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hypothyroid?

Hi I am new to this forum, but I am hoping I may be able to get some advice here?
For the last three years approx, I have felt my health almost deteriorate, In some ways I feel like a hypochondriac, yet in others I feel ignored. I have so many symptoms but no apparent cause which bothers me as there is no obvious cure or relief in sight.
It began with fatigue, and general woolly headedness, I'm normally quite 'on the ball' but my memory of late is embarrassing. Then my skin started to become really dry and itchy, like ants crawling under the surface. The skin on my face is really dry and my nose is often sore and peeling. My ears itch and often get sore too. My periods have been haywire as in really heavy for about 6 years, but about a year ago they started to change and went light and lasted longer. (I have a family history of early menopause, i.e mother, her sisters and their mother) So I went to the doctor and discussed these symptoms, she advised the pill to help regulate my hormones through this transition. I am 39 years of age B.T.W.
In the last year or so other symptoms have come along , my muscles and back ache almost every day, especially my lower back, the fatigue is worse, I did have frequent palpitations and night sweats which I assumed were menopause symptoms and these do ease on my three weeks on the pill, but return often on my 7 free days.
I have always been naturally a little constipated but this has become worse over the last year, and I am always feeling cold even in warm rooms, the only time I notice being warm is if I have had to seriously rush around, and occasionaly after a large meal.
My nails peel, my hair is dry and my eyes itch.
I have had a sun allergy which began in my teens, any part of my skin exposed to the sun for over five or ten mins, starts to itch like mad severaal hours later and raised spots appear, this can be quite painful and distressing and has worsened over last few years,  (more to follow)
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Avatar universal
All may not be lost, I have just received a print out from docs, and it said the result was for anti smooth muscle antibodywhich was positive at 1gG 1:40 it said in small print (usually associated with viral infections) However, platelets have dropped from last set of results above to 135. So I suppose this will have to be a waiting game ,other  auto antibodies tested were parietal cell / neg      antimitocondrial autoantibody / neg and anti liver kidney / neg
Hopefully this will mean something to someone who understands all of this!
No thyroid antibody tested though, very helpful!!!!
Regards Zoe
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Avatar universal
Hi again, I reckon I might have to wait until I get the next blood test and grill the nurse a bit, they are often a little more forth coming with the info, but no, the reference and result where not provided, so as you say in the dark still, I need to flex my back bone and question my doc I reckon , its so ingrained to take what a doctor says as gospel, and agree without question! Sad thing is that I like this doctor, and I dont want to cause hostilities with the person I need to help me, well thats how it feels :-(
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649848 tn?1534633700
COMMUNITY LEADER
The body produces several different types of auto antibodies, so we'd need to know which ones you have.   Most likely it's going to be the TPOab, because that's the most common one to be tested.  

Since you are positive to antibodies, we know you have some autoimmune condition.  Again, most likely, it will be Hashimoto's, which is the # 1 cause of hypothyroidism in the developed world.

Did the nurse happen to give you a result and reference range?
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Avatar universal
Hi, thank you for this info, Ive got to say the whole antibodies issue has worried me. It was the way firstly this blood test was taken without my knowledge i.e. I was told I was having a cortisol test.
Secondly the only info I was given was for the doc to say my white cell count was low, two days later she called again and said they had found some antibodies in my blood and this was probably due to a previous infection? (and so I THOUGHT perhaps viral antibodies) However, after Barbs advice I called the receptionist and bluffed a bit saying I didnt want to disturb the doc a third time and that she had told me there had been antibodies in my blood but that I could not remember what type, she read my notes and told me it was auto antibodIes . I feel like they are trying to withold the info from me. Six weeks is a long time to wait not knowing. Why six weeks, is it possible they will disappear from my blood?
Re calcium levels, there are none on the sheet but next to the test name it says (XE2q3) if this helps?  Re vit D2 and D3 (XAXhT) level, it does say that this result of 64nmol/L is sub optimal and should be greater than 75, but the doc made no comment on this either.
Confused and peeved is an understatement, appreciate all of your help guys x
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Avatar universal
An autoantibody is an antibody (a type of protein) manufactured by the immune system that is directed against one or more of the individual's own proteins. It is derived from the Greek "auto" which means "self", "anti" which means "against" and "body". Many autoimmune diseases, notably lupus erythematosus, are caused by such autoantibodies.
http://en.wikipedia.org/wiki/Autoantibody

If you have previously signed a release form that they can mail you your test results, tell them to mail them for you. This is how it works here in the US, but unsure about the UK.

Having a free t3 test is highly important, because thyroid symptoms correlate mostly with t3. For example, a 30% serum drop in t3 can be upwards of 80% in cells. I would link to this article, like I did for wikipedia, but that bookmark is on another OS and google isn't helping.
T4 is converted into T3 via things called "deidonase", if you are having trouble converting t4 to t3 for any reason, your t4 can be normal but your t3 will be off. On the other hand, you can be converting most of your t4 into reverse t3 and not have enough of the good stuff.

