PCOS vs Hashimostos: Hi. I've just had the... - Thyroid UK

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PCOS vs Hashimostos

Hexagon74 profile image
11 Replies

Hi.

I've just had the results from my Medichecks "Ultimate Performance" test and I am really very concerned. I took the blood test first thing in the morning after fasting and avoided levothyroxine for 24hrs.

The excellent accompanying letter (from a female GP) strongly indicates PCOS which seems to be strongly related to thyroid issues as well high prolactin, high cholesterol, raised LH, raised oestradiol and raised total testosterone.

I've been reading since getting the results yesterday and it strongly suggests that a lack of Inositol has a role in PCOS, thyroid function and auto-immune diseases. I likely lack Inositol or the ability to absorb it because I am allergic to stoned and pipped fruit (citrus fruits and nuts) from where it comes.

A recent ultrasound did NOT find any cysts but I think I have caught it early. The doctors found years ago that I have the BRACA-1 gene issue. My mother had ovarian cancer with many cysts on her ovaries.

I started on Levo (approx 3 years ago) after a previous Medichecks test showed hugely raised antibodies. These have not come down. The letter suggests I should increase my dose if I am still feeling symptoms - which I do have.

I am currently on 75mcg of Levothyroxine. I supplement (not completely regularly) with a Vitamin D3+K2 spray (3000IU/day).

Since this blood test I had the Mirena IUS progersterone coil to deal with my too frequent periods and spotting.

If you got this far, thank you for reading and any suggestions greatly received.

Results:

TSH 6.12 mIU/L (.27 - 4.2) 148.9%

Free T4 (fT4) 16.9 pmol/L (12 - 22) 49.0%

Free T3 (fT3) 4 pmol/L (3.1 - 6.8) 24.3%

T4:T3 Ratio 4.225 

Thyroglobulin Antbodies (TgAb) 4000 IU/mL (≤ 115)

Thyroid Peroxidase Antibodies (TPO) 139.2 IU/mL (≤ 34)

Folate - Serum 6.2 ug/L (8.83 - 60.8) -5.1%

Vitamin B12 52 nmol/L (37.5 - 188) 9.6%

Vitamin D 64 nmol/L (50 - 250) 7.0%

Ferritin 62 ug/L (30 - 150) 26.7%

Prolactin 554 mIU/L (102 - 496) 114.7%

Total Testosterone 1.85 nmol/L (0.29 - 1.67) 113.0%

Oestradiol 1422 pmol/L (114 - 332) 600.0%

Lutenizing Hormone (LH) 31.8 IU/L (2.4 - 12.6) 288.2%

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Hexagon74
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11 Replies
tattybogle profile image
tattybogle

First thing to do is let GP know TSH is 6 ( this shows your levo dose in insufficient).. they should increase dose of Levo ~ probably to 100mcg . ( they will probably have to do their own test to confirm TSh level)

TSH should be kept within lab range ,, and preferably towards the lower end of the range .

healthunlocked.com/thyroidu.... my-list-of-references-recommending-gps-keep-tsh-lower-in-range

healthunlocked.com/thyroidu... explanation-of-what-*high-tsh-is-telling-us-when-our-ft4-level-is-normal-on-levothyroxine-the-shoe-size-analogy.-*

Hexagon74 profile image
Hexagon74 in reply totattybogle

Thanks for the advise, will do so.

tattybogle profile image
tattybogle in reply toHexagon74

Vitamin results are not good either .. see what others advice to sort them out .

Raised cholesterol should hopefully improve once thyroid dose is optimised (Hypothyroidism causes raised cholesterol)

When testing TSH , get early am blood test , (TSH is highest early am and falls gradually through the day until it's lowest around 1-3pm.... when looking for a dose ncrease , you want to show GP the highest TSH of the day, not the lowest)

Delay taking that days levo dose until after the blood test (fT4 results will show a peak for a few hours after the dose is taken .. you want to avoid catching this peak in the fT4 test)

healthunlocked.com/thyroidu... suggested-thyroid-hormone-test-timing-protocols

Hexagon74 profile image
Hexagon74 in reply totattybogle

Thanks again, I’ve now edited my post as I avoided levo for 24hrs and had blood test at 8am like my others.

