Jaydee1507 recommended I start a new post with my latest blood test results. I’m due to speak to a doctor tomorrow and I’m guessing they’ll keep monitoring the situation.
I’ve had two sets of blood work done since I first posted. Any idea why they’d be so different a week apart? The GP I saw for another matter says the new results are reasssuring. I haven’t had a Vitamin D test yet. The only difference between these and my previous tests is that I stopped taking multivitamin and biotin supplements a week before.
Thanks for any light you can shed on these results.
1. Blood test by the GP on 12 Dec:
TSH 4.48 mIU/L (normal range 0.38 to 5.33)
Free T4 (fT4) 8.7 pmol/L (normal range 8.0 to 18.0)
Anti-thyroid peroxidase: 28 IU/mL (normal range below 22)
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.
Thanks so much for all the information and links, SlowDragon. I really appreciate your help.
I’m already on B12 injections every 12 weeks to resolve pins and needles, so my B12 level is in normal range. My last serum folate test (in September) was also normal.
My ferritin levels have been low for a while (hovering between 42-58). I have had thinning hair, although I am not anaemic according to the doctor. I struggle with iron supplements - even Spatone . I already eat an iron-rich diet.
I will ask about the possibility of an ultrasound scan.
My last serum folate test (in September) was also normal.
what was actual result
As you have B12 injections it’s recommended also to supplement a good quality daily vitamin B complex, one with folate in (not folic acid) may be beneficial.
This can help keep all B vitamins in balance and may help maintain B12 levels between injections
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
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
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)
Folate - Serum 10.7 ug/L (normal range 3.0 to 20.0)
Thanks for the information about B/folate supplementation. Based on what I learned here, I stopped all vitamins/biotin supplements a week before my blood tests.
Looking at your results I’d say your TSH is too high meaning your t4 or t3 or both are too low. If you have a TSH above 2.5 you’ll almost certainly be getting some hypothyroidism symptoms. Even though the NHS TSH level goes up to 5.50 it’s too high. My private endocrinologist has explained that to me. In others countries they treat people when their TSH is above 3. It’s just our poor standards in our nhs that leaves people struggling until they are desperate unfortunately. I was one of those people and I wasn’t treated until my TSH reached 36! By that time I was in a real bad way. I’m not 100% sure why our NHS leave patients so long to treat as it’s not productive in any way. People keep returning to their drs for help and also some may not be able to go to work. So it makes no sense. The only thing I can think of is that once diagnosed and prescribed levothyroxine all your prescriptions will be free of charge. Surely it can’t be based on that??
Your ferritin seems a bit low also which can be treated easily with ferris fumerate. I use this and try to keep my ferritin around 100. It does make you feel energised when your levels are correct.
McPammy, thanks for sharing your experience. I’m sorry you were struggling for so long before getting help.
I spoke to the doctor today, but they’ve said no further action is needed apart from an annual blood test (November). They won’t prescribe medication unless my TSH is over 10 (the most mine has been is 7.7). I’m going to book another private blood test in the spring to keep an eye on things.
The doctor previously prescribed ferrous sulphate, but I couldn’t tolerate it (even Spatone makes me queasy). I can’t take iron supplements with orange juice etc, due to gastritis, so I don’t think it absorbs properly.
If anyone knows of a good specialist near Bristol for future reference, I’d be grateful if you could send me a private message. Thanks so much.
GPs ignorance makes me want to spit,! Wonder if they'd take the same route if 'no treatment ' +see you in 12 months if they were the ones suffering,? I doubt it!
I spoke to the doctor today, but they’ve said no further action is needed apart from an annual blood test (November). They won’t prescribe medication unless my TSH is over 10 (the most mine has been is 7.7).
This is completely WRONG
You have had two previous tests with TSH over 7
With two separate tests with TSH over 5, and symptoms and raised thyroid antibodies you should be offered a “trial “ on levothyroxine
As detailed in replies by tattybogle and Tina_Maria
Here’s link for how to request Thyroid U.K.list of private Doctors emailed to you, but within the email a link to download list of recommended thyroid specialist endocrinologists
Ideally choose an endocrinologist to see privately initially and who also does NHS consultations so that might eventually transfer to NHS
Sadly, your results are classed as 'subclinical hypothyroidism' and in general no treatment is offered for this. However, if your TSH is raised on two occasions and you are symptomatic, they should offer you a 6 months trial of levothyroxine to see if your symptoms improve.
