OK - here's the next blog -
Part 1 - Symptoms vs Tests
This will sound all too familiar for some, for others stay with it...
...by the time I'm done I'll have covered thyroid imbalances, adrenals, gut issues, oestrogen, cortisol & DHEA, anti-thyroid Abs, pernicious anemia, Addison's disease.
And how to retain a sense of humour when you get angry...
Background - Symptoms & Diagnosis
August 2002, USA. I was diagnosed with thyroid issues. I had just had my first child.
I had terrible aches in my joints - I couldn't straighten fingers or walk when I woke up until it wore off. When tested TSH indicated I was hyperthyroid (so that's where the baby weight went...) but I had TPO-Abs so the endo waited for my thyroid to crash. It did within 6 weeks. I don't have test results from this time - I went back to work 5 days after giving birth. My mind was on my daughter, not on my health. Being told I had to take thyroxine for ever knocked me sideways - I'd always been super-healthy, but hey - that's life, right?
By September 2004. Everything had stabilised I was on 150mcg thyroxine.
fT4 = 17.0 (12-22)
TSH = 0.4 (0.2-4.0)
fT3 = 4.2 (2.8-6.0)
Anti TPO Abs were ~700 (ref range >60).
I still felt rubbish - extreme fatigue.
November 2004, Australia. My new Aussie GP listened to my symptoms and tested me for 'thyrogastric cluster' Abs and referred me to a gastroenterologist who checked for Crohns (another disease in the cluster). I was clear of Crohns.
Blood tests came back positive for gastric anti-parietal cell Abs. These can lead to pernicious anemia.
My ferritin stores were down at 68. I took a liquid iron supplement.
My B12 was low. I got B12 shots.
From 2004-2007, based on symptoms, my Aussie GP dropped my dose 25mcgs twice to 100mcg. According to the BTA I was now taking the 'standard' amount. I was still exhausted but I had two small children and a full time job - who wouldn't be?
November 2012, UK. After 4 years on 100mcg thyroxine - taking it religiously first thing in the morning - my symptoms were unrelenting - exhaustion, puffiness, stubborn midriff weight that wouldn't budge, depression, wild mood swings, disturbed sleep. I didn't know myself any more.
My UK GP patted me on the head, suggested menopause (haha) and told me to take sleeping pills to 'break my disturbed sleep cycle'. This was the 4th consultation where I'd raised my symptoms. He assured me the test results indicated I was well-managed.
NOTE: under NHS guidelines (on their site the Map of Medicine) he should have referred me to an endocrinologist as I was still symptomatic on thyroxine.
Thoroughly unconvinced, I didn't take the sleeping pills.
Instead - desperate for answers - I did a finger prick test at home - fT4 and TSH (£23.00).
I knew I'd be in range but wanted a base-line.
fT4 = 19.8 mmol/l (ref range 10-22)
TSH 0.26 (range 0.24-4.0).
But I felt horrid.
Intuitively more than anything else - I wondered about these results - at opposite ends of the ranges. If we're hypothyroid on thyroxine we're told to aim for this. So why did I feel ill?
I wondered what would happen if I reduced my dose or stopped taking it at all.
I did an autoimmune panel to see where my Abs were at
anti-TPO Abs = 347 >60 (autoimmune thyroiditis)
anti-TG Abs = negative
anti parietal cell Abs = positive (pernicious anaemia)
Around this time I was programming symptom checkers for a health business.
I filled out
- the hypothyroid checklist and was clearly symptomatic.
- the pernicious anaemia checklist - I was OK
(I have an iron infusion ~ 18monthly and B12 shots 3 monthly).
BUT when
- the oestrogen dominance checker I was symptomatic across the board and
- the adrenal fatigue checker I was symptomatic across the board.
Most notably recurrent waking 2-4am plus an almost total overlap in hypothyroid/hypoadrenal symptoms.
I'll deal with the oestrogen dominance later. It was the first thing I solved. It took 10 days to eliminate the wild mood swings from the picture all together (and save my marriage).
Adrenals
I dug deeper. I did the Holmes and Rahe Stress Test (I'll cover this in a later blog).
I failed it badly. I read Dr Peatfield's book and started tracking my basal temperature as a cross-check. I was horrified to find it lurked around 35oC all day and sometimes ventured lower. According to the NHS at this point you have hypothermia! (helpful - not).
I knew my thyroid was playing up but wasn't sure what was REALLY wrong and more importantly WHY.
I got more tests and a new treatment plan. My doctor wasn't interested so I sought the help of a Functional Practitioner.
Throughout the process I've done a variety of tests (thyroid panel, Abs, adrenals, CDSA, B12/iron/folate - urine, serum and spit) but have tracked TSH, fT4 + basal body temperature throughout. I will share all the results in the next blog (I'm compiling so they make sense).
Most importantly I've gone on how I FEEL, knowing T4 has an 8 day half life and things take time to settle - although, in my experience, change can happen quickly.
Summary so far is
Adrenals are in recovery
Thyroxine dose has halved once and is going to be halved again
No fatigue, no random pain, no digestive issues, sleeping properly through the night.
Feel human.
See the next blog for what I found out.
Some tests are great, some are questionable and some are crucial.
Please note - this is a work in progress but now I go on SYMPTOMS.
We all know our own bodies although they can surprise us in unpleasant ways.
I'll explain when and how my symptoms began to resolve. And there's another missing piece of the puzzle I stumbled across - my symptoms didn't only reflect thyroid and adrenal problems. When things have gone as awry for that long other things drift out of balance.
well done Skyfall. 
struck off or nearly struck off)). They're generally trained in nutrition but can specialise in particular areas like endocrinology - functional endocrinologists.
Thyroid with normal tests?
Hashimoto - how to bring persistently high Anti-TPO level down?
Thyroid Symptoms with normal blood tests
how my appointment went -with results 
test results (part 1), any help would be appreciated.
