Do I have hypothyroidism?

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I went to my gp recently as ive been struggling with fatigue, weight gain despite exercise, brain fog, sheer exhaustion, tingly fingers sometimes and anxiety. Every day I feel awful and I can no longer workout because if I do I feel terrible fatigue and pain for 3 days afterwards. My gp wanted to check my thyroid and b12 as he suspected both weren't right.

I've had low ferritin for 10 years, I struggle taking iron tablets so intake spatone supplement which is gentler. I put my tiredness down to the low ferritin but it's been lower in the past and I've not felt this tired.

I rang for my results and was told all normal by the receptionist. I didn't trust this so asked for a copy of my results. The are as follows

Serum TSH 5.33 mu/L ( 0.35-5.50)

Serum Free T4 - 11.0 pmol/L (7.0-17.0)

B12 - 212 ng/L ( 150-900)

Intermediate level. Consider treatment if evidence of deficiency.

Serum Folate 23.20

Serum Folate 15 ug/L (15-300)

I am speaking to my gp next week to discuss this I worry challenging him as he's marked all as normal but are they? I am in the UK.

Thank you

Ju

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16 Replies

  • Posted

    It looks like test results are neither one of the other, but is it possible that "Consider treatment if evidence of deficiency" that symptoms you have might also be taken into account. Of course it might be different had they done the FT3 which labs are refusing to do. The fact too that the TSH is at the very top of normal means it is struggling to keep the FT4 down. My GP's description would be that the TSH rises like a whip to make the donkey being the FT4/thyroid work.

    When I was first diagnosed they simply kept an eye on the tests before prescribing Levrothyroxine, but if that does not help you could face problems as they won't prescribe T3 or NDT.

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  • Posted

    I would have thought Tha your TSH level was definitely high. Many authorities say that 2-2.5 is where one feels best unless like me you have slightly suppressed TSH because you are having T3 as well as T4 . I had that level of TSH when I started on 25mcgms of Thyroxine almost 20 years ago and it was increased pretty rapidly after that. Your other symptoms, tingling and weight gain and low energy could also be accounted for by the underactive thyroid. I had what I thought was carpel tunnel syndrome until I was treated and I have never suffered from it since. I obviously am not a doctor but it would seem reasonable to ask your GP for a trial low dose of Thyroxine. You are only just in the normal range
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  • Posted

    I agree with both of the above replies. Many of your results are towards the boundary of normal. Low ferritin often goes together with hypothyroidism (underactive thyroid) - it needs to be at least 70, some say 90, for you to be able to process the thyroxine your body is making.

    Did you mean to write 'serum folate' twice, or was one of them intended to be something else?

    It might make it feel less daunting if, instead of thinking of it as 'challenging your GP', you think of it as: 'working with them and giving them the information they need to make you better'. This isn't meant to sound patronising, it's just that I've found that if I go into a situation in a collaborative frame of mind, I often get a better response from the person I'm talking to. Though I have to admit, that with some people, nothing works! In which case try another GP in the same practice.

    There are a number of iron supplements from which your doctor can choose - have you fed back to them that you don't tolerate the ones you were prescribed? A couple of other ideas are: check your vit D and selenium levels; take a list of your symptoms and ask if the results are normal why do I feel so bad? What else can be wrong?

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  • Posted

    Thank you all for your replies.

    Yes sorry I meant to type serum ferritin, not folate twice. My ferritin is 15.

    I have had iron that's made me feel unwell and my gp is aware and that's why I am on spatone instead.

    I shall speak to my gp tomorrow and ask about a retest and treating the low b12 and ferritin for now and see if he agrees to retest the thyroid. I am just concerned he will dismiss my thyroid is tsh is high

    Thanks again.

    Ju

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    • Posted

      Your concern re TSH is unfounded. High TSH indicates hypothyroidism. The process is: Your pituitary gland produces Thyroid Stimulating Hormone (TSH) when your body needs more thyroxine (aka T4). Your thyroid produces T4 which your body converts into T3

      for energy and to metabolise food. So, what this means is, if TSH is high your body is asking for more T4. If T4 is low your thyroid isn't producing enough of it. If T4 is ok but T3 is low your body isn't converting T4 to T3 properly. A ferritin level of 15 is too low for your thyroid to function correctly.

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    • Posted

      Thank you.

      Yes my ferritin is far too low. If I get this level up does this mean my thyroid will work normally? It's not true hypothyroidism?

      I'm speaking to my gp in a couple of hours and I am nervous.

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    • Posted

      All the best. If he won't listen, the moment you get out of his door, go to reception and make an appointment to see a different doctor.
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  • Posted

    NICE guidelines for the treatment of thyroid disease endorses a 'trial period' of levothyroxine to see if symptoms improve even if the blood results are in the so called 'normal' range (of course there is no such thing as a 'normal range', because we are all different and those ranges differ, depending on where you live. It makes the rigid adherence to lab ranges a ridiculuous charade). 
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  • Posted

    I spoke to my GP.

