Hi, I'm quite new here. I wonder if anyone can help. I am wondering if I could maybe have an underactive thyroid or maybe even Euthyroid Sick Syndrome? My symptoms are tiredness, weight gain, depression/anxiety, intolerance to cold and muscle cramp. I had a TFT blood test, which came back normal/probably euthyroid (2.3) and my GP wants to prescribe antidepressants, as she says that the results are not low enough to be euthyroid sick syndrome and that everything is quite normal. I am worried that the GP may be wrong. I would be very grateful if anyone who has gone down the same path could shed any light on my problem.
Underactive Thyroid/ Euthyroid Sick Syndrome - Thyroid UK
Underactive Thyroid/ Euthyroid Sick Syndrome
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Musicl
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TiggerMeAmbassador
I'd suggest getting a private test to check your thyroid hormone levels rather than just TSH
randoxhealth.com/en-GB/ might have a clinic near you or do home finger prick tests
monitormyhealth.org.uk/ save 10% with THYROIDUK10
Thank you for the information and links. That might be a good idea
Hi TiggerMe, is it ok to not get Tg Ab done? Is TPO Ab sufficient? I am thinking of getting a blood test done but can’t see it anywhere as an option…x
NHS only test TPO but others test.... Cheapest randoxhealth.com/en-GB/at-h...
It's possible to be high in one and low in another or low in both even if you have Hashi's
So it's hand to check both
Thank you ☺️
You dont say how old you are but these can all be peri/ menopause symptoms. I would hold off the happy pills for now if I were you. There could be a physical problem causing your symptoms. In my opinion GP's are far too quick to hand out antidepressants. They should rule out other causes before reaching for the prescription pad.
1. You and your GP dont know if you have a medical issue causing symptoms, 2. Antidepressants can have a lot of side effects, and once on them, they can be hard to get off.
I'm not against AD's, in the right circumstances they are totally necessary and life saving, but I feel they are handed out far too readily. GP's are often too overworked/ or dont care enough to get to the bottom your symptoms and sending you on your way with a prescription is an easy fix.
I am 78 years old. I think you are right about GPs. They hand out pills like sweets.
Not menopause then lol. Not wishing to sound cynical, but am going to anyway, GP's earn extra funding points for their practice based on diagnosing and treating certain conditions, diabetes, blood pressure, cholesterol, asthma and depression are all worth a lot of points per patient.
So there are cash incentives for " diagnosing" depression and putting you on antidepressants. To my mind very ethically dubious at best. As I said there will always be people who genuinely need them and benefit from them, but they are being prescribed far too freely. We have millions of people in the UK on these drugs.
Thank you for your reply. Yes, you are quite right, I'm sure that medics do very well out of pharmaceutical companies. I do prefer to go down the natural route if at all possible, as I don't like to fill my body with chemicals if there is another option. I will explore every avenue before I accept the antidepressants.
I think you are very wise to do so. You dont know that there isnt a physical cause of your symptoms as yet. A lot of people struggle with weight gain, fatigue and low mood due to SAD syndrome. The symptoms you describe are vague and can apply to hundreds of conditions.
SAD is a winter condition, and I have had these symptoms for quite some time.
I think one of the others pointed out your B12 is very low. I have PA and get B12 jabs every 2 months. Certainly fatigue and low mood are common with low B12. This deficiency needs addressing.
Thank you Sparklingsunshine, I am going to have a word with my GP, but I think I will have to think about changing surgeries.
My symptoms are tiredness, weight gain, depression/anxiety, intolerance to cold and muscle cramp.
Some of your symptoms could be caused by nutritional deficiencies.
For example :
Low iron and low vitamin B12 cause tiredness which, depending on severity, can be extreme.
Low iron can cause weight gain.
Depression/anxiety can be low iron and/or low B12 and/or low folate.
Low iron can cause intolerance to cold.
Low levels of one or more of the following can cause muscle cramps - magnesium, iron, vitamin D, salt, calcium can cause muscle cramps.
A diet too low in protein is common, and causes feelings of tiredness, exhaustion, and weakness.
Some symptom lists...
