New Hyperthyroidism diagnosis : Hi all, I am new... - Thyroid UK

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New Hyperthyroidism diagnosis

Keri41 profile image
13 Replies

Hi all, I am new here and have found reading through all the information I’ve found here invaluable. I have recently been diagnosed as having hyperthyroidism- my story is in my bio. I have my first endocrinologist appointment this week and I’m not sure what to expect. My GP wouldn’t prescribe Carbimazole without me seeing Endo first, she said I wasn’t a straight forward case 🫤 as she isn’t sure if I have an autoimmune condition (my TPO abs were 305-ref range is 0-8.9) or if the fact I have had an ultrasound that showed 2 cysts in my lower thyroid lobe is responsible. Either way I’m finding it all rather confusing and as I’m just starting out on my journey I thought I’d reach out and say hi and if anyone has any advice prior to my appointment or questions I should ask please respond.

I guess I should post my results….

Tsh 0.02 (ref range 0.38-5.33)

T4 18.4 (ref range 7.9- 14.4)

T3 7.5 (ref range 3.1 - 6.8 )

I am awaiting the results from my TRab test

hope I haven’t waffled on - Keri 😬

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Keri41
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13 Replies
SlowDragon profile image
SlowDragonAdministrator

Certainly looks more like early stage Hashimoto’s when thyroid under attack releases excess thyroid hormones as cells break down.

Your GP seems “on the ball”

Also need vitamin D, folate, ferritin and B12 levels tested and coeliac blood test

Heybella profile image
Heybella

Hi Keri 🫶

I think I’m going through similar at the moment.

I’m sorry I don’t have any advice but there are lots of fantastic knowledgeable people on here who will be in touch.

would be great to have a buddy through this? 😊

pennyannie profile image
pennyannie

Hello Keri and welcome to the forum :

So, as your Free T3 and Free T4 are slightly over the range - and since you have positive over range TPO readings this looks like Hashimoto's Auto Immune thyroid disease -

but it could be cysts causing these higher than ' normal ' readings ?

and once the TRab result comes back - this will rule in or out Graves Disease and if a positive - treatment for Graves takes precedence over Hashimoto's and some people have these 2 AI diseases running together.

There is no cure for either Auto Immune Disease - Graves is considered life threatening if not medicated with an Anti Thyroid drug - whilst Hashimoto's attacks and progressively damages the thyroid with you becoming hypothyroid and needing thyroid hormone replacement T4 - to support your damaged, failing thyroid gland.

I don't think I've ever seen a ferritin reading this low - this alone must be leaving you totally exhausted - have you had the infusion and feeling any better ?

If your Graves Disease antibody read comes back positive the NHS generally allocate a treatment window of around 15-18 months with an Anti Thyroid drug- such as Carbimazole or Propylthiouracil ( PTU ) -

all this does is simply ' buy you time ' - while we wait for your immune system response to calm back down again from whatever has triggered your immune system to malfunction -

and of course the question for you is - why you, and why now and what has triggered this phase of ill health ?

The AT will semi block your new daily thyroid hormone production and slowly your over range T3 and T4 will fall back down into range with the hope that this treatment offsets the worst of the symptoms being tolerated -

and hopefully, given enough time, as your immune system calms down so will your thyroid and reset itself without the need for any drugs.

When metabolism runs too fast as in hyperthyroidism or too slow as in hypothyroidism the body struggles to extract key nutrients through food - no matter how well and clean you eat - and it is important to keep your core strength strong and solid -

and if ferritin, folate, B12 and vitamin D are not maintained at optimal levels these can unnecessarily compound your ill health further -

and we can advise on blood test results as some NHS ranges are too wide to even be sensible.

We do now have some research which maybe appropriate depending upon the TRab results;

pubmed.ncbi.nlm.nih.gov/338...

ncbi.nlm.nih.gov/pubmed/306...

All things Graves Disease - elaine-moore.com

All things Hashimoto's - thyroidpharmacist.com

Hope this makes some sense - as I feel as though I've been waffling along several paragraphs ago !!

