Hypothyroidism symptoms, in range results, potential next steps?

[Jasoop]

Hi,

I've had fatigue and stomach issues for around 10 years following a bout of food poisoning however in the last few years these symptoms have become worse and now cover most of the symptoms named by the NHS for hypothyroidism, including in the last year or so developing what I assume is a goitre.

Previously I've been tested by a GP for B12 deficiency, celiac disease and thyroid issues amongst other things, and while I haven't seen the results they've always said the results are fine, and that my symptoms are due to stress, diet, alcohol (I'm teetotal due to symptoms) and the dreaded 'its in your head'.

I've paid for private tests to see if there is anything they haven't picked up and I've attached a copy of the assumed important results, in addition to these they came back with high cholesterol and in range liver results even though I feel like I've got a fatty liver. I had come off all supplements for 3 to 6 months before these tests and have restarted D3 supplementation since.

The results do seem in range however with the near upper range TPO Ab and my assumed Goitre development it does still feel like thyroid issues are the most likely source of my issues.

I'm looking for any opinions on my results and suggestions on what my potential next steps could be, including if I can rule out thyroid issues, would a NHS GP do anything with these results/symptoms or just say I'm in range, should I look into self medicating etc.?

For reference I'm Male in my 30's and my paternal grandmother was on levothyroxine for over 40 years.

Thank you in advance for any advice.

[Jasoop]

Apologies the results don't seem to have attached properly, hopefully this works.

Results

[TiggerMe]

I would work on getting your folate and Vit D optimized both need doubling at least and then retest your thyroid, are the first results whilst supplementing?

I wouldn't rule out thyroid issues in the future as your thyroid is under attack, you might find that removing dairy or gluten from your diet is beneficial

[Jasoop in reply to TiggerMe]

Thanks for the reply, both results are without tablet supplementation from around Aug 23, since Jan 24 I've restarted D3, I was however still eating fortified cereal (mainly for the fibre) throughout which has a range of vitamins B's and Iron added. I will look into adding more folate.

[TiggerMe in reply to Jasoop]

I think there is some merit in keeping your vits and mins optimized to minimize stress on the thyroid and slow the possible onset of hashimoto

[SlowDragon Administrator]

while I haven't seen the results they've always said the results are fine,

Assuming you are in the U.K.

You are legally entitled to printed copies of your blood test results and ranges.

The best way to get access to current and historic blood test results is to register for online access to your medical record and blood test results

UK GP practices are supposed to offer everyone online access for blood test results. Ring and ask if this is available and apply to do so if possible, if it is you may need "enhanced access" to see blood results.

Link re access

patients-association.org.uk...

healthunlocked.com/thyroidu...

In reality some GP surgeries still do not have blood test results online yet

Alternatively ring receptionist and request printed copies of results. Allow couple of days and then go and pick up.

[Jasoop in reply to SlowDragon]

To be honest, I've got the online account and requested my full record but when it came there was lots of information regarding consultations back to childhood etc. but no results, I queried this and got told that I'd got everything so I just gave up. It does look that any future tests will be added automatically to my online account.

[jimh111]

Your fT3 and fT4 would normally result in a suppressed TSH. You may have a small goitre because your thyroid is working hard to produce a lot of hormone. There is a rare genetic condition called resistance to thyroid hormone (RTH). This usually presents with elevated thyroid hormones and a non-suppressed TSH. It's possible you have a mild form. You can get similar results from a pituitary tumour called a TSHoma but this would lead to hyperthyroidism.I would insist on a referral to an endocrinologist on the basis of your unusual blood test results. They can carry out further tests and refer you for RTH testing at Addenbrooke's if necessary.

[jimh111]

This paper is very technical, it describes the investigation of patients with high thyroid hormones and a non-suppressed TSH doi.org/10.1210/clinem/dgad681 . In particular see Figure 2 academic.oup.com/view-large... .

Your thyroid hormones are not high but both are near the upper limit and your TSH is nowhere near the lower limit so I think this strategy would be applicable in your case. An endocrinologist referral is needed for these investigations.

[sparkly in reply to jimh111]

Sorry to jump in on this post but can you but can you pinpoint me to any research papers on low t3 uptake and severe cognitive issues.Also do I remember you having your own website or information regarding low uptake or some kind of resistance. I need a bit of help if that's ok

[jimh111 in reply to sparkly]

I have ibshypo.com . I suffered from IBS and it was my research into that which led to suspecting hypothyroidism, before my hypothyrodism became severe (hence the name of the website). My hypothyroidism was caused by endocrine disrupting chemicals which can inhibit peripheral thyroid hormone action. The pituitary has different thyroid hormone receptors which are not affected, consequently you get hypothyroidism with normal blood test results. I called this "Acquired Resistance to Thyroid Hormone (ARTH)" to differentiate it from the genetic form "Resistance to Thyroid Hormone (ARTH)" which presents with hypothyroid signs and symptoms, elevated thyroid hormones and a non-suppressed TSH.

I'm not sure what you mean by "low T3 uptake" but I suspect you mean impaired T3 action. This can result from resistance to thyroid hormone, deiodinase problems (especially D2), impaired cellular transport etc. Most endocrinologists haven't a clue about these conditions.

[Jasoop in reply to jimh111]

Thanks I will give this a read when I get chance.