Underactive thyroid??

[PamelaD00ve]

I've had various symptoms over the past 3-4 years, that have gradually worsened.

Low mood/depression - i was on 150mg sertraline but found i was still frequently feeling very low so decided to come off it earlier this year. I feel the same now as I did on sertraline.

Weight gain - I've always had to watch what I eat, but that no longer works. In 3 years I've gone from a 10-12 to a 16-18. It is mostly round my middle. Previously, if I gained weight on holiday, I could have a concerted effort for a few weeks and it would drop off. Now, restricting calories and being more active does nothing.

Fatigue and weak muscles - walking often feels like I'm walking through treacle. I put off going to toilet because the thought of walking upstairs is too much. I also get very short of breath now.

Heavy Irregular periods - I've had a private scan that showed nothing other than one largish fibroid. The private online gp said if I was a physical patient in her surgery, she'd suggest getting my thyroid checked. My mother also has an underactive thyroid and i have another autoimmune condition that makes me more susceptible to having thyroid problems.

Unfortunately my private medical insurance doesn't cover this. It is so hard to get a gp appointment, I ordered a full thyroid check on medichecks. Results came back as underactive thyroid (results in picture attached). Excellent, I think, a reason for how I've been feeling.

My gp won't accept medicheck results (fair enough) so I wait 4 weeks for a blood test. Phone for results yesterday to be told by receptionist "gp says these results are borderline and suggests re testing in 3 months" I ask what my results are, and they're completely different to medichecks results (would testing at different times of day affect the result, ie first thing in the morning, fasted for medichecks vs late afternoon after lunch for GP?) I'm going to ask for a print out of my results but she said it came back as TSH of 5.1 and free T4 of 11.

I said to receptionist im feeling dreadful. I can't wait 3 months. She has booked me a telephone appointment to discuss with gp... on 8th August. That's the first appointment.

Any words of wisdom or advice? You know, if you went back and told me 3 years ago how I'd be feeling in 2022, I'd have assumed gaining so much weight would be the hardest part, but it is the tiredness and feeling so low.

Everything always feels like a battle with my gp, I'm dreading the phone appointment on 8th Aug as I'm pretty sure ill get fobbed off.

Hi OP,
I have had an underactive thyroid for 29 years. The tiredness and the large weight gain are spot on. However I would also check for Rheumatoid Arthritis as the muscle weakness is not usually connected to thyroid function. Could you have long covid? I am being investigated for that after having the illness in March 2020.

Thanks. I did have covid in February, so I guess it is a possibility.

It isn't joint pain in my legs, it is more weakness/heaviness.

If you suspect autoimmune then they can also do a blood test to check for antibodies. My TSH was 10 when they agreed to treat but I now feel unwell at anything over 1 and that is treated by upping thyroxine dose.

The walking through treacle feeling is exactly how I used to describe it.

@LiveintheNow I didn't know there would be a different blood test for autoimmune thyroid disease, ill have a Google. Thanks

It could also be iron deficiency. My anemia/iron deficiency is the cause of my hypothyroidism

You should also check your vitamin B12 and vitamin D. I have also hypothyroidism and both vitamins are oftern found to be low.

Me
had for 6 years
100 levo
no weight gain whatsoever

Definitely hypo on the private results. Sadly not unreasonable to retest in three months, just in case it's something transient. It does happen.

Get back in there bang on three months and get blood drawn as early in the morning as possible having fasted (water only) since 10pm the previous night. TSH is on a circadian rhythm and highest in the morning.

Lots of advice from Thyroid UK website and forum.

Once your TSH is at 10, ie at the point where thyroxine will be prescribed, your GP may order a antibody test to see your hypothyroidism is autoimmune or not.
Next time you have your TFTs done, make sure you book your blood test as early as possible in the morning. TSH follows a circadian 24h pattern and is highest in the early hours of the morning and lowest mid-day to mid -afternoon. So to accurately capture your (obviously high TSH) make sure you have your bloods taken at 7:30am if possible. Not sure any phlebotomy depts are open before that time.
It's irrelevant whether you starve or not, that has no bearing on a TFT.
I fully understand that wading through treacle feeling, I think my TSH was 16+ on diagnosis.

A TSH of 5.1 and free T4 of 11 (assuming ranges are the same as medichecks) is enough to diagnose and treat. I was diagnosed and treated with similar results. They do often insist on a second blood test though as thyroid dysfunction can be transitory. (I don't think this is the case here as you've been symptomatic for years but they will want to be sure).

Yes you should have had follow up test fasting and early morning. Your TSH lowers as you go through the day and after eating. There is plenty of evidence if this and I've seen this clearly happen with my own results (before I knew better!). Make sure all future tests are early morning and fasting. Water only before the test. Don't discuss this with your doctor (pick your battles!), just tell reception you need an early morning test before you have to go to work.

You should also avoid any supplements with biotin in the week before as these can also affect the blood test result.

Please go and post your results on the thyroid U.K. forum on Health Unlocked to get more detailed advice about testing and accessing treatment and how the treatment should go. Thyroid disease is commonly under or incorrectly treated.

You should also check your ferritin as this could be low after years of heavy periods. Mine was. And this could also be contributing to the fatigue/wading through mud feeling. Ferritin under 50 can give similar symptoms to anaemia in women so don't be fobbed off with an "in range" result.

You might have to fight for adequate treatment. Do your research (watch your sources!) and prepare yourself for battle!

Good luck.

My legs were exactly like that and tests showed my feratin levels were very low. A course of b12 injections has greatly helped me

Omg - thanks so much for your posts @TooManyPJs @Underscore21 and @DeedIDo that all makes a lot of sense. Kicking myself for not getting a morning test - it was hard enough getting a test at all though tbh.

Thanks. Someone commented on my weight this afternoon, not in a ill-meaning way (an acquaintance from a different culture, praising how "bountiful" I look). I feel really embarrassed... trying to see the funny side.

Me - tsh of 5.66 and t4 of 13 - they told me last week that was borderline but because I have most of the symptoms, they took more blood on Monday and to check my t3, ferritin and vit d levels and then they're going to start me on treatment - hopefully by the end of this week, start of next (apparently - hoping the next gp I'm talking to doesn't change that!). I am shockingly tired, feel like I'm wading through mud and like you I've put on a lot of weight around my middle mostly, like 2 stone in 18months/2years that I can't shift. Never even occurred to me that it could be my thyroid - even though my sister has the same thing 🙄🙄

Hope you get some help and some answers soon

Thanks @onlymyselftoanswerto1 we sound quite similar symptoms-wise, but your GP sounds a lot more proactive! Good luck to you, I hope you get treatment and it works for you.

@TooManyPJs I posted on the forum you suggested and got one answer so far that is VERY helpful, so thank you 😊