newbie - help please

[Arewethereyet96]

Hi

I hope you can give me some pointers /help as I’m trying to work out what I need to treat first and my GP is not very helpful.

I am 49 and on HRT (evorel 50 & utrogestan ). I have known for a while that I have subclinical hypothyroid as I have had regular blood tests over the years and at times my thyroid TSH returns into the normal range. However my past few blood tests this is not the case. My T4 /T3 has always remained in the normal range though. Apparently my thyroid has been doing this for 10 years. I have never been offered treatment for my thyroid.

However my last test in November showed -

TSH -5.9 (0.35-4.94)

T4 - 9.9 (9.0-19.1)

T3 - 3.6 ( 2.4 -6)

serum ferritin - 35 (30 - 250)

I have had my HRT dose changed a few times in past few months - tried gel,, went back to a patch (higher dose) but my doctor felt I was getting symptoms of too high estrogen so I have gone back to a lower dose patch (50 ). I was getting headaches, nausea & had sore boobs, long periods 3 weeks apart.

I’d say over the past few months though my main symptom are anxiety- but I’ve had it in the past and this just feels different. I’ve been exhausted for a while but I’m still tired, my brain feels very slow and I can’t multitask like I used to. I’m forgetful, tearful, lost appetite, hair falling out, dizzy - just not myself and it’s getting me down. I’m waiting to see if the estrogen symptoms will be better on my next bleed so can attribute to that.

The Gp recommended I take Iron tablets and keeps suggesting sertraline for anxiety but I would prefer to see if I can sort this more organically and not have it brushed off as just ‘peri’. She says hypothyroidism doesn’t cause anxiety but I have read elsewhere that it can?

I am due to speak to my Gp on Monday and have repeat bloods booked for Tuesday. Is there anything I should be asking for? I think if my results are similar they will refuse any thyroid treatment- should I push for it? Do you think it would alleviate the symptoms?

Many thanks for reading! 🙏

[Lalatoot]

Yes hypothyroidism causes anxiety. And if you're me, it also caused panic attacks.When the body lacks thyroid hormones but needs to keep going it turns to adrenaline to fill the gap. Having a body part fuelled by adrenaline is no way to live!

I would be pushing for treatment

[Arewethereyet96 in reply to Lalatoot]

Thanks for the reply - yes I get panic attacks too. I do feel like I’m in fight or flight mode (strangely feel better in evenings). I have always had anxiety but I seemed to manage it in past but this time it seems to last all day as opposed to certain parts of day?

[SlowDragon Administrator]

Make sure you retest bloods EARLY morning

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

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

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

When were vitamin D, folate and B12 last tested

What vitamin supplements are you taking

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.

Low vitamin levels are extremely common when hypothyroid, especially with autoimmune thyroid disease

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

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

Testing options and includes money off codes for private testing

thyroiduk.org/testing/

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/testing/thyro...

Link about Hashimoto’s

thyroiduk.org/hypothyroid-b...

Symptoms of hypothyroidism

thyroiduk.org/signs-and-sym...

Tips on how to do DIY finger prick test

See detailed reply by SeasideSusie

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

[SlowDragon Administrator]

With two tests with TSH over 5 and hypothyroid symptoms you should be offered trial on levothyroxine

Especially if you have high thyroid antibodies

Starting levothyroxine - flow chart

gps.northcentrallondonccg.n...

Standard STARTER dose is 50mcg

Dose is increased slowly upwards in 25mcg steps over coming 12-18 months