Underactive Thyroid?: Hi There, looking for some... - Thyroid UK

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Underactive Thyroid?

Llan12 profile image
29 Replies

Hi There, looking for some help interpreting some thyroid blood test results. Based in the UK.

Background: Ever since I had my son two years ago I have had the following issues...swollen legs (worse in right ankle), heavy periods, depression, thinning hair, brain fog, forgetting words and clumsy, tinnitus, dry skin, can't loose pregnancy weight, numb toes. Many things which have been written off as being a new mum.

Finally had my iron and b12 reviewed and whilst low end were deemed 'normal'. I have had three months of iron tablets and five b12 injections which have helped with some of the above but now feel like symptoms have returned as this was three months ago now.

I paid for a private thyroid test as GP seems reluctant to consider this, can anyone tell me if these results look off even though all are said to be in the 'normal'range?

I also have low blood pressure which the GP has commented on but isn't concerned as still above 90 (106).

Any help much appreciated as so tired of feeling unwell. TIA 😊

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Llan12
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Jaydee1507 profile image
Jaydee1507Administrator

Welcome to the group. If you could complete your profile it helps members understand your thyroid journey so far and offer recommendations better. Click on your image icon to start.

Can you tell us a bit more about the B12 injections? Were these from the GP? Were you tested for pernicious anaemia? Will you continue to get B12 injections? Are you vegan or vegetarian?

Your TSH is pretty good but your FT4 is low.

It would be worth you getting thyroid antibodies tested - TPO & Tg to see if you have autoimmune hypothyroidism. GP can do the TPO test but not Tg (thyroglobulin) which is private only.

Private tests are available, see link for companies offering private blood tests & discount codes, some offer a blood draw service at an extra cost. thyroiduk.org/help-and-supp...

There is also a new company offering walk in & mail order blood tests in Crawley, Hove and Reigate areas. No charge for blood draw in clinic. Check to see if there is a blood test company near you. onedaytests.com/products/ul...

Did you also have folate & D3 tested by your GP? If not then again private tests are worth it.

When hypo we get low stomach acid which means we cannot absorb vitamins well from our food, regardless of a great diet. The key vitmins ferritin, folate, B12 & d3 need to be raised to OPTIMAL with supplements.

Has your GP retested after the course of iron tablets?

Llan12 profile image
Llan12 in reply toJaydee1507

Thanks for the quick response! Answers to your questions...

My original GP reviewed blood tests and said all was normal but I went to a private GP for 2nd opinion in Feb as it felt like a dead end. He noted my ferritin levels were low and due to very heavy periods and numbness in feet I try 3 months of iron tablets and 5 B12 injections ( I had them every other day for a week). He advised to see how I felt in the three months after treatment. I felt abit better but no symptoms disappeared.

I returned to the private GP last week to ask what next as my symptoms had returned and I'm waiting on the results of anemia blood tests for him to determine I need b12 injections going forward. He hasn't mentioned thyroid as an issue but I need to return to see him to determine the outcome of the test so want to pursue the thyroid discussion with him. He has simply said my swollen ankles/legs could be lymphedema and referred me to a vascular consultant for a scan which I personally don't feel will yield anything.

I'm not vegetarian/vegan.

I actually do have iron/vitamin and antibodies results from the private test I took- see attached. Afraid I don't understand what they mean! TIA.

Result
Llan12 profile image
Llan12 in reply toLlan12

Results

Result
greygoose profile image
greygoose in reply toLlan12

TPO antibodies: 19 (0-34)

Your antibodies are very close to the top of the range, so technically negative. But, antibodies fluctuate all the time. And, if you tested again next week, or the week after, they could be well over the top of the range.

So, you cannot rule out Hashi's on the basis of one negative blood test. Especially not a very high in-range result like yours. I think it's more than likely that you do actually have autoimmune thyroiditis - aka Hashi's. Just after the birth of a baby is when it starts for many women, so you're more likely to have it than not.

Llan12 profile image
Llan12 in reply togreygoose

Thanks-I will raise it to the GP and see if it can be retested😊

Jaydee1507 profile image
Jaydee1507Administrator in reply toLlan12

Your NHS GP should have treated you for low ferritin as NICE state that a level of 30 or less is deficient.

Ferritin is very slow to raise so its unlikely your level now is much higher than it was. It could be 18 months of supplementing to get your levels to a good place. Take iron with orange juice to help absorption.

Recommend retesting vitamins especially ferritin but also a full iron panel. Post results here when you have them.

Your thyroid antibodies were both negative but they do fluctuate and could be positive on another test. Also a percentage of Hashimoto's patients never have positive antibodies anyway.