Keri41 profile image
Keri41 in reply to pennyannie

Thank you so much for taking the time to reply and with such clear information, I really appreciate it.☺️ It’s so reassuring to be able to seek knowledge and comfort from others who are/have been through similar. I shall update you when I get my TRab results (they seem to be taking weeks to come back!) I have my endo apt Thursday and my haematology apt next Monday for an infusion. I’ve gone from being fortunate enough to never need to see a consultant or have anything too troubling wrong with my health to starting the year off with multiple issues! Onwards and upwards though. Kindest regards Keri

pennyannie profile image
pennyannie in reply to Keri41

Okey doke - update us after the appointment as your endo likely has the necessary blood test results.

Ask for copies of everything - and if not registered for online access to your medical records held at your primary care provider - ask the receptionist for the forms - and do it - as then you can view all your results at your convenience and share them here if they need explaining to you.

Start a new post with new information as the forum gets very busy and we try to answer as fully as possible within around 24 hours of the new post landing on the forum and answer as fully as possible within that time scale.

SlowDragon profile image
SlowDragonAdministrator

From your profile

diagnosed low iron levels- ferritin of 4. Unable to tolerate various iron preparations so have been referred for an infusion,

Have you had infusion yet?

Low iron and ferritin more frequently to being hypothyroid and high ferritin when hyperthyroid

any obvious reason for such low ferritin

Are you vegetarian or vegan

Heavy periods

nice.org.uk/guidance/ng20/c...

1.1 Recognition of coeliac disease

1.1.1 Offer serological testing for coeliac disease to:

people with any of the following:

persistent unexplained abdominal or gastrointestinal symptoms

faltering growth

prolonged fatigue

unexpected weight loss

severe or persistent mouth ulcers

unexplained iron, vitamin B12 or folate deficiency

type 1 diabetes, at diagnosis

autoimmune thyroid disease, at diagnosis

irritable bowel syndrome (in adults)

first‑degree relatives of people with coeliac disease.

Keri41 profile image
Keri41 in reply to SlowDragon

Hi, thank you for taking time to respond.

I have had low normal readings in the past on/off and these were put down to the fact I’m a vegetarian with heavy periods. I have been told as I’m not technically anaemic it’s not really a concern. This is the lowest they’ve been though. I have also had 2 courses of B12 injections over the last 6 years so I do have a yearly check on those levels. I’m hoping the infusion will help with tiredness etc.

Keri

SlowDragon profile image
SlowDragonAdministrator in reply to Keri41

When were B12, folate and vitamin D last tested

As vegetarian you will likely need daily B12 and daily vitamin B complex

Ideally get tested FIRST before 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

Low B12 symptoms

b12deficiency.info/signs-an...

methyl-life.com/blogs/defic...

With serum B12 result below 500, (Or active B12 below 70) recommended to be taking a separate B12 supplement

A week later add a separate vitamin B Complex 

Then once your serum B12 is over 500 (or Active B12 level has reached 70), you may be able to reduce then stop the B12 and just carry on with the B Complex.

If Vegetarian or vegan likely to need ongoing separate B12 few times a week if not daily

Highly effective B12 drops

natureprovides.com/products...

Or

B12 sublingual lozenges

uk.iherb.com/pr/jarrow-form...

cytoplan.co.uk/shop-by-prod...

B12 range in U.K. is too wide

Interesting that in this research B12 below 400 is considered inadequate

healthunlocked.com/thyroidu...

Low folate

supplementing a good quality daily vitamin B complex, one with folate in (not folic acid)

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...

Many Hashimoto’s patients have MTHFR gene variation and can have trouble processing folic acid supplements

thyroidpharmacist.com/artic...

B vitamins best taken after breakfast

Igennus B complex popular option. Nice small tablets. Most people only find they need one per day. But a few people find it’s not high enough dose

Post discussing different B complex

healthunlocked.com/thyroidu...

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 can be difficult to find at reasonable price, should be around £20-£25. iherb.com often have in stock. Or try ebay

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) and continue separate B12

Post discussing how biotin can affect test results

healthunlocked.com/thyroidu...

helvella.blogspot.com/p/hel...

