 so as it rises the thyroid is struggling more to keep up.
You many have read younger women should have a TSH under 2.5 as this is a level thought to be appropriate level for those planning conception.
What you really need to know is what your thyroid levels are, the free thyroxine & Triiodothyronine or FT4 & FT3 for short.
Can you add folate,ferritin & B12 results & lab ranges (lab ranges vary between labs, so needed for every test)
In range is not same as optimal for nutrients. You may help symptoms by improving levels.
Having low nutrients can also lower TSH.
Many use private home fingerprick tests to obtain full thyroid testing as GPs often won’t test everything.
I think you should full function also test thyroid antibodies as this will show if autoimmune damage is occurring & you then have a strong argument to start treatment as you approach low levels rather than having to wait until they are severe.
For consistency it’s recommended for thyroid test you fast overnight, book draw for close to 09.00. Stop any supplements containing biotin 3 days before as biotin can skew results.
Medichecks offers an advanced thyroid including TPO & TG antibodies, key nutrients including vitamin D.
Monitor my health (MMH) offers an advance thyroid but only test TPO. but this is an NHS lab so more accepted by doctors. Some do accept private results but often doctors prefer to ignore private tests altogether but the results gives you grounds to push for repeat testing.
There are other companies & options, this page list them with discounts codes available.
Serum ferritin level is the biochemical test, which most reliably correlates with relative total body iron stores. In all people, a serum ferritin level of less than 30 micrograms/L confirms the diagnosis of iron deficiency.
Never supplement iron without doing full iron panel test for anaemia first It’s possible to have low ferritin but high iron
and retest full iron panel test 3-4 times a year if self supplementing.
Look at increasing iron rich foods in diet
Eating iron rich foods like liver or liver pate once a week plus other red meat, pumpkin seeds and dark chocolate, plus daily orange juice or other vitamin C rich drink can help improve iron absorption
This is interesting because I have noticed that many patients with Hashimoto’s disease and hypothyroidism, start to feel worse when their ferritin drops below 80 and usually there is hair loss when it drops below 50.
Thyroid disease is as much about optimising vitamins as thyroid hormones
We have received further information the lab about ferritin reference ranges. They confirm that they are sex dependent up to the age of 60, then beyond the age of 60 the reference range is the same for both sexes:
Males 16-60: 30-400 ug/L
Female's: 16-60: 30-150
Both >60: 30-650
The lower limit of 30 ug/L is in accordance with the updated NICE guidance and the upper limits are in accordance with guidance from the Association of Clinical Biochemists. ‘
Recommend you read the many posts and replies by humanbean on iron and ferritin
I feel for you , my daughter has just recently been diagnosed with thyroid issues. She should be a second year law student but is now at a different university as a first year doing a less exhausting course as she put it as she suffered from anxiety and fatigue . She’s had a load of symptoms all her life and been constantly miss diagnosed even though I asked the doctors to check her thyroid readings as she has family on both sides with thyroid issues . They always say it’s within range . They had given her hypermobility , dyslexia , depression diagnosis over the years but she has battled on. She has had shakes. Tremors for the past few years and we have been back and forth to numerous consultants. Private and NHS only go get recently diagnosed with something called essential tremors. We were soo happy at the consultation thinking finally we had a result and he gave us a prescription that she would have to take for life. That elation lasted exactly 5 minutes when I googled essential tremors and realised that was a diagnosis for a tremor that wasn’t understood . Even worse when I googled the side effects of the drugs prescribed and saw the side effects I had to break the news to my daughter that she would not be taking the prescription . I also promised her that I would discover what was wrong with her . She was emotionally exhausted by now as her tremors are truly noticeable . I won't go into how I can across the clinic in Belgium for my hormone needs (HRT) , I thought , it’s a long story . The upshot of all of this is that going there has saved my daughters life and mine . Although are blood results show we are in range re thyroid . Low readings though . Our 24 hour urine test shows quite clearly that I am greatly deficient in T3 and by daughter has a serious deficiency in t3 and t4 . All of the miss diagnosis over the years on all her many symptoms are due to Thyroid issues . Both she and I are on ERFA. Basically you need to take your care into your own hands . Rely on the thyroid 24hr urine tests not blood tests . If you message me I can send you the clinic details and also where you can get the 24 hr urine test done in the UK . Maybe no need for Belgium .Good luck
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