Going around in circles : Had issues for years... - Thyroid UK

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Going around in circles

Aldersonclan•

3 days ago•7 Replies

Had issues for years. Had bloods taken several times. I will put the figures as 25/4/2014, 3/5/2019, 30/4/24, 13/5/24.

30/4 we’re private bloods the rest gp.

Albumin g/L= 41, 38, 44, 41

SHB = -, -, 31.8, -

TSH mIU/L= 0.97, 0.76, 0.95, 0.61

Free T4 pmol/L= 11.4, 12, 13.1, 11.2

T3 pmol/L= -, -, 4.2, -

FSH Iu/L= -, -, 3.1, -

LH Iu/L= -, -, 4.9, -

Oestrodiol pmol/L= -, -, 454, -

Testosterone nmol/L= -, -, 2.13, -

Prolactin mIu/L= -, -, 235, -

Free androgen index -, -, 6.7, -

Thyoglobulin antibodies kIu/L= -, -, 15.5, -

Thyroid peroxides antibodies kIu/L= -, -, <9, -

Progesterone nmol/L= -, -, 41.9, -

P:E ration= 105

Urea= 4.9, 4.5, -, 4.4

Creatin= 67, 61, -, 61

Cholesterol= -, -, -, 4.4

Active B12= -, -, -, 76

Serum folate= -, -, -, 3.3

Serum ferritin= -, -, -, 44

TTG ab (IgA)= -, -, -, 0.2

upon own research it seems its central hydrothyroidism.

My nurse agreed but needed the gp to sort the referral but she did not agree. Says all levels are in “normal” level but they aren’t within optimum.

I just don’t know where to go with this now. Thank you for reading and hope you manage some wisdom for me.

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Aldersonclan

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7 Replies

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SlowDragonAdministrator3 days ago

please add ranges on TSH, Ft4 and Ft3 results

And folate, B12 and ferritin ranges

No vitamin D?

Exactly what vitamin supplements are you taking

Folate looks deficient

Ferritin is too low

Are you vegetarian or vegan

Work on improving low vitamin levels and retest thyroid in 6-8 weeks

Was test done 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)

Here’s link for how to request Thyroid U.K.list of private Doctors emailed to you, but within the email a link to download list of recommended thyroid specialist endocrinologists

Ideally choose an endocrinologist to see privately initially and who also does NHS consultations

thyroiduk.org/contact-us/ge...

Aldersonclan in reply to SlowDragon3 days ago

How come ranges matter? Aren’t they what the clinic decide who is assessing them?

Tsh- 0.27-4.2

Ft4- 12-22

Ft3- 3.1- 6.8.

Dr took the last lot of bloods.

Only taking serotonin for my mood swings, anxiety etc linked to pmdd.

I eat everything.

Test was fasted and early morning. No medication within 24hrs.

NHS said she doesn’t expect me to be able to see an endocrinologist as I’m not out of “normal” ranges. Private I can’t afford as they are £400-£500 initial.

Aldersonclan in reply to Aldersonclan3 days ago

Taking ferritin now from dr

SlowDragonAdministrator in reply to Aldersonclan3 days ago

Initial private consultation usually £250

Follow up is cheaper

Free T4 (fT4) 13.1 pmol/L (12 - 22) 11.0%

Free T3 (fT3) 4.2 pmol/L (3.1 - 6.8) 29.7%

TSH should be much higher for such low Ft4 and Ft3

So Ft4 is either just below range or bumping along bottom of range

Ferritin. Aim to improve to at least 70 and nearer 100 may be better

Get vitamin D tested

How much vitamin D are you currently taking

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 vitamin D if over 50nmol, but under 75nmol (but they rarely do)

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

But 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 when supplementing

Can test via NHS private testing service

vitamindtest.org.uk

Retest thyroid 2-3 months after getting all vitamin levels optimal

Looking at possibly central hypothyroidism

Ever had head trauma or whiplash or traumatic pregnancy/labour ……dramatic blood loss can lead to Sheehan syndrome

Roughly where in U.K. are you

Ideally see thyroid, pituitary and adrenal specialist

Can do zoom consultations if not near suitable endocrinologist

SlowDragonAdministrator in reply to Aldersonclan3 days ago

How come ranges matter?

Different labs have different ranges so we always need to know actual ranges

Did thyroid issues start after being prescribed antidepressants

Some antidepressants can affect thyroid

But being hypothyroid can also result in low mood and anxiety

medicalnewstoday.com/articl...

Aldersonclan in reply to SlowDragon3 days ago

No all symptoms started many years ago.

SlowDragonAdministrator3 days ago

cks.nice.org.uk/topics/anae...

Serum ferritin level is the biochemical test, which most reliably correlates with relative total body iron stores. In all people, a serum ferritin level of less than 30 micrograms/L confirms the diagnosis of iron deficiency.

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

Stop iron supplements 5-7 days before testing

Medichecks iron panel test

medichecks.com/products/iro...

Look at increasing iron rich foods in diet

Eating iron rich foods like liver or liver pate once a week plus other red meat, pumpkin seeds and dark chocolate, 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...

Posts discussing Three Arrows as very effective supplement

Great replies from @FallingInReverse

re ferritin and Three arrows

healthunlocked.com/thyroidu......

healthunlocked.com/thyroidu...

Great reply by @fallinginreverse

healthunlocked.com/thyroidu...

Iron patches

healthunlocked.com/thyroidu...

Thyroid disease is as much about optimising vitamins as thyroid hormones

healthunlocked.com/thyroidu...