Thyroid :
healthunlocked.com/thyroidu...
Low iron and/or low ferritin (iron stores) :
thewayup.com/newsletters/08...
healthunlocked.com/thyroidu...
Low Vitamin B12 :
b12deficiency.info/signs-an...
Low Folate :
b12deficiency.info/folate-b...
Low Vitamin D :
medicinenet.com/14_signs_of...
Low Magnesium :
healthyandnaturalworld.com/...
Low calcium :
health.clevelandclinic.org/...
medicalnewstoday.com/articl...
...
Some general things to be aware of...
If you decide you need more magnesium (for example) it is essential to realise that not all supplements are the same, and you may have to buy what you need online. As an example, many cheap magnesium supplements are made of magnesium oxide but this is very poorly absorbed and there are other magnesium supplements which are much better. These comments apply to supplements for several deficiencies. "Cheap" often just ends up being a waste of money.
Another thing to be aware of is that low levels of iron and/or ferritin and/or vitamin B12 and/or folate, if they are low enough, will lead to anaemia. But, some people can have low levels for a long time before they develop anaemia. Doctors will treat anaemia if they discover it, but they won't very often treat deficiencies if the patient isn't anaemic. But low levels of nutrients can cause immense numbers of unpleasant symptoms, and in order to feel well we need to improve our levels.
Many of us end up treating our own deficiencies because we can then avoid the really poor supplements and the really low (or stupidly high) doses which are useless or dangerous. Doctors are not trained in nutrition or nutrient deficiencies, and anything they are not trained in they consider to be unimportant.
Thank you for your very informative reply. On account of being pescatarian, therefore not eating meat, I have regular blood tests and nothing has shown up as lacking.
Please add most recent vitamin D, folate, B12 and ferritin results
NHS only tests for and treats vitamin deficiencies
Low vitamin levels can cause significant symptoms
Eg B12 range is typically 180-680 approx.
GP will say anything within that range is fine
Good serum B12 level will be over 500
Thank you SlowDragon, I have gone into my medical records, which were done in March (they are due to be done again): B12, 238 ng/L (211 - 911). Ferritin, 25 ng/ML (10 - 322). Vit D, 102 NMol/NL (50 -100). Folate, 12.1 ng/ml (5.4 - 24). I would appreciate your opinion on the above.
Vitamin D, 102 NMol/NL (50 -100).
Folate, 12.1 ng/ml (5.4 - 24).
Both are good
B12, 238 ng/L (211 - 911).
B12 Extremely low, borderline deficient
Ferritin, 25 ng/ML (10 - 322).
Ferritin is deficient
Work on improving to optimal levels
Serum B12 at least over 500
Active B12 (private test) at least over 70
Ferritin minimum 70. Nearer 100 may be better
B12
Low B12 symptoms
b12deficiency.info/signs-an...
methyl-life.com/blogs/defic...
NICE guidelines on B12 and testing
healthunlocked.com/redirect...
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 or pescatarian 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...
Great reply by @humanbean on B12 here
healthunlocked.com/thyroidu...
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 and may need separate methyl folate couple times a week
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
Post discussing how biotin can affect test results
I would have thought both your ferritin and B12 results would have been flagged up as needing further investigation last March !!
I am certain that there is a lack of duty of care at my GP surgery and I am considering changing over to another surgery.
Well I think that evident -
let's hope they make up for lost ground and fast track sorting out these deficiencies -
you may find a more diligent service where you are than switching to an unknown
surgery and having to start again from square 1 when so, unwell.
The trouble is, It's not just this episode. I, and many others have been having problems with this surgery for some time. The NHS is not what it once was unfortunately.
I believe there could be a very large groundswell of people in a very similar situation - but just don't throw the baby out with the bath water -
you are now a little better informed from SlowDragon as to the NHS directives when ferritin and B12 are so low with NHS guidelines working in your favour - :
Just go one step at a time as it gets very stressful and you will need to pace yourself.