As an ongoing measure and as you've already gone down the injections route I would recommend tasking a good quality high dose, methyl/active B complex. This B complex has all the right vitamins at a not unreasonable cost for 90 days supply. amazon.co.uk/Liposomal-Soft...

Vitamin D should be around 100 - 150. Buy one that includes vit K2 to help it go to your bones. Some are available in oil or you can take it with an oily meal for better absorption. Use this calculator to work out how much to take to get your level to 100-150. wildatlantichealth.com/vita...

Llan12 profile image
Llan12 in reply toJaydee1507

Thanks much! I will share results when I have them.

Based on Thyroid info would you suggest I push for a referral to consultant to get expert view?

Jaydee1507 profile image
Jaydee1507Administrator in reply toLlan12

With negative thyroid antibody results and a good TSH I think its unlikely a private consultant would begin any treatment.

Best to start collecting results on a spreadsheet and retest every 3-4 months to gather evidence over time.

Also work on your low vitamin levels which will help how you feel.

Llan12 profile image
Llan12 in reply toJaydee1507

Thank you, I have the following results from various private thyroid tests from Feb 22 to Feb 23- looks like my antibodies were very low at one point? Do I still need more to go on with a consultant?

Results
Jaydee1507 profile image
Jaydee1507Administrator in reply toLlan12

Your results look fairly consistent in being low but again unlikely any doctor would treat you. Best to go down the optimal vitamin route and follow up with the full iron panel.

Llan12 profile image
Llan12 in reply toJaydee1507

Thankyou, really appreciate the info😊

pennyannie profile image
pennyannie in reply toLlan12

Everywhere I researched suggested that no thyroid hormone replacement work well until ferritin is at least over 70 - I now aim for 100 :

The NHS guidelines suggest that a ferritin under 30 needs further investigation and your surgery must first run a full iron panel to rule out any other causes of too low a level :

Once this has been done and there are no other issues the NHS will likely prescribe you a course of iron tablets.

In my experience the prescribe tablets are quite harsh on the stomach and when not offered a alternative I decided to buy my own.

Any brand of an iron bisglycinate will be kinder on the stomach and less constipating.

Llan12 profile image
Llan12 in reply topennyannie

Thank you for the reply. I will be asking about this.

Llan12 profile image
Llan12

B12 etc

Result
Jamima profile image
Jamima

Hi Llan 12 - in addition to all the good info you’ve been given, I’d suggest also doing a four point saliva cortisol test. I’ve had/had results very similar to yours and been through 2 gps and several private endos who all day there’s nothing wrong and yet I’m still symptomatic. I’m pretty sure I have secondary hypo which is where the pituitary is the problem, not the thyroid gland. It may well be a good idea to test pituitary hormones eg all sex hormones, and prolactin, medichecks do a good womens test which includes most of the pituitary hormones but not growth hormone. It’s a really difficult set of results because technically it looks ok, and all god go by TSH, and yours looks perfect, but it doesn’t align with such low frees, I’m the same. Did you have any problems during pregnancy/birth/breastfeeding?

Llan12 profile image
Llan12 in reply toJamima

Thank you! I'll look at the other tests too. Pregnancy was relatively straight forward, had to be monitored for gestational diabetes but they didn't find anything. Pregnancy ran to 42 weeks and c section but not that impacts anything.

Jamima profile image
Jamima in reply toLlan12

Apologies for all the typos, I was sitting in the sun! I meant gp, but obviously god isn’t far off the mark in many cases! It’s worth seeing what your sex hormones are doing and make sure you get testosterone tested too, low testosterone is aligned with low cortisol and both/either can cause many of your symptoms. Low cortisol can also go hand in hand with low thyroid. It’s a complicated HPA feedback thing, but once you start to see regular lows or highs in any tests, you can start to fit more pieces together. It’s interesting that your problems started post pregnancy. I was also 42 weeks, induced and emergency c section, I also had problems breastfeeding then suffered a miscarriage and now wonder if that was the start of a pituitary problem. Good luck and keep posting.

Llan12 profile image
Llan12 in reply toJamima

Thank you, it sounds like you had a difficult time - I really appreciate you sharing your experience. I will look into the above

SlowDragon profile image
SlowDragonAdministrator

Ferritin is going to take a while to improve up to at least 70

How frequently are you getting B12 injections. You can request more frequent that once every 3 months

Start taking a good quality vitamin B complex daily

This can help keep all B vitamins in balance and will help improve B12 levels too

Difference between folate and folic acid 

healthline.com/nutrition/fo...

B vitamins best taken after breakfast

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 £20-£25. iherb.com often have in stock. Or try ebay 

Other options 

healthunlocked.com/thyroidu....