Keri41 profile image
Keri41 in reply to SlowDragon

Hi, thanks again for taking time to inform it’s all a learning curve for me and I’m trying to learn fast to give myself the best chance.

I last had a B12/folate blood test in April 2023…

B12- 1400 (range 180-1000)

Folate 21 (range >4)

I used to take a multivitamin but stopped approx 6 months ago as didn’t feel I need but now I’m thinking I’ll restart!

I’ve never had a vitamin D test- I did ask once and dr said most of us are probably deficient so to supplement instead of test as tests cost nhs.

SlowDragon profile image
SlowDragonAdministrator in reply to Keri41

Multivitamins never recommended on here

healthunlocked.com/thyroidu...

healthunlocked.com/thyroidu...

SlowDragon profile image
SlowDragonAdministrator in reply to Keri41

I’m a vegetarian with heavy periods. I have been told as I’m not technically anaemic it’s not really a concern. This is the lowest they’ve been though.

Heavy periods are frequently a symptom of low iron/ferritin

Please add actual iron panel test results

my haematology apt next Monday for an infusion. I’ve gone from being fortunate enough to never need to see a consultant or have anything too troubling wrong with my health to starting the year off with multiple issues!

Extremely low iron/ferritin increases risk of developing thyroid issues

Low Iron implicated in hypothyroidism

healthunlocked.com/thyroidu...

Ferritin levels will drop again after infusion unless you get to grips with improving iron intake

Look at increasing iron rich foods in diet

Eating iron rich foods 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...

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...

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...

Iron deficiency without anaemia

healthunlocked.com/thyroidu...

Ferritin over 100 to alleviate symptoms

healthunlocked.com/thyroidu...

healthunlocked.com/thyroidu...

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

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

Really interesting talk on YouTube, link in reply by Humanbean discussing both iron deficiency and towards end how inflammation can also be an issue

healthunlocked.com/thyroidu...

Inflammation affecting ferritin

healthunlocked.com/thyroidu...

Updated reference ranges for top of ferritin range depending upon age

healthunlocked.com/thyroidu...

Thank you for your incredible patience while you have been awaiting the outcome of our ferritin reference range review. We conducted this with Inuvi lab, which has now changed the reference ranges to the following:

Females 18 ≤ age < 40. 30 to 180

Females 40 ≤ age < 50. 30 to 207

Females 50 ≤ age < 60. 30 to 264l

Females Age ≥ 60. 30 to 332

Males 18 ≤ age < 40 30 to 442

Males Age ≥ 40 30 to 518

The lower limits of 30 are by the NICE threshold of <30 for iron deficiency. Our review of Medichecks data has determined the upper limits. This retrospective study used a large dataset of blood test results from 25,425 healthy participants aged 18 to 97 over seven years. This is the most extensive study on ferritin reference ranges, and we hope to achieve journal publication so that these ranges can be applied more widely.

Retest iron panel 3-4 months after infusion

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

Test early morning, only water to drink between waking and test. Avoid high iron rich dinner night before test

Medichecks iron panel test

medichecks.com/products/iro...

healthunlocked.com/thyroidu...

Posts discussing Three Arrows as very effective supplement

Great replies from @FallingInReverse

re ferritin and Three arrows

healthunlocked.com/thyroidu......

healthunlocked.com/thyroidu...

healthunlocked.com/thyroidu...

Iron patches

healthunlocked.com/thyroidu...

Thyroid disease is as much about optimising vitamins as thyroid hormones

Keri41 profile image
Keri41 in reply to SlowDragon

My last ferritin/fbc blood test was Dec-that was when I was referred to haematologist for an infusion as can’t tolerate oral iron. I have also started tranexamic acid to reduce monthly loss through menstruation in hope that once topped up with infusion a multivitamin with iron in will do in maintaining levels.

I don’t know what an iron panel blood test is sorry. I’ve only ever had fbc (always normal) and ferritin. I never realised how low my ferritin level is or importance of it!

Keri

SlowDragon profile image
SlowDragonAdministrator in reply to Keri41

I gave you link to Medichecks full iron panel test above

Here it is again

medichecks.com/products/iro...

Iron, Ferritin, Transferrin and TIBC and inflammation test (CRP)

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