I've not posted for a while, life has been very busy.
So it's been nearly a year since I first noticed something was up with my thyroid hormone levels after visiting the GP about tiredness, body aches etc. and it came back as low t4. GP was of course not bothered.
I've been keeping an eye on things via private blood tests with MMH and wanted to share my latest results to see everybody's thoughts.
T4 is on the low side again, but what caught my eye is how much my tsh has dropped. Google tells me low t4 and tsh means pituitary gland problems (I know it's not actually low yet, however I'm wondering if it carried on with this pattern it would be eventually...)
I will attach photos of the results. Please tell me your thoughts, it would be much appreciated.
In the meantime I have requested a GP appointment to try and persuade them to refer me to an endocrinologist - long shot I know. But worth a try I suppose. I'm really feeling the symptoms recently, and have barely any hair left on my head the amount that's been falling out 😭
Eta: will add photos in comments.
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Mummybear0213
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If you have an underactive thyroid (hypothyroidism), treatment may be delayed until this problem is treated. This is because having an underactive thyroid can lead to an increased cholesterol level, and treating hypothyroidism may cause your cholesterol level to decrease, without the need for statins. Statins are also more likely to cause muscle damage in people with an underactive thyroid.
You also need coeliac blood test if not been done yet
While still eating high gluten diet ask GP for coeliac blood test first as per NICE Guidelines
I'll need to log in and get the actual results when I get the chance but I did get the full health blood test done with MMH which showed my folate was low and they suggested I supplement. Vit D is also borderline (I was using the Better You spray thanks to your recommendation a while ago which certainly helped with my low vit D).
Cholesterol levels were fine.
I think I'll pop into the GP walk in bloods clinic this week before I see them in 2 weeks so at least they'll have something on their own records, no doubt they will dismiss these results 🙄
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
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.
Thank you for your incredible patience while you have been awaiting the outcome of our ferritin reference range review. We conducted this with Inuvi lab, which has now changed the reference ranges to the following:
Females 18 ≤ age < 40. 30 to 180
Females 40 ≤ age < 50. 30 to 207
Females 50 ≤ age < 60. 30 to 264l
Females Age ≥ 60. 30 to 332
Males 18 ≤ age < 40 30 to 442
Males Age ≥ 40 30 to 518
The lower limits of 30 are by the NICE threshold of <30 for iron deficiency. Our review of Medichecks data has determined the upper limits. This retrospective study used a large dataset of blood test results from 25,425 healthy participants aged 18 to 97 over seven years. This is the most extensive study on ferritin reference ranges, and we hope to achieve journal publication so that these ranges can be applied more widely.
Vitamin levels are low as direct result of Hashimoto’s
Low vitamin levels tend to lower TSH, especially low ferritin
Improving low vitamin levels to optimal is likely to improve symptoms and may increase TSH so that you can get started on levothyroxine
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
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
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
Post discussing how biotin can affect test results
Considering that your FT4 is under-range, one would expect the TSH to be a lot higher. The FT3 looks to be at the bottom of the range, too - but we can't see a range.
What time of day was the blood draw for this test?
Nothing to do with your T4, it's the TSH that is affected by the time of day and by tea/coffee and some foods. TSH is highest before 9 am, and at its lowest around midday. And as doctors tend to dose by the TSH we want it as high as possible.
Hi. I've recently been diagnosed with central (secondary or tertiary) hypothyroidism. My TSH and Ft4 followed a similar pattern. There's a lot in my biog about my experience and diagnosis.
Thank you, that was really interesting to read but I'm sorry you've had to fight so much and have been ignored repeatedly with your concerns. Seems like the norm sadly doesn't it.
This is a slide all GPs need to understand! Individual fluction of fT4 is much smaller than the population reference range. You may sit higher in the range or lower. Fluctuating from high to low in the range within an individual is not normal...
You clearly understand your results and symptoms as being consistent with having hypothyroidism. Your GP clearly doesn't understand, which is a worry, but not surprising, which is even more worrying.
What is fascinating about your results and symptoms are that they are consistent with Hashimoto's thyroiditis and in addition the declining tsh suggests you could also be developing secondary or central hypothyroidism - just as you suggest.
Finding a GP who understands hypothyroidism and will treat you appropriately is the logical next step. Have you considered having a private consultation?
Obviously I'm not medically qualified and the above are suggestions based on your beautifully presented results.
Honestly at this rate I'm willing to make the sacrifice and see someone privately if the GP isn't willing to listen or refer me to someone who might. It's just so expensive
I would ask for a TSH and then press for an antibody test to see if its autoimmune - My GP was the one who has been monitoring mine as subclinical for years but in August, coinciding with more symptoms that she was happy with, has ordered an antibody test, results of which are due next week. Maybe look up on reputable website or 2 for symptoms and make a note of any that apply before you go to see your doctor.
I have just checked mine and I had a serum TSH which recommended range is 0.27mu/l - 4.20 mu/l and mine is 10.5 which looks somewhat different to that seen above. As a bit of a novice, I am perplexed. Please help.
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Alarming hair loss happening
Is a suppressed TSH harmful to health? 
Dissapointed & don't know what to do!
GP review - low TSH on NDT
