fatigue

[Avadip12]

hello I am new on here. I have been treated for polymyalgia rheumatica PMR for 15 yrs . I no longer suffer the high level of discomfort, but have the most dreadful fatigue the past 3 yrs . I have had investigations for poor adrenal function ESR CRP, but all normal . What has been slightly abnormal is my TSH in the past year it has been 4.95 T4 10.5 , my hair has been dropping out and I have very dry skin .( but I am on prednisolone 3.5 mgs ) should I push for further thyroid investigations , other than keep repeating my TSH very 6 mths . It’s just that I am so fed up of lack of energy. I would be grateful for any information, many thanks

[SlowDragon Administrator]

Yes definitely

prednisolone may falsely lower TSH

hair loss frequently linked to low iron/ferritin

Low ferritin tends to lower TSH

What’s the range on Ft4

TSH is far too high

PMR is believed to be autoimmune, having one autoimmune disease makes others more likely

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

Also both TPO and TG thyroid antibodies tested at least once to check if autoimmune

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

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

About 90% of primary hypothyroidism is autoimmune thyroid disease, usually diagnosed by high TPO and/or high TG 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.

Significant minority of Hashimoto’s patients only have high TG antibodies (thyroglobulin)

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)

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)

Post all about what time of day to test

healthunlocked.com/thyroidu...

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

Testing options and includes money off codes for private testing

thyroiduk.org/testing/

Medichecks Thyroid plus BOTH TPO and TG antibodies and vitamins

medichecks.com/products/adv...

Blue Horizon Thyroid Premium Gold includes BOTH TPO and TG 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

support.medichecks.com/hc/e...

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

[Avadip12 in reply to SlowDragon]

Thank you for that information. However will a GP prescribe after you have been tested via any of these private site . Or will they then ask you to repeat it all again via NHS if your lucky enough to have have a GP who is that pro active to resolve your fatigue. Many see you as a heart sink patient .

[SlowDragon Administrator in reply to Avadip12]

Knowledge is power

First step get full testing

Likely to see low vitamin levels

As an example

If vitamin D is 15nmol (50-200)

GP onligated to retest and then treat

If Vitamin D is 51nmol that’s not optimal level, but GP not required to treat

You would need to self supplement

Ferritin

GP’s often reluctant/wary of iron/ferritin

Ferritin below 30 is deficient, but we see hundreds of members on here with Ferritin between 5-30, never tested further or treated

B12 range is far too wide at typically 180-700

[Avadip12 in reply to SlowDragon]

Sorry my T4 is 10.5

[SlowDragon Administrator in reply to Avadip12]

Yes what’s the range on Ft4 (figures in brackets after result)

Different labs have different ranges

Ft4 10.5 (12-22)

Ft4 is below range

Ft4 10.5 (7-14)

Ft4 is mid range

[Brightness14]

You will require TSH, FT4, FT3 plus B12, Folate, and Ferritin tested. How is your Vitamin D level.

When my Ft3 is low I have pains all over my body.

[Avadip12 in reply to Brightness14]

It was picked up that I had low vit D 2 yrs ago . When I was the endocrinologist for possible adrenal fatigue. I was given a very large dose for a month , to get me back on track

[TiggerMe in reply to Avadip12]

Have you continued to supplement Vit D to keep your levels up?

[Avadip12 in reply to TiggerMe]

Yes thank you as I have to take calcium because of my steroid use