What to ask GP?

[infomaniac]

I was tested last year and found to have high thyroid antibodies (no meds given as TSH was apparently normal) and was told to be re-tested in six months. In September I cut gluten & dairy out of my diet in the hope it might possibly change things but my "main" symptoms: thinning dry hair, mood swings/depression, constipation, brain fog and difficulty losing weight are no better so I'm reluctantly going back to GP on Saturday. I really don't want to take medication but I'm hoping that I may be one of the lucky ones who sail through it with no probs!

Could anyone tell me in plain terms exactly what I should ask doc to test for? I really find it quite hard to get my head round all the Ts (1,2,3& 4!)

Thanks a lot x

[Clarebear]

Hi - the thyroid tests to ask for are TSH, FT3 and FT4, although if TSH is in range they are unlikely to test the other two unfortunately.

It would also be sensible to be tested for iron, ferritin, vitamin D, vitamin B12 and folate. These are commonly low in people with hypothyroidism and can cause similar symptoms. Also as you have thyroid antibodies, this indicates that your troubles are of autoimmune origins and thus you are more likely to be susceptible to other autoimmune condtions such as pernicious anaemia and coeliac.

Good luck xx

[shaws Administrator]

This is part of an article in Pulse and if you want the whole article email [e-mail] to send to your GP before your appointment

Part Answer to question 2.

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.