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

endo.confex.com/endo/2016en...

endocrinenews.endocrine.org...

In week before blood test, when you stop vitamin B complex, you might want to consider taking a separate folate supplement (eg Jarrow methyl folate 400mcg)

Are you taking vitamin D supplement?

Llan12 profile image
Llan12 in reply toSlowDragon

Thank you! If I start getting regular b12 injections does taking another b vitamin supplement at the same time as well impact anything?

I'm also not clear how I got low ferritin and b12 in the first place but I'm guessing this blood test I'm waiting on might explain?

SlowDragon profile image
SlowDragonAdministrator in reply toLlan12

Many women suffer from anaemia due to monthly blood loss, especially if periods are heavy

Being anaemic tends to result in heavy periods

What’s your diet like

Are you vegetarian or vegan

Or….Do you eat lots of red meat, offal and seafood

Low thyroid levels tends to result in low stomach acid, poor nutrient absorption and low vitamin levels as direct result

Low vitamin levels results in thyroid being affected, and reduces conversion rate of Ft4 (storage hormone) to Ft3 (active hormone) …..

Your Ft4 and Ft3 are both very low…….

SlowDragon profile image
SlowDragonAdministrator in reply toLlan12

As you have B12 injections it’s recommended also to supplement a good quality daily vitamin B complex, one with folate in (not folic acid) may be beneficial.

This can help keep all B vitamins in balance and will help improve/maintain B12 levels between injections

SlowDragon profile image
SlowDragonAdministrator

Ferritin

cks.nice.org.uk/topics/anae...

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 and retest 3-4 times a year if self supplementing. It’s possible to have low ferritin but high iron 

Medichecks iron panel test 

medichecks.com/products/iro...

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

List of iron rich foods

dailyiron.net

Links about iron and ferritin

irondisorders.org/too-littl...

davidg170.sg-host.com/wp-co...

Great in-depth article on low ferritin 

oatext.com/iron-deficiency-...

drhedberg.com/ferritin-hypo...

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.

healthunlocked.com/thyroidu...

Posts discussing Three Arrows as very effective supplement 

healthunlocked.com/thyroidu...

healthunlocked.com/thyroidu...

Thyroid disease is as much about optimising vitamins as thyroid hormones

healthunlocked.com/thyroidu...

restartmed.com/hypothyroidi...

Post discussing just how long it can take to raise low ferritin 

healthunlocked.com/thyroidu...

Iron and thyroid link

healthunlocked.com/thyroidu...

Excellent article on iron and thyroid 

cambridge.org/core/journals...

Posts discussing why important to do full iron panel test

healthunlocked.com/thyroidu...

Good iron but low ferritin 

healthunlocked.com/thyroidu...

healthunlocked.com/thyroidu...

Chicken livers if iron is good, but ferritin low

healthunlocked.com/thyroidu...

Shellfish and Mussels are excellent source of iron 

healthline.com/nutrition/he...

Heme iron v non heme

hsph.harvard.edu/nutritions...

Ferritin over 100 to alleviate symptoms 

healthunlocked.com/thyroidu...

Great research article discussing similar…..ferritin over 100 often necessary 

ncbi.nlm.nih.gov/pmc/articl...

Low Iron implicated in hypothyroidism 

healthunlocked.com/thyroidu...

Ferritin range on Medichecks 

healthunlocked.com/thyroidu...

healthunlocked.com/thyroidu...

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. ‘

Llan12 profile image
Llan12 in reply toSlowDragon

Wondering if you had an opinion on the below results. I'm getting my blood test results back Friday and speaking with the GP then. I'm trying to be prepared as possible with all the great info provided here. In addition to not highlighting any anemia issues in the first instance, I'm now concerned about this reference below on renal tests which were done at the same time back on Feb regarding stage 1 CKD which weren't discussed either. Reading around thyroid info, surely all my symptoms point to 'renal' type symptoms that should be looked at and even more so if my thyroid results look questionable? TIA

Test
Jamima profile image
Jamima in reply toLlan12

I don’t know anything about kidney function but there might be a forum on here that does? I’ll like the post and hopefully someone will pick up on it.

Llan12 profile image
Llan12 in reply toJamima

Thankyou😊

Jamima profile image
Jamima in reply toLlan12

Apologies the forum is called kidney dialysis- I’m sitting in the sun again! They might help or direct you to somewhere that can. Good luck.

Jamima profile image
Jamima in reply toLlan12

There’s a forum called kidney disease on here they might be able to help.

Llan12 profile image
Llan12

Wow thank you, I'm grateful for all the info!

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