is this subclinical hypothyroidism? : Hi, Any... - Thyroid UK

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is this subclinical hypothyroidism?

Karenedawson profile image
15 Replies

Hi,

Any guidance would be much appreciated please… this is all new to me. I managed to persuade my GP that I have symptoms of hashimotos and to humour me a TSH test , T4 /T3 and anti TPO blood test was done. However the bloods were done at 10:30am, I’ve been having biotin in my multi vitamin and drank coffee before the test (not realising the above have an effect on the test result).

My results are TSH are 4.0 ml/Ul (0.3-5.5)

T4 level is 10.4 pmol/L (10.0-22.0)

Triiodothyronine is 4.1 pmol/L (3.1-6.8)

Anti TPO test 603 (normal 0.0-24.9).

I’ve been really ill since January subsequently got diagnosed with pernicious anaemia , long story short have had way over the normal loading doses for B12 deficiency and have been taking multi vitamins, magnesium and potassium tabs.

My biggest debilitating symptom is lethargy , being cold (have to have 40c baths to warm body) and joint and muscle pains.

Thank you for reading my post

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Karenedawson profile image
Karenedawson
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15 Replies
J972 profile image
J972

Hi Karen,

Without the ranges I’m afraid members won’t be able to make the most informed comments. You can edit your original post.

You obviously have tested positive for TPO antibodies which suggests Hashimoto’s.

Karenedawson profile image
Karenedawson in reply toJ972

thank you - I’ll try again!!

SlowDragon profile image
SlowDragonAdministrator

So high TPO antibodies confirms Hashimoto’s

GP should retest thyroid again in another 6-8 weeks

Book 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)

Free T4 (fT4) 10.4 pmol/L (10 - 22) 

Ft4 only 3.3% through range

Free T3 (fT3) 4.1 pmol/L (3.1 - 6.8)

Ft3 only 27.0% through range

Ft4 is absolutely rock bottom and Ft3 far too low

Likely low vitamin levels

Request GP tests folate, vitamin D and full iron panel including ferritin NOW

And as per NICE guidelines you need coeliac blood test too

Multivitamins are NEVER recommended on here, especially for Hashimoto’s

Most contain iodine, which can make hashimoto’s worse

Stop multivitamins

Get tested and then supplement GOOD QUALITY separate vitamins as required

As you have PA and B12 injections you should be taking daily vitamin B complex. This can help keep all B vitamins in balance and may help improve B12 levels between injections 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 5-7 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)

Post discussing how biotin can affect test results

healthunlocked.com/thyroidu...

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

Vitamin D likely low

SlowDragon profile image
SlowDragonAdministrator

Why are you taking potassium

Better to eat a banana

Karenedawson profile image
Karenedawson in reply toSlowDragon

Thank you so much for your info.

Am allergic to bananas!!

redhead41 profile image
redhead41 in reply toKarenedawson

Try potatoes or tomatoes

greygoose profile image
greygoose

Given the consistancy of results, I would say yes - although I balk at saying 'subclinical' because that means 'without symptoms', and you have symptoms - because it would be unusual for the biotin to make every result wrong.

And your TSH is too high - unfortunately not high enough for a doctor to diagnose! - but a euthyroid (normal) TSH would be around 1, so that is high and hypo.

Your FT4 is only 3.33% through the range! Should be around 50%. And your FT3 is not much better at 27.03%. Should be around 50% but slightly lower than the FT4. And the fact that is is higher than the FT4 suggests that the thyroid is failing, because that's what it does when the thyroid is failing.

And, of course, antibodies don't lie, and they are screaming 'Hashi's' - or Autoimmune Thyroiditis, and they say in the UK.

Drinking coffee would only have affected the TSH, not the other results. Also, it would have been higher if the blood draw had been before 9 am. So, next time you test - and you much keep testing until you get results that interest a GP - make sure you get the blood draw before 9 am and only drink water until afterwards.

Multi-vits are never recommended on here, for many reasons. One of them being that they usually contain iodine and that is an absolute no-no for people who are hypo - especially with Hashi's. So, if I were you, I'd get my vit D, folate and ferritin tested and just take what is needed to optimise them - we can help you with that.

As you are having vit B12 shots, are you taking a daily B complex to keep the Bs balanced? Because they all work together. :)

Karenedawson profile image
Karenedawson in reply togreygoose

Thank you so much for your guidance x

Cornwaller profile image
Cornwaller

Hypothyroidism is a common co morbidity of PA. You have Hashimoto's. You have symptoms are consistent with Hypothyroidism and you are unwell. Your thyroid panel results are all close to demonstrating Hypothyroidism. Your GP should have started you on a trial of levothyroxine to see if you respond thereby confirming or refuting the diagnosis. You could ask them - a trial always sounds better.

Vernonwendy profile image
Vernonwendy

Karen, I have nothing of value to add except to offer you some moral support. I have been in your shoes and it’s not a fun place to be. I have had Hashimotos for about 8 years although I didn’t even realize it was Hashimotos until joining this group. It’s hard to be your own advocate when you feel so unwell but you are in the right place, and there is light at the end of the tunnel!

Karenedawson profile image
Karenedawson in reply toVernonwendy

Ah thank you for the encouragement. Think I may be in for a bit of a battle with my GP this week to try and persuade him to prescribe levothyroxine !!

Vernonwendy profile image
Vernonwendy in reply toKarenedawson

You may. But try to stand your ground. It’s hard to stand up to GPs but they certainly are not authority’s on thyroid disease!

Lottyplum profile image
Lottyplum in reply toKarenedawson

Can you take someone with you to help fight your battle with your GP+advocate for you? Get all the info you can get here prior to the appt+sock it to yet another ignorant GP!! 😁

MissMonty profile image
MissMonty

"Be your own Thyroid Advocate" book by Rachel Hill is packed full of useful advice, she also has a great website to take a look at. I found the information easy to digest as written by a fellow patient rather than a medical professional xxx

Karenedawson profile image
Karenedawson in reply toMissMonty

Thank you very much xx

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