    He said my ferritin was in my boots so I am on ferrous gluconate 300mg once a day.

    My B12 he just said 'that's normal, no need to treat it'. I tried to question him but he wasn't budging.

    My thyroid, he agreed my TSH at 5.33 was high end of normal so borderline result. He said that is likely to flip over to the other side then we can treat it, he said he wants to do a blood test again in 6 months. 6 months??!!! He said 'there is no point checking it every 2 minutes'. Not that I asked him too. He said 'with hypothyroidism being through your mums side you will probably end up with the same and need thyroxine but I can't give you thyroxine until you got over the 5.5'. I asked would I be symptomatic at my result and he said 'probably not'. I told him how unwell I feel and how bad the fatigue was but he just dismissed it was being my ferritin and nothing to do with my thyroid.

    I will leave this 6 weeks then I will see my GP for a chat and ask for my bloods done be redone maybe beginning of November, that way it's been about 10 weeks. I cannot carry on feeling like this if it is my ferritin.

    In the meantime I will take my iron for my ferritin. Should I be taking something for b12? as I know 212 is a low result. I take a multivitamin from Biocare and that contains 30ug of b12. I have been taking that for a while now.

    So I now feel silly, as though I have imagined how ill I feel, he probably thought oh it's Julie the worrier, as I have anxiety on my notes. He didn't seem to take how I felt seriously and just said it would be my ferritin. I didn't feel there was much else I could say as he said it can't be my thyroid at 5.33.

    Thank you all for your help.

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    • Posted

      Not surprised you are anxious when you are feeling so rubbish. Find a doctor who will treat your symptoms and treat you with sympathy. Mention the NICe guidelines to them and go with a friend.
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    • Posted

      Hi jingyd, it's your GP's appalling bedside manner that is at fault - you are not being silly. You did really well and got what you needed out of him despite his dismissive attitude. I personally would see a different GP next time. You don't have to see your named GP, you can see any GP in the practice. Try them all until you find one that will treat you with rrespect and include your symptoms as part of his analysis, not just the blood tests. Take heart from the fact that it is the better GPs who do so - and they don't feel threatened when their patients ask questions! So, back to the question in hand: is this all down to ferritin? I'm not medically qualified, I've just been on the receiving end of this stuff as a hypothyroid patient for 34 years, however... yes a large part of it will be the low ferritin and its good that you have been prescribed iron tablets. Guven your GP's approach, I very much doubt he gaveyou any hints on the best way to take iron tablets to minimise the side effects. It's worth asking your pharmacist. What I've learnt from being on ferrous sulphate (aka another type of iron tablet)for many years, is: taje them with food, with a whole glass of water. Avoid milk for 2 (4?) hours either before or sfter taking them as it impairs the absorption of iron; vitamin C helps the absorption. Drink lots of water to stave off the constopation 6-8 glasses a day. A handful of dried apricots are good.
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    • Posted

      I don't personally think the ferritin is the only thing wrong. I'm more concerned about your TSH level than your B12. Personally given your symptoms I think there would have been value in giving you a trial dose of thyroxine, particularly in light of your family history (Mum with thyroid disease) - as scazzoh says, this is all part of the NICE guidelines that GPs have to follow. Your GP is being selective about which ones he follows!

      It's worth making an appointment to see a different doctor in two weeks time. (At my surgery we have to book at least 2 weeks in advance unless its something that you need to be seen that day for. (You might have picked up the odd hint that I don't rate your GP at all). I'll PM you some good sites to look at. This will help you become more knowledgeable and increase your confidence when talking to your GP. A couple of things to watch out for: GPs ate supposed to check afrenal glands before starting you on thyroxine, but rarely do. Also you could do with a whole load of vitamins and minerals checking, as deficiencies often occur when the thyroid is struggling. Well done! You got as much out of your GP as anyone could have done.

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    • Posted

      Thank you Barbara for your advice. I shall be taking note of those tips.

      I shall be going back to my GP, he is lovely and very helpful. I know he will agree to a retest and I know he will agree to test antibodies. THe last 2 GPs I have had to deal with aren't so good. The GP that called me I don't have faith in and the one who sent me for the tests is a GP i used to see and he is nice but I prefer the younger GP that joined a few years ago and he has been brilliant through my anxiety and medication process.  I shall be going to speak to him in a few weeks with my husband.

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    • Posted

      Thank you Barbara,

      I did what I could, he wasn't very helpful at all over the phone. Everything I said I had read he just slammed down as wrong and wouldn't take me on.

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