SeasideSusie profile image
SeasideSusieRemembering

Hexagon74

You might want to refer back to your previous post where I address your vitamin levels:

healthunlocked.com/thyroidu....

Your folate and B12 levels are worse now than they were back then so presumably you didn't do anything after my suggestions?

Your Vit D has increased from 55nmol/L to 64nmol/L by taking 3,000iu D3 sporadically, it would have increased more if you'd followed my suggestion of taking 4,000iu daily. And do you take magnesium as previously mentioned, this helps the body convert D3 into it's usable form so is important.

Ferritin still has a way to go.

Optimal nutrient levels are needed for thyroid hormone replacement to work properly so it would be a good idea to get to work on them.

Hexagon74 profile image
Hexagon74 in reply toSeasideSusie

Thank you for your comments. I did go to the Doctors and they wouldn’t do a Vit B12 test but did put me on folate for a bit. I felt a little better so didn’t think about it after I finished the course. I also changed my diet incorporating liver and other foods that were suggested. I can see now that wasn’t enough 😞 I am listening again trying to do the right things. I often get distracted from looking after myself with 2 ageing and ill parents.

SeasideSusie profile image
SeasideSusieRemembering in reply toHexagon74

Did you check the links for signs/symptoms of B12 deficiency after previous post? Did you have any? If so did you list them to discuss with your GP? If you had any symptons of B12 deficiency then B12 injections or supplements should be started before starting folic acid for the reasons outlined in reply to previous post.

Check the lists now. Your level, as it's below 70, still suggests you could have B12 deficiency so again, if you do have any signs/symptoms you should list them, discuss with your GP and get further testing. The link I gave previously to Viapath has a link at the bottom of their web page to print off the pdf to show your GP to support your request for testing.

Did your GP test your folate level after you finished the course of folic acid? What was it?

Your current folate level is still below range and is in the range that is used to indicate folate deficiency:

cks.nice.org.uk/anaemia-b12...

Folate level

◦Serum folate of less than 7 nanomol/L (3 micrograms/L) is used as a guide to indicate folate deficiency.

You should go back to your GP to discuss this and ideally he will prescribe another course of folic acid. Once this is finished ask to have folate level retested, if it's within range GP will not prescribe further folic acid so you will have to buy your own supplement. Come back with the new result after finishing a new course folic acid if GP prescribes and we can then suggest how you should proceed to further improve and maintain a decent level.

Medichecks does an iron blood test:

medichecks.com/products/iro...

This is the full iron panel. It would be a good idea to do this to see if you have iron deficiency.

Your nutrient levels are very poor and the most likely cause is your Hashi's as this can cause gut/absorption problems.

As for Hashi's, some members have found that adopting a strict gluten free diet can help, although there is no guarantee.

Gluten contains gliadin (a protein) which is thought to trigger autoimmune attacks so eliminating gluten can help reduce these attacks.

You don't need to be gluten sensitive or have Coeliac disease for a gluten free diet to help.

Gluten/thyroid connection: chriskresser.com/the-gluten...

stopthethyroidmadness.com/h...

stopthethyroidmadness.com/h...

hypothyroidmom.com/hashimot...

thyroiduk.org.uk/tuk/about_...

Supplementing with selenium l-selenomethionine 200mcg daily is said to help reduce the antibodies, as can keeping TSH suppressed. Some people prefer to test selenium before supplementing, although I've read that a dose of 100mcg daily is considered to be a safe dose if testing is not carried out.

SeasideSusie profile image
SeasideSusieRemembering in reply toHexagon74

I have just checked to see what tests are included in the Ultimate Performance bundle.