Thank you pennyannie
Hello Musici and welcome to the forum :
A euthyroid ( normally functioning ) thyroid would present with a TSH at around 1.20 - 1.50 :
A TSH creeping up over 2 - is suggestive of your thyroid struggling and years ago - once the TSH was over 3 you were diagnosed hypothyroid and prescribed - thyroid hormone replacement.
The prescribing of anti- depressants is like a ' get out of jail free ' - card to doctors -
with patients sent away - feeling that they haven't been taken seriously enough and questioning their own mental health.
Hello pennyannie, Thank you for your reply. I think that there are different formats for blood test results. Mine appears on my medical records as: Serum: TSH Level 2.3 miu/L (0.2 - 4 normal) Do you know if this correct?
Most ranges for a TSH are around 0.27 - 4.50 :
The NHS ranges for thyroid are ' wide ' and if in the range you results will not be flagged as ' needing further attention ' -
and the anti depressant a more lucrative option than undertaking a thorough thyroid hormone blood panel to analyse / measure the actual, vital, T3/T4 thyroid hormones.
Thank you Pennyannie. I will have a word with my GP about T3/T4. I much appreciate your advice.
SlowDragonAdministrator
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 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
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...
healthunlocked.com/thyroidu...
Great reply by @fallinginreverse
healthunlocked.com/thyroidu...
Ferrodyn supplement
healthunlocked.com/thyroidu...
Iron patches
healthunlocked.com/thyroidu...
Thyroid disease is as much about optimising vitamins as thyroid hormones
healthunlocked.com/thyroidu...
restartmed.com/hypothyroidi...
Post discussing just how long it can take to raise low ferritin
healthunlocked.com/thyroidu...
Iron and thyroid link
healthunlocked.com/thyroidu...
Posts discussing why important to do full iron panel test
healthunlocked.com/thyroidu...
Good iron but low ferritin
healthunlocked.com/thyroidu...
healthunlocked.com/thyroidu...
healthunlocked.com/thyroidu...
Chicken livers if iron is good, but ferritin low
healthunlocked.com/thyroidu...
Shellfish and Mussels are excellent source of iron
healthline.com/nutrition/he...
Iron deficiency without anaemia
healthunlocked.com/thyroidu...
Ferritin over 100 to alleviate symptoms
healthunlocked.com/thyroidu...
healthunlocked.com/thyroidu...
Great research article discussing similar…..ferritin over 100 often necessary
ncbi.nlm.nih.gov/pmc/articl...
Low Iron implicated in hypothyroidism
healthunlocked.com/thyroidu...
Really interesting talk on YouTube, link in reply by Humanbean discussing both iron deficiency and towards end how inflammation can also be an issue
healthunlocked.com/thyroidu...
Inflammation affecting ferritin
healthunlocked.com/thyroidu...
Updated reference ranges for top of ferritin range depending upon age
healthunlocked.com/thyroidu...
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.
Thank you very much, Slow Dragon for all your advice. It has certainly given me a lot to think about. You have been so informative, and you are very knowledgeable. I am very grateful that everyone on this page has been so helpful.
Work on improving vitamin levels and retest thyroid and vitamin levels in 3-4 months
UPDATE: Hello Slow Dragon, I have seen my GP today and she says that all my vitamins/minerals were within the correct range. Being as they were last tested in February, and most of them at the low end of the range, I requested to have them done again. She grudgingly agreed, so it will be interesting to see if they have altered within the past nine months. I will let you know as soon as I have the results.
Well done for pushing for retesting
Your b12 result is indicative of possible deficiency and you have symptoms which could be b12 deficiency and/or early stages of hypothyroidism. The two conditions occur together in many people.
You have a dilemma. If you supplement b12 your serum levels will go up, your GP will likely then say you don't have b12 deficiency and the increase in your b12 level may also not be sufficient to reduce the symptoms.
It's a complex area to get your head around at first. I would suggest you do some reading re b12. A good starting point is the PA forum on healthunlocked.com also the PA society website. This should help you work out a way forward, the good people on the PA site are super helpful.
Something worth noting is that some GPs are generally not particularly knowledgeable about b12.
Finally, the above are suggestions and I am not medically trained.
Thank you Cornwaller for your advice.
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