51 yr old woman with lots of symptoms needing h... - Thyroid UK

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51 yr old woman with lots of symptoms needing help understanding results!

Katiepie72 profile image
15 Replies

Hello! There is a history of thyroid disorders in my family (sister, mum, grandmother). I have increasingly more health issues that may or may not be also linked to peri-menopause although I have been on HRT for a while. I have high cholesterol, hearing loss (non age-related, unexplained), muscle pains (very restricting), foggy thinking, poor short-term memory, forgetfulness, thinning hair, including edge of eyebrows and thinning eyelashes, bloating, occasional dizziness and pins and needles, non-existent levels of testosterone, raised MCHC etc… My doctor wouldn’t do the full panel as at the time my TSH was 2.75. I’ve just had some private results back and altho I will check with my doctor I just wondered if anyone here might be able to offer any thoughts? It all looks ‘fine’ but I do have symptoms and there is a family history. I’m not wishing thyroid issues on myself, I just don’t feel well and I don’t want to miss anything! Thanks in advance!

TSH 2.58 mIU/L (0.27 - 4.20) 58.8%

Free T4 (fT4) 13.4 pmol/L (12.0 - 22.0) 14.0%

Free T3 (fT3) 4.3 pmol/L (3.1 - 6.8) 32.4%

T4:T3 Ratio 3.116 

Thyroglobulin Antbodies (TgAb) 17 IU/mL (≤ 115)

Thyroid Peroxidase Antibodies (TPO) 11.2 IU/mL

C-Reactive Protein (CRP) 2.6 mg/L (≤ 34)

Folate - Serum 5.5 ug/L (3.0 - 20.5) 14.3%

Vitamin B12 499 nmol/L (200 - 900) 42.7%

Ferritin 47 ug/L (30 - 250) 7.7%

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Katiepie72
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15 Replies
Jaydee1507 profile image
Jaydee1507Administrator

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.

What time of day did you take this blood test?

TSH varies throughout the day and is highest at 9am or earlier when you should book blood tests for. Fast before the test and stop any biotin containing supplements 4-7 days maximum before.

Tg antibodies are positive indicating autoimmune hypothyroidism or Hashimoto's where the thyroid gland is slowly destroyed.

Both FT4 & FT3 are fairly low although TSH isnt really reflecting this but is over 2 which is suspicious.

Suggest you retest as I describe above in 3-4 months.

No result for vit D.

NHS easy postal kit vitamin D test £31 via

vitamindtest.org.uk

Folate is low and B12 borderline. Suggest you take a good methyl B complex to keep all the B's in balance.

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...

Ferritin should be around 90 - 100 for best use of thyroid hormone. Suggest increasing iron rich foods in diet and eating them often. Chicken livers, pate, red meat etc

Link with ideas for dietary iron:

dailyiron.net/

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.

Katiepie72 profile image
Katiepie72 in reply toJaydee1507

Thank you, Jaydee. I took the test at 9am. I am not currently taking any supplements but I did eat beforehand so I’ll avoid that next time. I’m definitely going to look into supplements-I’m vegetarian so that probably doesn’t help! It’s interesting what you say about Tg antibodies - I’ll look into that. Thank you again for the response and the links.

SovietSong profile image
SovietSong

Vitamins take a bashing when hypo and yours look low.Hopefully the admins will reply shortly as they’re more clued up.As you know GPs only test TSH and T4 if your lucky.My GP refuses to do anything unless TSH is around 9 or 10 and pays no attention at all to symptoms.Lots of those symptoms are typical of hypothyroidism,muscle pain,brain fog and bloating especially.Funny you should mention the hearing loss because that was a weird symptom of mine when T3 was low.Your T4 is “in range” by the skin of its teeth at 14%.

Katiepie72 profile image
Katiepie72 in reply toSovietSong

Thank you for your reply - did your hearing improve when your T3 improved?

SovietSong profile image
SovietSong in reply toKatiepie72

Yes almost immediately. I was on Levo and my T4 levels were pretty good but I could never get my T3 levels up to a decent level so had to add a little T3. Low T3 causes the symptoms.

Katiepie72 profile image
Katiepie72 in reply toSovietSong

That’s interesting. I had a look online and there’s a lot of information about links to hearing loss and T3. I think I need to see a specialist.

SovietSong profile image
SovietSong in reply toKatiepie72

Go well prepared.Write down all your symptoms and that it is common in your family.Take those private results with you as well.In the meantime you can work on your vitamins.I wish you well with it all.

Katiepie72 profile image
Katiepie72 in reply toSovietSong

Thank you!

