Tsh rising Gp says menopause

[richard123]

Dear all

Can anyone advise tpo 650 range 0-49

Tsh 3.79 range 0.5- 4

My Gp says my symptoms are more Likley to be

Menopause I'm 39!! I was scanned due to heavy periods

And found to have adenomyoma, I gave read this cam be due

To hypothyroid she says will refer me to endo to ask if he would give

Trial treatment? She said she can't break rules!

I have dry hair/skin, irregular heavy periods, fatigue, puffy eyelids

Itchy dry skin, puffy legs.. She says more like menopause dispute

Labs.. Any advice please..

Thank you and happy Christmas x

[Jackie]

Ridiculous! it is obvious that what ever else you need a referral. Also TSH, T4 and Free T3 tests urgently. There are lots of useful tests the endo should do but make sure you have ferritin as it sounds to me as if you could be very deficient in iron. Before asking for a referral , make sure who you want to see ,that they are very good and listen. Do not rely on GP`s choice. I do quite well with consultants looking at a top hospital , the CV`s of consultants I want . Then if possible ask other people. Some people do confuse Nice with good so be wary of that!

Good luck

Jackie

[BillieSt in reply to Jackie]

on the other hand, it could well be the menopause. Surely best to have blood tests which could show, although I recall having an excellent GP who took clinical symptoms into account when I went through it. TSH given is within normal range, periods and dry skin are menopause symptoms and there are a lot of similarities between menopause symptoms and thyroid. Why would anyone wish thyroid problems on themselves? Being hyperthyroid,l wouldn't wish it on my worst enemy!

[greygoose in reply to BillieSt]

A truly 'normal' TSH is around 1.25. 3.79 is way too high in the real world!

I didn't see anywhere where she said she wished thyroid problems on herself, she just wishes to feel well. She has high antibodies, that would suggest a thyroid problem, no? Never heard that you have high antibodies due to the menopause.

What she needs are FT4 and FT3 tests, but even those can't completely rule out a thyroid problem. Especially if she has symptoms of low thyroid. Which she has.

If it looks like duck and it quacks like a duck...

[richard123 in reply to greygoose]

Thanks for replying and understanding.

Merry Christmas..

[Clarebear]

My doctor wondered if it was the menopause and tested FSH which came back fine - I think this is the test for the menopause. I have never heard of the menopause raising TSH x

[shaws]

Many women have menstrual problems which are due to the thyroid gland problems and sometimes have unnecessary ops because of the reliance on the TSH.

If you have hashimoto's due to high antibodies you should be given levothyroxine. This is a link

ehow.com/about_5212448_high...

This is an extract from Dr Toft's article in Pulse.

2 I often see patients who have an elevated TSH but normal T4. How should I be managing them?

The combination of a normal serum T4 and raised serum TSH is known as subclinical hypothyroidism. If measured, serum T3 will also be normal. Repeat the thyroid function tests in two or three months in case the abnormality represents a resolving thyroiditis.2

But if it persists then antibodies to thyroid peroxidase should be measured. If these are positive – indicative of underlying autoimmune thyroid disease – the patient should be considered to have the mildest form of hypothyroidism.

In the absence of symptoms some would simply recommend annual thyroid function tests until serum TSH is over 10mU/l or symptoms such as tiredness and weight gain develop. But a more pragmatic approach is to recognise that the thyroid failure is likely to become worse and try to nip things in the bud rather than risk loss to follow-up.

Treatment should be started with levothyroxine in a dose sufficient to restore serum TSH to the lower part of its reference range. Levothyroxine in a dose of 75-100µg daily will usually be enough.

If there are no thyroid peroxidase antibodies, levothyroxine should not be started unless

serum TSH is consistently greater than 10mU/l. A serum TSH of less than 10mU/l in the absence of antithyroid peroxidase antibodies may simply be that patient’s normal TSH concentration.

[nobodysdriving in reply to shaws]

this is good shaws, it is also 'not so good'

I had a TSH of 4.27 at diagnosis, so according to him it was my 'normal TSH concentration'?

yeah right LOL (last paragraph)

[shaws in reply to nobodysdriving]

You are right - the fact that Dr T says that if no antibodies wait till TSH of 10 beggars belief. Can we have specialists who have thyroid problems and do not do well on t4.

[Clarebear in reply to shaws]

I don't have raised thryoid antibodies and my endo didn't want to start me on thyroxine even though TSH was 18.0 as FT3 and FT4 were just scraping along in the normal range

He said that my TSH was high due to "heterophile antibodies" (something to do with mice??) and that there was nothing wrong with my thyroid. Of course this turned out not to be the case and it was my thyroid after all. It totally screwed me up at the time though

[nobodysdriving]

even thought the TSH is in 'normal range' it is NOT normal, it is quite raised.

Also we have to notice something here: she has quite high antibodies! that is 'not' the menopause at all!

High TPO antibodies with that raised TSH points to Hashimotos.

thyroid.about.com/b/2011/04...

was your blood taken as early as possible in the morning? TSH is highest at 2am and then starts to fall, with the lowest in the evening (so afternoon blood test will show lower TSH).

Also with hashimotos you can get a 'wildly swinging' TSH, take your blood tomorrow and your TSH could 50!

I'd put my foot down and ask for further tests and an endo referral but don't accept to be referred to the endo your GP sends you to, do your 'homework' first and ask around which endo will be likely to pay attention and treat you with a TSH in range and high antibodies.

There is plenty of evidence that treatment is warranted to those with an 'in range TSH' and high antibodies if symptomatic (and you are)

Menopause LOL AH! yeah maybe 'one day' but right now that is not the priority

[richard123 in reply to nobodysdriving]

Thank you for your reply, my thoughts exactly

She is referring me to endo only because I insisted.

Thanks again and happy Christmas.

[GuardianAngel]

A quick blood test will tell you and the doctor if its menopause related then you can proceed from there. all the best Karen

[GettingThere]

Hi, both situations could be correct. I was diagnosed with a thyroid problem, heavy periods didn't get better, dry skin did not improve, then I was diagnosed as menopausal aswell!! Took HRT hugely better. Could be both! I was about 32 when the thyroid condition started to surface and about 36 when menopausal symptons started. I am no expert on thyroid conditions, my doctor seems to manage my treatments quite well, but could I suggest a simple blood test for the menopause and a referal to an endo, kill two birds with one stone.

Wishing you all a happy christmas.