Just had blood test results back from gp as I've had a few concerning symptoms lately, out of breath easily, aching leg muscles when walking, itching scalp and underarms, generally feeling exhausted most of the time
My results came back abnormal for tsh 6.1mlu/l range (0.3-4.5)
Free t4 13.5 pmol/l range (10-22)
T3 not tested
I've not seen my gp yet to discuss but could I ask a few questions as I know nothing about thyroid problems
Do these results suggest subclinical hypothyroidism?
Could these results have been influenced by taking a supplement containing biotin, 60ug
Will I be given treatment considering I have ckd stage 3 also
Thanks for listening
Susan
Written by
Blackcat122
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The TSH suggests full-blown hypo being over 6, but your GP will say sub-clinical because he probably knows nothing about it, either, and will most likely want it to go over 10 before he will diagnose.
But, what time of day was the blood draw for this test? That makes a difference.
Taking biotin can make a difference, too, but on which test, and by how much is impossible to say. You should stop the biotin about a week before the test.
And impossible to say whether you will get a diagnosis with those results due to your kidney problems. Depends how clued up your GP is.
TSH is at it's highest around midnight. But, obviously you can't have a blood draw then. It drops slowly until about 9 am, and then drops sharply til midday, when it's at its lowest. Then it starts to rise again.
So, at 2.30 pm, it wouldn't have been at its lowest, but impossible to calculate how high it would have been before 9 am. It was pretty high, anyway. We always recommend having the blood draw just before 9 am, if possibly, and fasting. Could make all the difference between a diagnosis and no diagnosis.
Back in 2004 I was diagnosed as hypo and having low basal temperatures by the late Dr Peatfield and successfully treated with Eltroxin until 2009. When the symptoms returned in 2012 my new GP would then not prescribe the eltroxin as my bloods were borderline in range and so that's been a struggle ever since.
Along the way and whilst I've since picked up PMR in 2019 and CKD3 in 2021 your post above is the first I've heard "that poor kidney function can be directly linked to being hypothyroid"
As all the GPs, Endocrinologists & Nephrologists that I have seen over these years have never made any mention of it, and yet I would have openly and fully declared all my medical history to them all, can you suggest any further reading on this matter?
It could be many things.Yes, it could be thyroid but those are symptoms of B12 Deficiency, Folate Deficiency or Anaemia or Vitamin D Insufficiency as well. Your kidney condition can also add to the problems from deficiency if you have salt imbalance at the moment or you are dehydrated as well.
It's a bit of a vicious circle , each makes the other worse.
Vitamin B12 and Folate Deficiencies can cause short term thyroid dysfunction until the deficiency is improved , it can also cause insulin desensitivity, weight gain and putting in fat in unusual places, muscle wastage in the arms and legs , Anaemia , Vitamin D deficiency, exercise intolerance and various cardiac , digestion and neurological symptoms.
Your best first step is to arrange an appointment with your GP to get your baseline blood tests done , especially if you haven't had these tests in the last six months.
You can request these on the NHS for free if you have a current health condition or take certain medications to monitor how well you are doing and to help you adjust your diet to prevent future problems.
All but Vitamin D and HbA1C can be requested every 6months , Vitamin D and HbA1C ( Diabetes test) every 12 months.
The essential blood tests to request are : full blood count , Ferritin/Iron, Liver Function Test , Kidney Function Test, Vitamin B 12, Folate , Vitamin D and in your case Magnesium.
If you haven't had one in the last 12 months you should also request Diabetes HbA1c and Total Cholesterol.
Stop any supplements you take 4 days to at best a week before your blood tests for accurate results.
Make sure you have drank enough before any blood tests because otherwise it can be misdiagnosed as dehydration causing the results and make the test harder to do.
If your GP refuses ask what medical reasons they have to do this and repeat that you are having symptoms but also want a baseline of results to help you make the right Self Care decisions and need these tests for guidance. You can complain if they do not do these.
