Menopause Matters Forum
Menopause Discussion => All things menopause => Topic started by: Sid on July 28, 2022, 02:34:06 PM
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Hi
I am post menopausal and on 2 pumps of Oestrogel and have a Mirena, but I have been getting badly fatigued, am always cold, have a low body temperature and have put on weight. My GP reluctantly agreed to test my thyroid, but because the TSH came back at 4.15 (within range) the lab did not do T4. I am wondering whether to arrange a test privately through Medichecks but wasn’t sure how easy it was to get enough blood using the equipment they provide. I can see that you can pay extra to have a nurse do it, and wondered if this was necessary. Has anyone else managed to do it at home and was it tricky? Or maybe I shouldn’t worry unduly about a TSH of 4.15 (my GP isn’t, but then he doesn’t have to go to bed every afternoon due to exhaustion!). Thanks for your help, ladies
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Hi. I have used medichecks for 7 years. Blood prick tests are easy to do and I’m not great with that sort of thing normally. I find them accurate as well, finger pricks for other hormones aren’t necessarily but for thyroid it is and my symptoms always correspond with the blood test results.
Your TSH, although not a good diagnostic tool, is actually too high and itself indicates hypothyroidism. The NHS I’m afraid is hopeless with thyroid care too, very outdated and also limited in medication choices. I would not advise using NHS for thyroid care personally. If it is possible, at the moment in the uk private care is far superior in this area and the NHS is not treating thyroid issues appropriately.
You want a full thyroid hormone panel that checks everything, Medi has a comprehensive one for around £80-100. They have an extra one that tests some vitamins and minerals along with hormones. That’s good to check vit D, B12 and others that are massively affected if you have a thyroid issue due to absorption issues. Once you have results you can post them in this thread, I’m good at reading them and can help you understand your situation if you like. Being in range for any hormone isn’t the only thing to look at, there are optimal levels for all of them. A normal TSH is actually 1. Your Free T3 should be in the upper quarter of the range and free T4 midway or above. I feel best when it’s exactly midway with my T3 just in the upper quarter but no higher. It’s taken years for me to understand this about myself and what dosage gets me there.
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Thanks, ATB. That’s hugely helpful. I’ll book a test :)
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You’re very welcome. Someone online helped me when I first started on this journey too :)
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I've done a Medichecks test for ferritin and it was definitely okay to get the required amount of blood out although I was slightly intimidated by the idea at first and the size of the test tube ;D
With the thyroid test, the first time I had my bloods run they just did TSH as it was within normal range - but the second time I explicitly asked my GP for free T4 and she said she would write that request on the form but couldn't be sure the lab would do it, if TSH was normal. Well - they did do it (even though TSH was normal), because she requested it. So you could try your doctor again and ask them to at least request it from the lab...
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Doing just TSH and T4 won’t be any good joziel. It has to be the full thyroid panel which the nhs don’t do. :-\
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I think the only thing I'm missing now is the T3?
I did ask the GP about it and they said it would be incredibly unlikely for my TSH and T4 to be solidly normal and for there to be anything amiss with my thyroid. But I know by now that doctors should not be taken at face value ;D ;D
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As a matter of interest Joziel, if you don’t mind sharing, what were your TSH and free T4 results? x
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My TSH was 0.95mU/l and my 'free thyroxine', which I think is free T4, was 15.5pmol/l.
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Thanks for sharing Joziel.
TSH is good, do you have the ranges for the free T4 in the test you took?
Nether the less, you might need too still do the full panel to see if you are converting to free T3.
I’m not saying this is happening with you but it gives you a fuller picture of your thyroid function.
ATB- I believe vim right in what I’m saying, but correct me if I’m wrong!
X
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The range was 10.0 to 25.0 (I was 15.5).
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Sounds ok, hopefully ATB will confirm. But you don’t know your free T3 without the full panel.
I really don’t know how important it is for you to check it out right now though, as only been on a thyroid journey this year so not experienced enough to offer more advice. But the consensus seems to be that you need the full thyroid panel to completely rule out any issues x
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Yeah you actually can have ok free T4 but free T3 not at optimal, it isn’t as common but you can. A full panel will also include reverse T3 & antibodies, which are important as well. Your free T4 is not quite halfway on the range, which it should be, so it would be a good idea for you to get a full panel Joziel. Being ‘in range’ doesn’t mean much, there are optimal places to be and based on that range you would want a Free T4 at least at 17.5. Even being a little low can indicate an issue. It isn’t glaringly obvious you are hypothyroid but you may want to double check.
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Hi Sid, hope you don't mind me posting on your thread, ATB kindly offered to comment on my results. I got tests through my GP. TSH: 2.1, it was 2.4 last year, and previously 1.9, T4 :16.7. also antibody positive. According to my GP that's normal.
I would be grateful for comments ATB if you can, or anyone? :)
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Hey Stella, if your thyroid antibodies are above range, you have hashimoto’s hypothyroidism. I’m not used to seeing ‘ antibody positive’ so not sure what that means? The tests you need are ‘free’ T4, not total T4, and Free T3- that’s the active thyroid hormone, our body is meant to convert some of the free T4 to Free T3 for us to use ( Some people can’t convert, so they need to be given T3 along with T4 ). I can’t tell you much just with a total T4 result, I would need the free T3 & T4, plus the ranges which appear in brackets after the result. Where your result is on that range is the important part. NHS doesn’t routinely test the things I mention though, they tend to do TSH ( just a messenger and not a real hormone ) and total T4, sometimes.
