Symptoms but blood tests Normal?

[jennylouise91]

Hello, I have symptoms of underactive thyroid. - heavy periods

- fatigue

- pins and needles in hand

- fatigue

- cold

- anxiety and depression.

- struggle with weight loss

My mum has underactive thyroid and maternal nan also.

Contacted gp as have very heavy periods, on slimming world but can't get past 2.5st loss regardless of healthy eating and exercise. I've been on anti depressant for 8 years. Constantly tired, dry skin and other symptoms listed above. Had an ultrasound scan in 21 ( another booked for a few weeks time) which ruled out pcos and fibroids. I take tranxemic acid for heavy periods but doesn't touch it. Saw gynae recently who recommended cutting out cows milk, and supplements- iron, zinc, turmeric.

I had blood tests in Sept 23 which showed hypothyroidism perhaps developing results below

Serum TSH level: 5.90 mIU/L Normal range:0.27 to 4.2

Serum free T4 level:

12.5 pmol/L Normal range:11.0 to 21.2

Serum ferritin:

34 ug/L Normal range:13 to 150

Serum vitamin B12: 348 ng/L Normal range:197 to 771

Laboratory comment:

Note the B12 reference interval quoted is for White and Asian populations. The reference interval in Black populations is higher.

Serum folate:Normal range: No range Laboratory comment:

##TEST CANCELLED## Specimen haemolysed

Further tests undertaken last week results below.

Serum iron level - 9.5 umol/L Normal range 14.0 - 30.0

Serum cholesterol 3.4 mmol/L Normal range 1.0 - 5.0

Serum HDL Cholesterol 0.8 mmol/L Normal range 1.0 - 99999

Serum triglycerides 2.6 mmol/L Normal range 0.5- 2.0

Serum T4 level - 12.6 pmol/L Normal range 11.0 - 21.2

Serum TSH level - 1.95 mIU/L Normal range 0.27 - 4.20

Gonadotrophin levels - Serum fsh level 6.6 IU/L no Normal range. Laboratory comment: Reference Ranges:

Follicular 3.5 - 12.5 IU/L

Mid-cycle 4.7 - 21.5 IU/L

Luteal 1.7 - 7.7 IU/L

Post-menopause 25.8 - 134.8 IU/L

Serum LH level: 2.5 IU/L

Normal range:No range

Laboratory comment:

Reference Ranges:

Follicular: 2.4 - 12.6 IU/L

Mid-cycle: 14.0 - 95.6 IU/L

Luteal: 1.0 - 11.4 IU/L

Post-menopause: 7.7 - 58.5 IU/L

Se thyroid peroxidase Ab conc: < 15 IU/ml Normal range:0 to 33.9

Serum total 25-OH vit D level: 46 nmol/L

Normal range:No range

Laboratory comment

Reference Ranges:

Deficiency <25 nmol/L

Insufficiency 25 to 50 nmol/L

Therapeutic Target > 50 nmol/L

Showed low in iron and Vit D - taking supplements and booked in for another blood test mid Feb.

Looking for help interpreting results. I felt so relieved when they said I likely had underactive thyroid as it seemed to explain so much but the current test shows back in the normal range.

Can anyone help me understand why the thyroid test results could change so much in a few months?

[greygoose]

Hi jennylouise91, welcome to the forum.

I had blood tests in Sept 23 which showed hypothyroidism perhaps developing results below

Serum TSH level: 5.90 mIU/L Normal range:0.27 to 4.2

No, not 'perhaps developing', already there. You are technically hypo when your TSH gets over 3, and in some countries you would be treated at that level. But, the NHS likes it to get over 10 before it will treat!

Further tests undertaken last week results below.

Serum TSH level - 1.95 mIU/L Normal range 0.27 - 4.20

Where both the blood draws for these test taken at the same time of day? Because TSH is highest early morning and fasting, and drops throughout the morning after that.

The FT4 hasn't changed, so I suspect they were tested at different times.

Was the FT3 not tested?

[jennylouise91 in reply to greygoose]

Yes different times first at 8:30, second at 16:45, having read some of the posts on here I can see that will affect results.

Just double checked results and FT3 not tested.

[greygoose in reply to jennylouise91]

OK, so that explains it.

And that FT4 result explains your symptoms. It's in-range, but far from 'normal'. And, if the FT4 is too low, then the FT3 probably is, too. And, it's low T3 that causes symptoms. Plus your low nutrients. For example, the pins and needles in your hands could very well be caused by your low B12. B12 should be at least 550.

[SlowDragon Administrator]

Work on improving all your low vitamin levels…..almost certainly low because you are hypothyroid

Then get new test including Thyroglobulin antibodies via Medichecks or Blue Horizon

NHS currently refuses to test TG antibodies unless TPO are positive

So will need to test privately

ALWAYS test 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)

your ferritin is terrible and iron below range too so you are anaemic

What iron supplements has GP prescribed

[SlowDragon Administrator]

Low vitamin D

GP should prescribe 1600iu everyday for 6 months. But you might want to take higher dose

NHS Guidelines on dose vitamin D required

ouh.nhs.uk/osteoporosis/use...

GP will often only prescribe to bring vitamin D levels to 50nmol.

Some areas will prescribe to bring levels to 75nmol or even 80nmol

leedsformulary.nhs.uk/docs/...

GP should advise on self supplementing if over 50nmol, but under 75nmol (but they rarely do)

mm.wirral.nhs.uk/document_u...

But with Hashimoto’s, improving to around 80nmol or 100nmol by self supplementing may be better

pubmed.ncbi.nlm.nih.gov/218...

vitamindsociety.org/pdf/Vit...

Once you Improve level, very likely you will need on going maintenance dose to keep it there.

Test twice yearly via NHS private testing service when supplementing

vitamindtest.org.uk

Vitamin D mouth spray by Better You is very effective as it avoids poor gut function.

There’s a version made that also contains vitamin K2 Mk7.

One spray = 1000iu

amazon.co.uk/BetterYou-Dlux...

It’s trial and error what dose we need, with thyroid issues we frequently need higher dose than average

Vitamin D and thyroid disease

grassrootshealth.net/blog/t...

Vitamin D may prevent Autoimmune disease

newscientist.com/article/23...

Web links about taking important cofactors - magnesium and Vit K2-MK7

Magnesium best taken in the afternoon or evening, but must be four hours away from levothyroxine

betterbones.com/bone-nutrit...

medicalnewstoday.com/articl...

livescience.com/61866-magne...

sciencedaily.com/releases/2...

Interesting article by Dr Malcolm Kendrick on magnesium

drmalcolmkendrick.org/categ...

Vitamin K2 mk7

betterbones.com/bone-nutrit...

healthline.com/nutrition/vi...

[jennylouise91]

Thanks, will do next test early morning as last test was 16:45! Wasn't aware this would affect. Took blood test during period as advised by gynae so this would impact iron levels. Just over counter iron - 28mg