Request a copy of your results, don't just rely on hearing things are normal. You can have very low, very high or borderline results for many of the nutrient tests which still come under the title "normal" but are actually a marker that you have Medical Insufficiency and it needs to be dealt with a change in diet or a short term supplement to get back to healthy mid range results, this is especially important if you have a preexisting health condition , you are over 60 or you have ongoing symptoms like yours.
This may all sound a bit scary but actually if you have a nutrient Deficiencies with the right changes in diet, better hydration and supplements ( in some cases you might need some injections) the deficiency, Insufficiency and symptoms can improve quite quickly and improve your thyroid function whether you have a thyroid health issue or just a short term thyroid problem.
Are you taking Biotin for a medically reason , was it prescribed ?
There are various health issues which can be affected by high doses of biotin supplements. It can also affect blood test results , so until you know what is causing your symptoms unless you have been prescribed Biotin by your health professional stop taking it.
You've already had some tests but if those didn't include the ones above request the ones you have not had as soon as possible. GPs often overlook B vitamins and Folate as potential problems and don't test for them , even though it is more beneficial to test them before thyroid checks or at the same time. You're thyroid results do suggest a thyroid problem but it would probably be better to have the thyroid tests repeated again under the most optimal conditions for the most accurate results. Even if your B12 test was mid range normal , it may be beneficial to request an Active B 12 test.
The standard test is for Total B12 and this can be high even if your active level is Deficienct which occurs in Functional B12 Deficiency. If that is the case you require injections.
Tests for Pernicious Anaemia would also be a good precaution for you.
People with kidney illnesses can still get thyroid treatment which is organised in a way that fits in with their current kidney treatments. In fact it's important to treat any other health conditions you have to improve how well your kidneys work and how successful your kidney treatment is.
Some doctors consider it's important to do parathyroid tests within good time for patients with CKD as well.
Vitamin B12 , Folate and Vitamin D Deficiencies are common in people with kidney related diseases because the kidney plays a key role in Vitamin D metabolism and storage and insulin regulation. Vitamin D deficiency can cause B12 Deficiency and vice versa.
Thanks bleayeyed for your replyIt's such a minefield!!
I answer to the biotin question, I didn't even know it was in the multivitamin supplement I was taking for hair skin and nails, until I read about it affecting thyroid blood tests and thought I should check
I've had a comprehensive set of tests done in the last week, and all except tsh and kidney function came back within range.
I've an appointment with the gp a week on Monday so I will mention everything to her
Hi sorry to hear you are going through all this - I have Lupus nephritis and my GFR improved when put on thyroid hormone eventually - after having to wait 15 years but that is another story - I took biotin recently for my scalp issues and hair and I am on steroids and it knocked down my cortisol levels which would be fine for someone who doesn’t have the need for help as I have adrenal insufficiency- so biotin could have pulled down your adrenal reserves.
Hi again Susan - are you under the care of a renal consultant- I feel you should be - I am - also the amount of biotin in a multi wouldn’t cause that much difference- I was taking a very high dose separately - ask to be referred !
Hi Blackcat122 , just reading through your post. I don’t have CKD, but my gfr result isn’t great. I also have Hashimoto’s and have been on thyroid medication since 2016 (long time to get it acknowledged, like many of us).
How does Candesartan help kidney disease? I’ve just started a low dose to see if it will help prevent my migraines. I’m on 4mg at the mo. I’m concerned about it causing bone issues (I’ll get my own post at some point), but haven’t read anything about kidneys when taking it. 😊🧁
Hi Love cakeMy gp said that candesartan is protective to the kidneys, although initially it can cause a drop of egfr, but then it can slow the disease progression
Also dapagliflozin, primarily prescribed to diabetic patients, of which I'm not, has been found to be beneficial to ckd patients with proteinuria
Hi Blackcat122, I have first to say pleased to meet you , I have had an overactive thyroid, for years and take 150mg Thyroxine daily of late I have had all the systems you describe, and more worryingly my bp is flying ,this mornings reading was 181/95, been up and down the last 6 months and I still haven't actually seen my gp ,I suggested to him it could be todo with thyroid he said yes possibly but he would refer me back to Endocrinology needless to say I've heard nothing more , but what you describe apart from bp sounds exactly the same , I wish you luck 🤞
Please push and push - you need expert help - although in saying that we know more than them - you need help with that BP reading - you need to see an endo - have you tried reducing your dose ?