What was your CRP and what were your

Serum Iron

TIBC

Transferrin Saturation

These tests are the iron panel (so you don't need to do a separate one as I've mentioned in my reply above) and these will tell us about your inflammation and iron status.

What were the results of the Red Blood Cells test, this will show if you have anaemia?

What were the results of the Adrenal Hormones test (mentioned by radd in her reply)?

These results all help build the picture and may throw further light on your current situation.

Hexagon74 profile image
Hexagon74 in reply toSeasideSusie

Thank you again,

My red blood cells are generally in the accepted range apart from the MCH, my adrenal hormones are also in the accepted range. My HBA1C also seems to be with the safe range and has been stable for the last 3 years. Hopefully if I sort out my Vitamins and increase my Levo everything else will calm down. I did go to the doctor about the other systems I had (sorry can't remember the list as it was a while back), but not really sure I was listened to. The doctor I have now is female and I think will listen and hear me.

Ferritin 62 ug/L (30 - 150) 26.7%

Iron 19.4 umol/L (10 - 30) 47.0%

Transferrin saturation 29  (25 - 45) 20.0%

TIBC 68 umol/L (45 - 81) 63.9%

UIBC 48.4 umol/L (13 - 56) 82.3%

Red cell count 4.86 10^12/L (3.8 - 5.8) 53.0%

MCH 26.9 pg (27 - 32) -2.0%

DHEA 4.1 umol/L (0.96 - 6.95) 52.4%

Cortisol serum 445 nmol/L (133 - 537) 77.2%

CRP HS 0.73 mg/L (≤ 3)

HBA1C 36 mmol/mol (20 - 41.99) 72.8%

radd profile image
radd

Hexagon74,

TSH is too high and thyroid hormones too low. You need a Levothyroxine dose increase. 

You have raised both TPOAb and TGAb. An adequate dose of Levothyroxine can help reduce thyroid gland activity that in turn helps reduce activity of thyroid antibodies but will likely not be enough. Many members have found adopting a gluten free diet to be beneficial and also optimising some of the natural anti inflammatories such as Vit D, Vit C and fish oils, etc. 

Are you supplementing folate, Vit B12 and B Complex? Ferritin is also too low. Have you had a complete iron panel? What are your blood glucose levels like? Have you had cortisol tested (blood or saliva)? Often optimising thyroid hormones, iron and nutrients can help quell PCOS symptoms because all hormones work together. 

PCOS can be driven by either insulin resistance or/and adrenal dysfunction (which is common in hypothyroidism). Classic PCOS has raised androgens (either testosterone or the more potent DHT), and you do not need to have ovarian cysts to have PCOS because ….. ‘While insulin resistance and elevated insulin often drive the ovarian production of testosterone, it is the hypothalamus-pituitary-adrenal (HPA) axis that stimulates the production of DHEA/DHEA-S and androstenedione. These hormones can be converted to testosterone by peripheral tissues in the body. This process can occur independently from the ovaries and any involvement with insulin. This means that a woman with PCOS symptoms could have normally functioning ovaries with no cysts and no insulin resistance, yet still fit the symptomatic profile of the syndrome.

-Laura Schoenfeld, MPH, RD  

Prolactin often follows TSH and high oestrogen can feel very aggressive. Adding progesterone is good as will help oppose and works to reduces testosterone in a number of ways. Also supplementing myo-inositol that not only helps PCOS but Hashi symptoms too. 

'How Myo-inositol Can Improve Hashimoto’s Symptoms by Isabella Wentz' -thyroidpharmacist.com/artic...

Another great resource is The Period Repair Manual by Lara Briden ..

Abridged PDF - larabriden.com/sample/prm2-...

Comprehensive Book - larabriden.com/period-repai...

Hexagon74 profile image
Hexagon74

Thank you, this makes sense.

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