Abnormally cold! : just had a thyroid function... - Thyroid UK

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Abnormally cold!

Bev1951 profile image
10 Replies

just had a thyroid function test as complained to GP of not being able to regulate my body temperature very well. As the weather gets colder so do I which might seem normal but it’s dropping as low as 33.5* when air temperature is 19 degrees C. Thought of winter approaching is worrying as had this problem all last winter too. It doesn’t take much drop in air temperature to make me feel abnormally cold!

The GP only tested Serum TSH which came back normal at 1.5 miu/l (range 0.3-5.00) so my worry seems to have been dismissed.

Is this result misleading? Do I need to request more tests and if so what would they be? I am 72 and on 75mcg levothyroxine daily - had one lobe removed many years ago.

Happy to pay for private testing if one can be recommended.

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Bev1951
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SlowDragon profile image
SlowDragonAdministrator

Welcome to the forum

Just testing TSH is completely inadequate

For full Thyroid evaluation you need TSH, FT4 and FT3 tested

Also both TPO and TG thyroid antibodies tested at least once

Very important to test vitamin D, folate, ferritin and B12 at least once year minimum

About 90% of primary hypothyroidism is autoimmune thyroid disease, usually diagnosed by high thyroid antibodies

Autoimmune thyroid disease with goitre is Hashimoto’s

Autoimmune thyroid disease without goitre is Ord’s thyroiditis.

Both are autoimmune and generally called Hashimoto’s.

Have you ever had thyroid antibodies tested?

20% of autoimmune thyroid patients never have high thyroid antibodies and ultrasound scan of thyroid can get diagnosis

Low vitamin levels are extremely common when hypothyroid, especially with autoimmune thyroid disease and especially as we get older

what vitamin supplements are you currently taking

Stop taking any supplements that contain biotin 5-7 days before any test

In U.K. medics hardly ever refer to autoimmune thyroid disease as Hashimoto’s (or Ord’s thyroiditis)

Recommended that all thyroid blood tests early morning, ideally just before 9am, only drink water between waking and test and last dose levothyroxine 24 hours before test

This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip)

How long have you been left on just 75mcg levothyroxine

Which brand of levothyroxine are you taking

Approximately how much do you weigh in kilo?

Private tests are available as NHS currently rarely tests Ft3 or all relevant vitamins

List of private testing options and money off codes

thyroiduk.org/getting-a-dia...

Medichecks Thyroid plus antibodies and vitamins

medichecks.com/products/adv...

Blue Horizon Thyroid Premium Gold includes antibodies, cortisol and vitamins

bluehorizonbloodtests.co.uk...

Only do private testing early Monday or Tuesday morning.

Link about thyroid blood tests

thyroiduk.org/getting-a-dia...

Link about Hashimoto’s

thyroiduk.org/hypothyroid-b...

Symptoms of hypothyroidism

thyroiduk.org/wp-content/up...

Tips on how to do DIY finger prick test

healthunlocked.com/thyroidu...

Medichecks and BH also offer private blood draw at clinic near you, or private nurse to your own home…..for an extra fee

Come back with new post once you get results

Bev1951 profile image
Bev1951 in reply toSlowDragon

Thank you very much. I will ask my GP if he will repeat and extend test - if he won’t get a full test done privately!

Test was done in the morning but after thyroid dose and breakfast…🙈

I’ve been on 75 for a long time - it was raised once as high as 125 but experienced bad palpitations at night so reduced to a “comfortable “ for palpitations level.

Never had any of the other thyroid checks done, my consultant put me straight onto levothyroxine following the removal of one lobe due to a follicular adenoma in 2009.

I weight 65kg and struggling to lose weight in spite of a small appetite - breakfast and one other small meal about 5:00pm. Rarely anything else other than a biscuit with a cup of tea in the day! My 3 sisters all have underactive thyroids in case it’s relevant!

SlowDragon profile image
SlowDragonAdministrator in reply toBev1951

65kg x 1.6mcg = 104mcg per day as guideline dose by weight

suggests you are not on high enough dose levothyroxine

Which brand of levothyroxine are you taking

As vegetarian you should always be taking a daily B12 and daily vitamin B complex

Highly likely low iron and ferritin too

Test FIRST before starting any supplements and retest at least annually ……

test vitamin D twice year when supplementing

academic.oup.com/nutritionr...

The present review of the literature regarding B12 status among vegetarians shows that the rates of B12 depletion and deficiency are high. It is, therefore, recommended that health professionals alert vegetarians about the risk of developing subnormal B12 status. Vegetarians should also take preventive measures to ensure adequate intake of this vitamin, including the regular intake of B12 supplements to prevent deficiency. Considering the low absorption rate of B12 from supplements, a dose of at least 250 μg should be ingested for the best results.3

Optimal vitamin levels

Vitamin D at least over 80nmol minimum

Serum B12 at least over 500 (NHS test)

Active B12 at least over 70 (private test)

Folate at top of range

Ferritin at least over 70

Bev1951 profile image
Bev1951 in reply toSlowDragon

Many thanks - your help is invaluable!

Bev1951 profile image
Bev1951 in reply toSlowDragon

not taking any supplements of any kind… should I be? I’m vegetarian in case it matters

helvella profile image
helvellaAdministrator in reply toBev1951

Many vegetarians, all vegans, and most of us as we get older, are likely to be low in vitamin B12.

Vegetarian diets are usually low or very low, vegan diets are usually extremely low, and as we get older, we are less able to absorb any B12 that is present.

If it is just to ensure we get enough, 50 to 100 micrograms a day is likely enough. But if we have any real impairment, we might need 500 or 1000 micrograms a day.

RedApple profile image
RedAppleAdministrator in reply toBev1951

helvella has pointed out the likelihood of vitamin B12 deficiency. However, before taking any B12 supplement it's advisable to get your current B12 level tested.

Your GP can do this, but, NHS tend to only do a basic serum B12 test, which isn't the best way to know your true B12 status. Ideally, you need an Active B12 test.

You can do a fingerpick test at home for Active B12. This one is good value and includes other tests which are also useful. monitormyhealth.org.uk/anae...

helvella profile image
helvellaAdministrator in reply toRedApple

Good addition - I should have said something like that! Thank you.

Bev1951 profile image
Bev1951 in reply tohelvella

Many thanks to you both! I’m on it!!!

trisha7 profile image
trisha7

Testing TSH is the usual NHS GP pathway but as I learned from this forum and others, it doesn't give the full picture. They should do the full raft of tests. 75mcgs is low too, but I know they only look at the TSH numbers. They should really listen to all your symptoms. I did have to persist and beg for more Levothyroxine. I have also reduced my symptoms a lot by taking the gluten free route and have so much less pain and brain fog to name 2 symptoms. I have never had private blood tests so I'm sorry I can't comment on that point. Good luck with GP.

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