Advice please Thyroid??

[Joliplace]

Hello. I have been reading for a while now whilst searching to help my daughter. She is age 20 and for the last year or so hasn't been feeling so good. long story short, She has gone from a a size ten to gaining four stone. She is only 5ft 2 so it has really changed her. Her sleep is erratic, she feels cold and felt sick/dizzy a lot. She got a lot of nosebleeds. She had started to get some facial hair and sometimes her periods were erratic. Her legs are quite swollen and don't look right. She had a lymphatic drainage massage and the lady said she was holding fluid in them. I think her mental health is really struggling. During lockdown the GP put her on the progesterone only pill after two bad periods and the weight seemed to pile on then. A few months ago as things didn't improve came off the pill and she pushed for bloods. the results of that showed folate deficiency and pointed to PCOS. She had a scan and that showed that one ovary has follicles all over it but the other is fine. The GP gave her 5mg folate and said once that had finished to buy her own. That the weight gain is part of it and thats all she can do apart from put her on the pill again. I have this month pushed for more bloods so we can see if this has improved now her folate has finished and asked for other levels to be looked at. They will only do bare levels and no T3 or T4 etc. She has been logging food and exercising five times a week and still gaining weight. Her sleep is horrific and she is struggling. She was just referred to a weight class and counselling! I feel we are getting nowhere. I have paid for the gold thyroid package from Blue Horizon. Sent that back this week and typically it has gone awol in the Royal Mail so i have asked for another to be sent today. So we will try again. I am not sure where to go with this. Dr says tsh levels are ok so no point doing other tests. Does anyone know if there is anything that can mimic PCOS and not be that? She is so unhappy and i just want to help her. i thought doing the Blue Horizon test may help give a general idea of if something is amiss elsewhere. Does anyone have any advice for us please? I attached her tsh and folate results below from a few months ago. I feel like i am rambling but i don't know if what i am saying is relevant to this or helpful so apologies if not. You all seem a really nice helpful bunch and I thought i would post for any ideas. Thank you

[Joliplace]

After posting this i got her Blue horizon results. Weird as they said they didn't have them. I will post them below.

results

[Jaydee1507 Administrator in reply to Joliplace]

Welcome to the group.

Sorry I don't know anything much about PCOS. What time of day were these tests taken?

Her folate in the first test is deficient. She needs to show this result to her GP and they should prescribe 5mg folic acid.

Her B12 is on the low side. Suggest she buys a good B complex like Thorne Basic B or this one is also good. amazon.co.uk/Yipmai-Liposom...

Ferritin would be better at 90-100. Try eating chicken livers a few times a week or pate.

Vit D is deficient. Use this calc to work out how much she needs to take to get it to 100. Buy a D3 that has K2 with it. grassrootshealth.net/projec...

On the second test her TSH is above 2 but still within range. It could be that her thyroid is struggling. Her FT4 is on the low side but her antibodies are negative so no autoimmune thyroid condition on this test at least.

Perhaps address the low vitamin levels and restest at 9am or as close as possible when TSH is highest, in 3-4 months time.

[Joliplace in reply to Jaydee1507]

thank you. First test was 11am at drs back in November. She’s finished her 5mg folate now and that’s being checked again next week. Second test was this week at 8am. I have sent her GP the results as Blue horizon flagged up the cortisol was high also. I’ll take a look at your suggestions for what to purchase. Appreciate it.

[Jaydee1507 Administrator in reply to Joliplace]

She will likely need to continue with a folate supplement of a lower dose that you will have to buy. The B complex does contain 400mcgs methylfolate though.

When you book thyroid bloods, always book for 9am or as close as possible as this is when TSH is highest.

[radd]

Joliplace,

Welcome to our forum,

Hypothyroidism and PCOS can not only mimic each other but be intrinsically linked. 

The progesterone produced after ovulation  (about  day 19 onwards) slows the release of LH by an inhibitory feedback mechanism that becomes skewed in PCOS resulting in higher LH production. This drives the theca cells to convert more cholesterol to androgens and elevated androgens not only cause improper follicle development and further erratic menstrual cycles and missed periods but also abnormal hair growth and acne.

Therefore, dosing progesterone cyclically can be helpful in encouraging a reduction in LH stimulation but not the Pill that GP’s so readily dish out for any young women suffering menstrual difficulties as the problem will still remain underneath. 

Insulin resistance (common in adrenal issues caused by low thyroid hormone) may cause high levels of  circulating insulin that encourage the ovaries to make more androgens. It also lowers SHBG so ‘freeing’ more testosterone. Some members have recommended supplementing Myo-inositol for PCOS which apart from helping regulate blood glucose is an anti-inflammatory and anti-oxidant.

Shame ferritin is haemolysed. Will her GP not do an iron panel? TSH is climbing as FT4 is low and FT3 remains adequate as the body tries to retain well-being, (most likely) at the expense of the adrenals, and so hence the high cortisol. Great there is no thyroid antibodies. Jaydee1507 has already offered good suggestions re nutrients. 

There is good PCOS podcast by Dr Eric Balcavage and Christa Elz. Also great info at the Period Repair Manuel ... larabriden.com/sample/prm2-... and Cyclic Progesterone Therapy ... larabriden.com/cyclic-proge...

Isabella Wentz and Myo-inositol ..... thyroidpharmacist.com/artic...

[Joliplace in reply to radd]

thank you.

She has bloods appointment on Tuesday at GPs for basics which include ferritin etc. they refused to do the T3 T4 bits as nothing wrong with TSH levels they said. So I went ahead and did the Blue Horizon ones. So these will get done. I’ll post results when they are back.

She hasn’t seen anyone face to face through it all apart from nurse for bloods and ecg. Everything else by text or call. I dropped the results off yesterday and hopefully a dr will see them, or at least when they look at her results from next weeks there. The GP said it is what it is and the only help she can give is going back on the pill if her periods go erratic, they are quite manageable and can be quite regular. Not sure if it’s because one ovary is normal looking maybe?

I asked for a referral on and was told there was no need. Hence coming on here to research and read up other experiences. My next step will probably be to find a dr who can help us. I looked on the list and we have someone I had already looked at Chichester way.

Thank you again

[radd in reply to Joliplace]

Joliplace,

It might be better to take her to a hormone specialists clinic to receive specialist care not usually available on the NHS (there are various around the UK now that menopause/HRT receives more attention) . PCOS can not be wholly reversed but it can be managed well to avoid infertility.

I really wouldn't rely on GPs or even general medicine as it is way behind functional or integrative where hormones are concerned.

[Joliplace in reply to radd]

I looked on the thyroid Uk website and got their list. There is one in Chichester. I will probably go to her.