Any thyroid experts around? TSH of 7.51

[Sleepybunny21]

I recently had a blood test for a whole raft of symptoms, and it has come back that my TSH is slightly high. I just wanted to get some opinions from other underactive thyroid sufferers before I speak to the Gp on Tuesday so that I don't get fobbed off. My results and the ref ranges are

TSH 7.51 (0.34 - 5.60mu/l)
FREE T4 9.5 (7.9 - 20 pmol/l)
Serum B12 266 (120-625ng/l)
Serum foliate 6.6ug/l
Serum ferritin 28 (11-307ug/l)

I was tested for thyroid a year or so ago, a and my TSH was 3.6, so it has increased a lot. Should I be pushing the GP to treat this level? Do they generally treat if its only a little underactive as I seem to be?

I'm no expert, but I would be pushing for your thyroid antibodies to be tested to check for Hashimoto's. That TSH is very high and I would feel dreadful with that! I would be pushing for treatment or a referral to an endocrinologist.
Also your ferritin is quite low so I would look at increasing that.

Definitely push for treatment of your thyroid issue. At the same time, you need to get treatment for your low iron stores (ferritin), which needs to be mid-range, your folate, which at less than 7 is officially deficient, and your B12, which needs to be at least 500 and is currently only over the cut off point of 200. It's very common to find vitamin and mineral deficiencies with thyroid disease, especially if it's been building up for some time and it's all fixable, although you may need to be persistent.

Lots of good advice on the ThyroidUK forum on the Health Unlocked site.

Would over the counter supplements for iron / B12 / Folates be effective, or is it something the Gp should be prescribing?

Don't take anything till you've spoken to the Gp re folate and b12 .

They may not see the ferritin as an issue so you could start some iron. I'd hope they will but at the same time the iron they prescribe can upset your tummy. I Have found spatone and diet helpful in the past but everyone is different.

Technically your tsh number is subclinical and I believe the Nice guidance says you can trial low dose thyroxine if you have symptoms.

Always get tests done in the morning, as early as you can consistently manage.

Stop taking any vitamins with biotin in (b7) a few days/ week before a test.

If you start taking thyroxine, take it consistently and with a large glass of water, leave up to half an hour before eating or having tea/ coffee.

Don't take it the morning of your test, take it afterwards.

So I have had an appointment with the doctor, and he says he won't treat the hypothyroidism until the TSH is over 10, or I've had 2 blood tests 3 months apart with a raised TSH.

The appointment has left me in tears. I did ask if I could try medication and see if it would help symptoms, but he was adamant that doing so would be against NICE guidelines, and was saying that thyroid medication is high risk, and if he prescribed it and I had a heart attack he'd be blamed for prescribing it, and that doctors can't prescribe stuff just because the patient asks for it. So this has really made me feel shit, as it sounds like my options are feeling crap like I do now, or developing a heart condition!

Also he says my ferritin B12 and Folates are fine as they are within range.

I came back negative for celiac, a test à requested as I've had chronic diahrea for months now, and I asked for further tests to rule out inflammatory bowel conditions, which he agreed to ask for reluctantly, but said that the request might not be granted because he doesn't have the authority to grant the test, it has to be a consultant.

He also said that sometimes they investigate symptoms but never get to the bottom of it and it's just one of those things and there's not anything wrong with the patient.

I feel so depressed, I think I'd got my hopes up that I'd get treatment. I don't know if I should go to another GP or what I should do

Your doctor is a dick.

Get another, explain your symptoms and get the treatment you need.

Is fatigue your main symptom OP?

I'd start supplementing your iron levels now OP ; your ferritin is low. I'm pretty sure you can buy iron sulphate OTC.
Then go back to your GP in 3 months and ask for repeat bloods. As a previous poster said, it is imperative to have your TFTs done as early as feasibly possible in the morning. TSH fluctuates throughput the day, and is highest early morning-you need to try to capture that for an accurate diagnosis.

See another GP ASAP. Gosh that sounds awful you poor thing.

It's usual for underactive to cause loose bowels. Have you tried changing your diet eg FODMAPs? Ideally best done with a nutritionist. Dairy (lactose) and gluten can be a part of that. Or try probiotics?

My other thought is whether there's some issues with peri/menopause going on. Which can affect bowels and also thyroid.

Have a look through the British thyroid foundation and/ or give their helpline a ring. I'm sure with symptoms (exhaustion) a subclinical state can warrant treatment.

Did the Gp feel for any goitre? I had no idea I had a slight one.

I can recommend spatone, two satchets taken with vitamin c (eg half a fizzy tablet) and don't eat anything for an hour before or after, especially caffeine or anything with calcium in it.

OTC tablets can upset poorly tummies more. I've just got my own ferritin up quite well doing that, and had success in the past.

I would not be getting out of bed with TSH and free T4 of those levels. I definitely wouldn't be making it to work.

On the subject of goitre, I've had. One all my life, as have my mum and brother, and aunt and grandmother!

I think supplements for now is a good idea, hopefully I can get my energy levels up marginally until my next blood test. I shall get some spatone. I have taken iron tablets in the past because my periods are horrifically heavy, but found I just can't tolerate them, they go straight through me and its rather unpleasant!

Lots of drs won’t treat the thyroid until the tsh goes above 10. While 7 is out with reference range (there is no normal) if you’re not symptomatic they’re unlikely to do anything. My GP refused to treat me with a TSH of 29 and it wasn’t until a perinatal consultant tested it at 45 that I managed to get treatment and I had to fight with the old bat for that. I had been symptomatic for years before the bloods reflected that.

Ironically I get symptomatic at about a tsh of 3 and while the endocrinologist was happy to base medication on symptoms and and tsh when I went back to GP care it was back to have to be over 5 or 10. Over 6 weeks

You can be retested in 6 weeks and if it still shows high and you firmly believe you have thyroid symptoms then argue to try levothyroxine at the Lowest dose to start. It can fluctuate slightly which is why they usually want a second high reading before considering treating. Ask why they’re refusing to treat you if they still refuse.