TSH110 profile image
TSH110 in reply toKatiepie72

My hearing was badly affected, I was very overtly hypothyroid by the time I got a diagnosis. My hearing made a good recovery with thyroid hormone therapy but I have bad tinitus, not sure when that started. Luckily I can ignore it.

It is a shame you cannot get treatment now. If the TSH goes over 5 you can argue for a Levothyroxine trial, I’d stress the family history of it and write a list of symptoms to rattle off to the GP. Only the most cruel GP would leave it till TSH is 10 but unfortunately they do exist.

Katiepie72 profile image
Katiepie72 in reply toTSH110

Thank you TSH110, I’m glad your hearing improved!

pennyannie profile image
pennyannie

Hello Katiepie and welcome to the forum :

Whilst all your thyroid results are in the ranges - they are not ' sitting ' as they would if you were ' euthyroid ' and having normal thyroid function :

A euthyroid reading would hae a TSH reading of around 1.20-1.50 with a T3 and T4 around mid point in the ranges - around 50% with T4 tracking slightly higher than the T3.

Hypo symptoms start to occur when the TSH creeps over 2 and years ago treatment was started when the TSH tipped over 3 :

Your T3 is higher in the range than your T4 and inverted -

showing your thyroid struggling as the body will always preserve T3 over T4 as best as it can -

and currently with a T4 at just 14% there is not enough T4 circulating in your blood stream to convert with ease into enough T3 to keep your body running effortlessly - and why you now have these symptoms - telling you something is not quite right.

When metabolism isn't running ' just so ' the body, amongst other things, struggles to extract key nutrients through food, no matter how well and clean you eat - and core strength vitamins and minerals can nose dive through the ranges - compounding your health issue further -

I now aim to maintain my ferritin at around 100 - folate around 20 - active B12 125 ( serum B12 500++ ) and vitamin D around 125 -

I can't see a vitamin D reading and the other 3 are all too low in the ranges to be offering you much support at all -

the CRP reading - is inflammation - and shows your body upset and should be lower -

your antibodies appear to be negative so currently the cause of your thyroid ill health is not Auto Immune.

I think if you work on the vitamins and minerals this may well help feel better but unfortunately since your thyroid results appear to all be in the ranges - you will likely not be seen as suffering from hypothyroidism - yet :

If you can afford to go Private you may find a doctor prepared to take a 2nd look and prescribe T4 - Thyroid UK - thyroiduk.org - the charity who support this patient to patient open forum hold a list of recommended thyroid specialists both NHS and Private so you could email admin for the Patient to Patient Recommended list of Specialists.

Katiepie72 profile image
Katiepie72 in reply topennyannie

Hello pennyannie

This is really helpful, thank you. I do feel as if I’m running ‘sub-par’ and your interpretation makes sense. I’m definitely going to make some notes from everyone’s comments here and look at the list of specialists.

I’ve got myself some vitamins today so that’s a small step at least.

This is such a great forum.

Thanks again!

SlowDragon profile image
SlowDragonAdministrator in reply toKatiepie72

Folate - Serum 5.5 ug/L (3.0 - 20.5) 14.3%

Vitamin B12 499 nmol/L (200 - 900) 42.7%

as a vegetarian you should be supplementing B12

Have you been doing so?

B12 seems ok …just

With serum B12 result below 500, (Or active B12 below 70) recommended to be taking a separate B12 supplement

A week later add a separate vitamin B Complex 

Then once your serum B12 is over 500 (or Active B12 level has reached 70), you may be able to reduce then stop the B12 and just carry on with the B Complex.

If Vegetarian or vegan likely to need ongoing separate B12 few times a week

Highly effective B12 drops

natureprovides.com/products...

Or

B12 sublingual lozenges

uk.iherb.com/pr/jarrow-form...

cytoplan.co.uk/shop-by-prod...

In-depth article on different forms of B12

perniciousanemia.org/b12/fo...

B12 range in U.K. is too wide

Interesting that in this research B12 below 400 is considered inadequate

healthunlocked.com/thyroidu...

perniciousanemia.org/b12/le...

And why aiming to keep B12 over 500 recommended

perniciousanemia.org/b12/le...

Low folate

supplementing a good quality daily vitamin B complex, one with folate in (not folic acid)

This can help keep all B vitamins in balance and will help improve B12 levels 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) and continue separate B12 until at good levels

Post discussing how biotin can affect test results

healthunlocked.com/thyroidu...

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

SlowDragon profile image
SlowDragonAdministrator

very common on vegetarian diet to have low iron/ferritin

Plant based iron is much harder to absorb

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

If taking any iron supplements stop 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 eg 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.

Katiepie72 profile image
Katiepie72 in reply toSlowDragon

Thanks for all of the info, SlowDragon, you’ve given me a lot to consider here and I’ll work my way through it.

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