For anyone that would like to learn more about interpreting lab results this link is a good start point to begin to understand. I have found over the years of reading hundreds of results that women are still individual and will have a point within the optimal parts of the range that suits them best. I’m a bit too anxious for instance, if I let my free T4 go more than midway, with the free T3 at the lower part of the upper quarter too is best for me.
https://stopthethyroidmadness.com/lab-values/
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Thank you ATB.
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YEs thanks, I find the whole thyroid thing incredibly complicated.
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I do too and I’ve done a tonne of research and run a support group! This is why it’s so hard to get good care, doctors also find it too hard!! I know more than my GP!
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I looked again and it is free T4 level 16.7 and it's within the range (9-19). It states that the test was for T3&T4 but only specifies result for T4. Serum TSH is 2.1 within the range (0.35+4.94). Antibodies are above the range but the GP said that, because the hormones are within the range, nothing should be done about it. Does this make sense? :o
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Hi Stella. Yes your free T4 is just above the halfway on the range, so doesn’t indicate hypothyroidism but knowing the Free T3 is important in itself but also because the relationship between the two tells us something too. With high antibodies but within optimal range numbers you don’t need to medicate but you do need to test regularly, that’s my understanding. Symptoms are also important though. You could also take your daily morning body temperature and monitor that as consistently low body temp usually indicates a hypothyroid state.
https://stopthethyroidmadness.com/hashimotos/
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Hi Stella
There are some supplements that can help reduce thyroid antibodies, namely vitamin D, zinc and selenium.
Have a Google.
Don’t go too high with the selenium though 100mcg to start and then increase to 200mcg.
X
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With the selenium, you can just eat 3 brazil nuts a day. That's apparently the same as taking a selenium supplement only it tastes better and is probably better absorbed ;D
So, someone tell me, if we want to test all these thyroid things properly and fully and we can't do that via our regular GP, how do we do it? I can't see any way we can reliably do it ourselves? Is it a Medicheck thing?? The saliva tests don't seem to be accurate going by what I read...
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The selenium in Brazil nuts is highly variable depending on many factors, in fact it is not unknown for just one to have a high 400mcg.
So advice is to not overdo them.
Yes it would be a Medichecks blood test, full thyroid panel.
You cannot test thyroid function by saliva. X
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Oh that's pretty simple then. Can the Medichecks test be the finger prick one? It doesn't need to be venous?
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This is the minimum you want, as it covers all necessary thyroid tests
https://medichecks.com/products/thyroid-function-antibodies-blood-test
They also have an advanced one that includes other things like vitamins, iron and inflammation status, this can be finger prick but they include folate and that one thing in the bundle is not as reliable if done by finger prick so they have a blood draw option too.
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Great thanks!!
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Thank you ATB and all for your comments! :)
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You’re very welcome :) Feel free to message me as well x
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ATB, I did a bit of reading of the links you gave and it seems that low iron can either cause similar issues to thyroid issues or be involved with the thyroid issues.
My ferritin is a bit low at 43ug/l. But it is within the normal range. Can low ferritin which is still within what they consider to be normal, still cause symptoms?
I've been taking Spatone every day but I don't know if it's strong enough to be making much of a difference... I have some other gentle iron tablets to take.
Edited to add, gawd, I think I need to fix my iron levels. I read this (whilst jiggling my restless leg up and down): https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5986027/
" If symptoms are in accordance with iron deficiency, the patient should be considered iron deficient at least up to a serum ferritin concentration of 100 μg/L, "
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Yeah, I’ve had long-standing ferritin issues since hypothyroidism( not other iron tests which are fine ). Yes, low ferritin, hypothyroidism and menopause all have similar symptoms although over time I’ve developed a way of identifying the differences for me. It is also true that hypothyroidism, untreated or poorly managed, can be the cause of low ferritin due to an issue with something else that I’ve forgotten the name of right now, that may affect the ability to store iron. Even when I had iron infusions I didn’t get my ferritin up much because my thyroid condition wasn’t treated.
In my opinion, based on studies I’ve read and some experts explaining, I don’t think our ferritin needs to be that high at all. There is always, always, conflicting info on this kind of thing, and when I look at studies I try and look at the study design and compare with other studies to figure out what makes sense to me. After years of stressing about my ferritin, after discussing it with the various specialists I’ve seen, I’m happy if I’m between 30-60. I don’t want to be higher than that, lower and I get symptoms. I’ve tried everything anyway and I cannot get it higher than 45 and now I don’t want to. My husband has same diet and lifestyle and his is 110, which actually concerns me and I’m keeping an eye on that.
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Oh my gawd it's so complicated ;D
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Yes! I spent years reading reading reading. I had done a couple of courses before that in nutrition and sports which helped me, and in my 20’s I studied anatomy and physiology as part of a larger course so I have a bit of a foundation but it’s still hard and there’s still a LOT we don’t know.
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