Hi everyone! - i recently had a full bloodwork panel done privately as i've been feeling quite ill for some time now and suspect that my thyroid is to blame but have no idea on what these results mean..
I have attached a picture of the thyroid results and also below are the results of my antibodies, cortisol, prolactin and iron:
TSH - 4.45 mu/L (range 0.27-4.2)
Free T3 - 4.54 pmol/L (range 3.1-68)
Free T4 - 18.4 pmol/L (range 12-22)
Thyroidglobulin Antibodies: 10.9 IU/mL ( range 0-115 )
If not, this is an out-of-range TSH result - showing that your thyroid IS struggling - but not yet bad enough for you to be prescribed levo (thyroid meds) - particularly as thyroid antibodies are low and free T4 is in range. Generally you will need TSH to get much worse (and potentially to feel quite seriously ill) - often as high as 10 to be treated, which rather makes a mockery of having a lab range which is less than half that and already far higher than a person with no thyroid issues would reach, and given that in some countries you would be helped once TSH was more than 3 ...
I am currently not on any thyroid medication but i am experiencing symtomps that seem to be thyroid related such as constant low body temp / feeling cold, anxiety, irritability, hands and feet are cold all the time, joint and muscle aches, working memory is very poor and also fatigue.
I also wanted to add that i have levo on hand and was wondering if i could a dosage of 25mg T4 for 6-8 weeks to lower the TSH and increase T4 -> increase T3? do you think i could possibly be subclinical as i am experiecing symptoms?
Yes, you are "subclinical" - because TSH is MUCH higher than it should be. But taking a teeny-tiny dose of levo is likely to make things worse, because levo replaces the hormone your thyroid makes rather than supplements it.
On the basis of your weight - 71 kg and 1.6 mcg of levo per kilo - you are likely to need an initial dose of between 100mcg and 125 mcg once you do start to be treated.
I'd go to the GP and explain that you have lots of hypo symptoms, and an out-of-range TSH and ask at what point you will get treated. As an otherwise presumably healthy, young man they may look on you more kindly than most of us, who are generally told we're menopausal/peri-menopausal/hormonal and/or depressed!
Interesting... so according to what you are saying my dosage would be somewhere between 100-125mcg Levo, correct? would it be wise to start on a 50mcg dose rather than 25mg and slowely increase dosage? or just go full replacement dosage from the get go?
25 mcg is usually for the very old, very young or very frail
Current NICE guidelines are for initial doing to be by weight rather than to build up slowly from the "traditional" 50 mcg starter dose - but a GP is unlikely to do that until you have, at an absolute minimum, had 2 out-of-range TSH results.
And it's worth remembering that your actual thyroid hormones are around half-way through range, so these aren't a total disaster ...
Before the tests? no i just ate brazil nuts for selenium, ate fish and took magnesium, vitamin d + K aswell as zinc ocassionaly.. that's about it. Regarding the multi vitamin it is called Male multiple by Solgar
If you are want to do an iodine test then a non-loading urine test is said to be the best test. Genova Diagnostics offer this test.
Urine Iodine Test:
Specimen requirements: Urine
Cost: £71.00Order Code: END25
Turnaround time: 5 - 10 days
Iodine is an essential trace element, vital for healthy thyroid function. Adequate levels are required to enable the production of T3 and T4 thyroid hormones, whilst also being required in other areas of health. Deficiencies can lead to impaired heat and energy production, mental function and slow metabolism. Urine iodine is one of the best measures of iodine status. This test is not performed as a loading test, but can be used to establish existing levels or to monitor iodine supplementation.
I do eat alot of eggs and dairy alongside meat and ocassionaly fish... do you think i don't need to supplement with iodine then? and no i haven't tested my iodine levels yet..
Hi. Your cortisol level is over range, which is to be expected when the thyroid is struggling. The adrenals take over to compensate. Do keep an eye on that.
These are the NICE guidelines that your doctor should be following:
1.5.4 says that if you have 2 tests, 3 months apart with TSH over range, but under 10, you have sub-clinical hypothyroidism. You should be given a 6-month trial of levothyroxine and if you feel well on it, you should be allowed to carry on taking it.
1.3.6 and 1.3.7 say
Over 65s and people with heart disease should be started on a low dose and titrated up (test every 6-8 weeks and increase each time until the patient is on a full therapeutic dose).
Everyone else should be started on a full therapeutic dose calculated by body weight (1.6 mcg per kg)
This equates to eg 100mcg for somebody who is 60kg.
If your next test shows TSH is still over range, ask your doctor for a trial of levo. You can show them the NICE guidelines if they’re awkward about it.
Hi Maggie! thank you for the reply i was wondering if i manage to get my Thyroid back to Optimal/Healthy levels, do you think my cortisol would come back lower? and also let's say my doctor allows me to trial levo, as an otherwise healthy individual, would i start on a lower dose of 50mg and slowely increase or start right at therapeutic dosage for the get go???
The cortisol should come down when you’re on treatment, but may take a while. The longer you’re underactive, the more complicated it can get.
If you’re under 65, and healthy, you should be started on a full therapeutic dose according to the guidelines. There has been good feedback from people who have been started that way.
The lower starter dose is usually for older people or those with heart disease to ensure that they’re not over stimulated.
That's interesting, i read a little bit about the Thyroid/Adrenal connection but found it hard to understand some of it but do you think if i can get my thyroid optimal that the cortisol levels will even out to a more healthier level?
Hi. Your prolactin is above the range. This can be a sign of under active thyroid. As it affects your sexual function, if you emphasise this at your next appointment, it may help to get the doctor to take some action.
I went to my doc last week and told him that i need to get my thyroid looked at due to my blood results and also cortisol/prolactin so he told me i am going to do bloods for that aswell as a night saliva test for cortisol
Next appointment is on Thursday, so heres to hoping!
Yes, very enlightened doing a cortisol saliva test, which means free cortisol is being tested not free and bound. Although one cortisol reading doesn’t show the whole picture - 4 to 6 samples morning to night can give you a profile of your levels, or a stress test through the endocrinologist if they think there’s a problem and you’ve got symptoms of over/under production. If you do get prescribed thyroxine replacement though, it’s likely to lower your available cortisol as it increases your cortisol clearance rate. Cortisol is a dynamic thing and complicated to assess - if you were stressed at the time you were tested, or had been exercising, consumed caffeine, just eaten, had an infection, they can all raise your levels. Hope you get some answers.
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