How do you feel? Yes, symptoms of peri-menopause and hypothyroidism can overlap, but with a past TSH of over 7 and T4 very low on occasions, it is clear that your thyroid is struggling. At the beginning, there are swings where your high TSH can motivate your thyroid to produce more hormones, which is indicated in your last result, but the free hormones are still low and the TSH is still elevates, which signals that it is asking your thyroid to produce more, which it clearly can not.
There is guidance on the treatment of subclinical hypothyroidism, so if you have another test where your TSH is above the reference range but still below 10, you can ask for a 6 months trial of levothyroxine according to the NICE guidelines:
Consider offering a 6-month trial of LT4 monotherapy in adults less than 65 years of age if:
The TSH level is above the reference range but lower than 10 mU/L and FT4 is within the reference range on 2 separate occasions 3 months apart, and
There are symptoms of hypothyroidism.
If symptoms do not improve after starting LT4 therapy, measure the TSH level and if it remains raised, adjust the dose of LT4. Once the TSH level is stable (2 similar measurements within the reference range 3 months apart), check TSH annually.
We know that measuring TSH alone is not sufficient, but at least this guidance could give you more leverage in accessing treatment.
GP is incorrect to say they can't/ won't treat until TSH is over 10 . Current NHs guidelines ( see below) tell GP's they can consider starting levo when they have 2 over range TSH's taken 3 months apart IF symptoms of hypothyroidism are causing problems , and that they should take your over range TPOab 's into account too.
it very much depends on attitude of the GP you see , but for example this post show someone who was started on levo with 2 TSH's of just over 6 : healthunlocked.com/thyroidu...
they will assume that because your latest (GP) TSH was back within range , you are not worsening / or are improving , so they think they can now forget about your previous higher TSH's and make you wait another year . It's worth letting them know about the more recent MMH results which show TSH as over range again , and ask to have your follow up Test brought forward to 3 mths not a year .... They can't diagnose based on private results , they have to do their own , but ,,,, do point out to them that MMH tests although 'private' are done in an NHS hospital lab (Exeter), so they should take them reasonably seriously.
"1.5 Managing and monitoring subclinical hypothyroidism
Tests for people with confirmed subclinical hypothyroidism
Adults
1.5.1
Consider measuring TPOAbs for adults with TSH levels above the reference range, but do not repeat TPOAbs testing.
Treating subclinical hypothyroidism
1.5.2
When discussing whether or not to start treatment for subclinical hypothyroidism, take into account features that might suggest underlying thyroid disease, such as symptoms of hypothyroidism, previous radioactive iodine treatment or thyroid surgery, or raised levels of thyroid autoantibodies.
Adults
1.5.3
Consider levothyroxine for adults with subclinical hypothyroidism who have a TSH of 10 mlU/litre or higher on 2 separate occasions 3 months apart. Follow the recommendations in section 1.4 on follow-up and monitoring of hypothyroidism.
1.5.4
Consider a 6-month trial of levothyroxine for adults under 65 with subclinical hypothyroidism who have:
a TSH above the reference range but lower than 10 mlU/litre on 2 separate occasions 3 months apart, and
symptoms of hypothyroidism.
If symptoms do not improve after starting levothyroxine, re-measure TSH and if the level remains raised, adjust the dose. If symptoms persist when serum TSH is within the reference range, consider stopping levothyroxine and follow the recommendations on monitoring untreated subclinical hypothyroidism and monitoring after stopping treatment. "
Thank you all so much for your feedback. I greatly appreciate it.
The GP wouldn’t budge on having a blood test done before a year. I want to actively manage my health, so my plan is to get my blood tested privately in three months’ time. Armed with these results and the information you’ve given me, I’ll go back to the doctor. (I did mention the MMH results, but they weren’t interested.)
To be honest, I’m not sure if I’m symptomatic or not because many of my symptoms (joint/muscle pain, thinning hair, tiredness) could be down to perimenopause. I find it bizarre that not a single doctor has run through hypothyroid symptoms with me yet. HRT has definitely helped with brain fog. This thyroid issue was picked up in a blood test for another health reason.
Can I ask, if you start a trial of levothyroxine, does that impair your body’s ability to produce it naturally if you decide to stop it?
if you took levo then stopped , your thyroid should go back to producing however much T4/T3 as it was before . It might take a little while for things to normalise , because TSH may take a few weeks to rise enough to stimulate thyroid to make more T4/T3 again ., so it's possible you'd have some hypo symptoms for a few wks until your own T4/ T3 production rose again , but you might not notice much at all , it depends on how fast your TSH responds to changes in fT4 level, how low it went on levo , how long it stayed that low etc etc , but it should definitely get back to where it was eventually.
( as far as i know , it's not like the adrenal system , where there is concern the adrenal system wont be able to start up again after a period of steroid use)
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