First post! Advice on bloods please and any tips on managing fatigue

[annie2374]

Hi all - what a wonderful community! I've been lurking a few days but would appreciate some advice on my blood test results please (F53). It's a bit of a long history but I thought it may be useful for others and for when I have updates - blood results below if you want to skip it.

I noticed a small lump in my neck (left side) earlier this year and finally went to the GP. They suspected it was a thyroid nodule and referred me for bloods and an ultrasound. At this time I was feeling fine, but a few weeks after the left hand side of my neck swelled and I began to feel awful - tired, achy. I had also put on 6 lbs after Christmas and increasingly suffering from the cold (particularly my feet). I saw another GP who said I had a goitre and expediated me under the 2WW for the ultrasound. This found 2 small nodules, c. 6mm, one looks fine and the other may be suspicious but they want to rescan in 3-4 months. They then referred me to ENT and I had a camera to look at my throat (which was fine) and they referred me for an MRI that I'm having next week. After reading the posts on here I asked for the TPO test (there's a family history of thyroid and autoimmune issues) so had those drawn (& I've become alcohol intolerant in the last couple of weeks). Last week I went back to the GP for more pain killers and was feeling really awful - they checked my blood pressure which was high (180/100) and put me some diuretics. This is beginning to make me feel better and I lost 3lbs in 5 days. I went back to the GP yesterday as I can feel the sensation of a tightness around my adam's apple (before the sensation was just on my left side). They can't advise much but it may (also) be a thyroglossal cyst that usually has a more central presentation. It will all be revealed next week.

The lab in my UK county has different ranges to many posted on here, so I'm being told my thyroid function is normal (though I do have the TPO antibodies). Vit D low (I'm supplementing that now) but apart from the diuretic and painkillers I'm not on other meds. I'm not unhappy with my GP's and they seem willing to start me on levothyroxine even if my bloods are in range, but because of all the symptoms they want to see what's happening with the MRI scan before starting me on medication which seems fair. They don't seem to think the high blood pressure is related but I've seen some posts that may indicate otherwise. Is it common? I'm adding in the lab ranges/comments

Ferritin 101 ug/l (under 100 may indicate anaemia)

Folate 6.8 ug/l (under 3 suggests deficiency)

TSH 4.53 mu/l (0.38-5.33) - same result a month apart

T4 8.9 pmol/L (7.9-20.0)

B12 262 ng/L (145-914)

T3 4.8 pmol/L (4.0-6.6)

Vit D 42 nmol/l (under 50 may indicate deficiency)

TPO 263.6 KU/L (0-8) hospital managed abnormal- raised

Any comments would be appreciated. I'm really fatigued and any advice on managing that would be helpful. I can do stuff for an hour or so then have to rest for a couple of hours. I'm used to feeling well and like many of you I'm sure, finding it frustrating. Should I push to see an endo? I don't know if I'm being too passive.

Thanks all

[Obsdian]

You'll get lots of advice soon on all different aspects.

I wanted to post something that helped me in regards to managing fatigue. I had googled managing fatigue and came up witg this free course aimed at chronic fatigue but was very relevant to me.

uhdb.nhs.uk/fatigue-educati...

Looking up the spoon theory also helped me understand the changes.

[annie2374 in reply to Obsdian]

I really appreciate that, thank you! The course looks very helpful - thanks for taking the time to respond.

[Dahliasanddaisies]

Hey Annie, welcome sorry you're feeling so rough. The fatigue has turned my life upside down over the past 2 years. What helps me (apart from obviously getting the right dose and vitamin levels etc)- frequently resting properly, no screens. I like to listen to meditation for 30 mins or so a few times a day.

- don't put pressure on yourself to make plans or do anything too much. Make like as simple as possible for now

- eat nutrionally balanced food (hard when tired)

- let yourself have as much sleep as you need

- fresh air and sunshine ever day (hahaha)

Take care and don't rush getting better x

[annie2374 in reply to Dahliasanddaisies]

Thanks so much

[GlowCoach Administrator]

Welcome to the group. If you could complete your profile it helps members understand your thyroid journey so far and be able to advise you better. Click on your image icon to start. Fill out the free text box at the top.

Your TSH is quite high and free hormone levels quite low so I would accept the GPs offer of starting Levo as soon as you have your MRI done.

Most people with hypothyrodisim are treated by their GP which in most cases works well. Theres really nothing to be gained by seeing an Endo, especially as your GP is about to start treating you.

Most Endo's are diabetes specialists with little knowledge about hypo. You will get better information from this group.

Other than low thyroid levels your B12 level is actually very low and will be contributing to your low energy levels.

Are you vegan or vegetarian? If not:

B12 - do you have symptoms of B12 deficiency? The reference range for B12 is very wide and cut off point too low. theb12society.com/signs-and...

If you do then you should discuss this with your doctor for further tests for Pernicious Anaemia.

If not, then start with a methyl B12 sublingual spray or lozenge for a week, then add a good B complex. Once you run out of the separate B12 just continue with the B complex.

cytoplan.co.uk/vitamin-b12-...

amazon.co.uk/Better-You-Boo...

B complex suggestions: Slightly cheaper options with inactive B6:

amazon.co.uk/Liposomal-Soft...

Contains B6 as P5P an active form:

bigvits.co.uk/thorne-resear...

healf.com/products/basic-b-...

Explanation about the different forms of B6:

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

B complex comparison spreadsheet:

healthunlocked.com/thyroidu...

The B complex contains folate as well as B12 so should raise your folate to a better level.

Vitamin D should be around 100 - 150. Buy one that includes vit K2 to help it go to your bones. Some are available in oil or you can take it with an oily meal for better absorption. Many members like the ‘Better You’ range of mouth sprays that contain both bit D & K2. Use this calculator to work out how much to take to get your level to 100-150.grassrootshealth.net/projec...

Your ferritin looks good BUT can be falsley raised if you have inflammation and its also possible to have good ferritin and low iron.

As you have significant fatigue symptoms you could ask GP for an iron panel to check that.

Many with autoimmune thyroid disease aka Hashimoto's benefit from a gluten free diet. A smaller percentage of those also need to remove dairy from their diet to feel well. These are intolerances and will not show up on any blood test.

[annie2374]

That's incredibly useful thank you. I'll update my profile tomorrow and read everything you've suggested.

I'm not veggie/vegan and will look at the B12 now. I have been reducing gluten for a few months as I do feel better off it. I'll look at how to reduce it further in my diet. I appreciate your comments about an Endo and GP care too - I'm glad to hear that's usual and it would be appropriate to start Levo given my blood results. It's so new to me right now, I'm grateful for your support. I have never thought much about vitamins but realising now just how important it is to pay attention to this, your guidance has made this much easier for me, thanks.

[SlowDragon Administrator]

please add to your profile that you are not in U.K.

also helpful to add gender and age