Hello posthinking01, I have been having these problems since March, they tweak my bp meds and suggest this and that , but nothing changes , I sent Friday afternoon at the hospital a&e, and was sent home ,with more or less a pat on the head and told what I already knew ,it's very frustrating
Your high BP can also be as a result of too low thyroid hormone - my Mother had horrendously high BP 200 odd and when she went on thyroid hormone it went back to normal - so did her enlarged heart - the BP comes from the kidneys not the heart as some people think - it affects the heart but comes from the kidneys. Another way of getting down the BP is by taking CoQ10 but you would need to be careful if you do take it as it really does reduce BP- I know I took a tablet and went off to work not realising in those days my BP was a little lower than it should be and I nearly fainted. Did some research and found out why - but that is an option for you - I only recommend Nature's Best products as they are 'professional' ones now available to the general public.
I’ve had stage 3 CKD status for over a decade due to higher creatinine blood range only.
If you have other abnormal kidney results either urine or bloods or some symptoms it definitely should be looked into…or if like my situation nothing will be done if just high creatinine. I had to beg to get ultrasound as I was having some pain and as wasn’t happy that I wasn’t even told… but due to various autoimmune conditions I have I started looking at my results myself and taking my own health into my hands then found this out… everything looked ok on my scan … although obviously that doesn’t rule everything out at all… My GP said don’t worry, they think this is my normal as it’s been consistently this for a long time with no other underlying symptoms … ironically creatinine levels did go down to stage 2 only one blood test though ( could be lab error) when I was on Liothyronine (T3) but my next test was back to stage 3 and my FT3 didn’t improve much either unfortunately.
I was told high protein diets and dehydration can cause higher creatinine levels so prior to testing they always ask me to drink sufficiently and lower my protein day before it’s made no difference really.
There’s a link with thyroid conditions and creatinine levels being higher.
My TSH levels were 51.6 (0.3-5-5) and FT4 -7.3 (12-22) in 2013
I didn’t know had any issues 🫣
Now for past 3years my TSH is just in range always under 1 and FT4 around 20 but bad conversion my FT 3 always rubbish
Non of these changes has had any changes in creatinine levels.
Hi CoeliacMumLike you I'm stage3 ckd for just over 2 years
It originally started with just high creatine and urea in the blood, but since February this year I've developed proteinuria which is being treated by my gp with candesartan and dapagliflozin.
So until you get Ft3 to GOOD level you won’t know if kidney function will improve
As coeliac and Hashimoto’s you will need high enough dose pT3 to bring Ft3 at least 60-70% through range…..and many members find they need Ft4 at similar level too
I had same conversation with 2 - same old situation re TSH going under range.
They said many things can slow conversion and as adding in T3 for a year made no difference it’s likely something else causing conversion problems… then a forward looking out of hours Dr recommended see gynaecologist as perimenopausal issues and oestrogen is big trouble for thyroid when in excess and not clearing… so exploring this area and been left with option of full (everything taken away) hysterectomy, which is probably source of pelvic hip lower back pain as found endometriosis I was aware year before of adenomyosis … that said I’ve had 6 months of shutting down hormones and had Thyroid tested after 3 injections and it made little difference to my FT3… so I do agree that probably more T3 is required but I cannot get hold of it now as no prescription and prefer to be monitored than self prescribe at present due to various factors.
I only have one kidney, so I am all over my numbers. Just want to let you know that my GFR has gone up 13 points in the last couple of years.
For me this came after a thyroidectomy. Meaning finally proper thyroid hormones. My thyroid panels previously were not showing issues (except by the brilliant radd🤩🤸) , yet my thyroid came out totally diseased (surgeon's words & backed up by pathology).
So definite connection for me between kidney function & thyroid.
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