Hashimoto's thyroiditis is usually diagnosed by thyroid antibodies, but 20% of people with this condition do not have the antibodies. That's 1 in 5, which seems much more important of a distinction when said that way.
"TPOAb, and less frequently TGAb are present in serum. High levels are diagnostic of autoimmune thyroid disease. TGAb are positive in about 80% of patients, and if both TGAb and TPOAb are measured, 97% are positive. Young patients tend to have lower and occasionally negative levels. In this age group, even low titers signify the presence of thyroid autoimmunity."
http://www.thyroidmanager.org/chapter/hashimotos-thyroiditis/
Your immune system does fluctuate, which you've seen some of with your white blood cells. Some people will end up being negative, but will at a later date test positive. Don't test it just once. It is also helpful to be tested for graves' antibodies, TSI as Barb brought up, because there are cases where people have all three antibodies.

You didn't give a range on vitamin d, but 64 nmo/l to ng/ml is 25.64 ng/ml. This is low. The range is 30 - 100 ng/ml although it will depend on the person. I've done a *lot* of research on vitamin d lately because my level was/is 4.6, so while ranges can be different for different areas, this one is pretty consistent. People with thyroid issues do have trouble keeping good levels of vitamin d. It depends on the person, really, but it cannot hurt to try taking some vitamin d3. It needs to be d3 because d2 leaves the system sooner than d3 thus it is not the most beneficial although it will work for people that are not deficient or insufficient.

We'll need a range on the calcium, because I have an inkling you might have an ionized test which is different than the regular.
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Avatar universal
Hi again , just come off the phone and the receptionist clarified that it was 'auto antibodies' if this is of any help .

Regards Zoe
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Avatar universal
I see what you mean, will see if I can get hold of them and post on here :) Maybe with a bit of luck it will be the infection 'good' ones then if she has said it looks like ive had a bad ilness.

Thanks Barb :-)
Helpful - 0
649848 tn?1534633700
COMMUNITY LEADER
You need to know what antibodies they found.  There are some that are good, because they fight infections, there are others that actually attack certain parts of the body, indicating an autoimmune disease.  

For instance, Thyroid Peroxidase Antibodies (TPOab), Thyroglobulin Antibodies (TGab), attack the thyroid and eventually destroy it, so it can't produce any hormones; this is called Hashimoto's Thyroiditis.  Thyroid Stimulating Immunoglobulin (TSI) attacks the thyroid in a different manner - it causes the thyroid to produce too much hormones; this is called Graves Disease.

Can you call and ask the name of the antibodies, along with the result and reference range?  That would help immensely in figuring out what your issue is.
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Avatar universal
Will see if I can, but not due back for few weeks so will add them then, the call was vague to be fair, and the weird thing is my white cells where higher than this in the blood test I posted on here a few weeks ago, which was about five weeks after the infection, so would that mean anything different?

As for antibodies she just said they had found them and that she was sure it was because of an early infection so until I get further clarification I suppose I am in the dark. Would you think a sinus infection is enough to leave antibodies 8 weeks later then?

Thank you as ever for your help, :-)
Helpful - 0
649848 tn?1534633700
COMMUNITY LEADER
White blood cells are the ones that fight infection, so if you had a sinus infection that has cleared, it stands to reason that your white cell count would drop.

Did they mention what antibodies were found?  Can you get a copy of the report and post those results here?
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Avatar universal
Hi Again,
Got results back and cortisol came back fine but my white cell count has dropped to 3.2 and they found some antibodies in my blood. I have been told this via a phone call so havent got any specific levels. The doctor said that I have probably been ill or had a bad infection and this is just a reaction. However I have to go have levels checked again in 6 weeks.

The only illness I can think of was about 8 weeks ago when i had some sort of sinus infection and my face hurt, then followed a cold? is that serious enough would you think?

Help, I'm at a loss to know whats what now.

Regards Zoe
Helpful - 0
649848 tn?1534633700
COMMUNITY LEADER
I'll look forward to seeing the cortisol tests and hope there's something there, but suspect it will come back to thyroid.

You'll need to get the FT3/FT4 testing to confirm the issue.
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Avatar universal
So exasperating!!!
Will see what happens after cortisol, and where to go next.
Takes two and a half weeks just to get a blood test done, so will report back after that :-)
Thanks again x
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649848 tn?1534633700
COMMUNITY LEADER
This is what often find with our members from UK.  Many members have had to try to get different doctors and/or go private (outside the NHS) to get adequate testing/treatment.  Some have found that if they insist long enough, they can get the tests.

Doesn't hurt to test cortisol, because yes, abnormal cortisol can cause symptoms.  The problem, with that, is that most doctors only do an A.M. cortisol test and let it go at that, whereas cortisol naturally changes throughout the day, in accordance with the circadian cycle. The best test for cortisol is a 24 hour saliva test.
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Avatar universal
Update.

Been back to the doctors, she says there is no need for further tests as my thyroid is definitely fine, I asked about t3 or antibody tests and she said there is only a need to undertake any further thyroid tests if those previous (TSH and ft4) were abnormal.
She is now going to undertake a cortisol test though as she says if this is abnormal it can cause similar symptoms?

any ideas?
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Avatar universal
Wow, thank you for such an in depth answer! I have had more info and explanation from you than my own doc provided. I will try pluck up the courage to go back and suggest those tests. Will also look at B12 and your other suggestions :-)
Once again, many thanks for such an in depth and very clear response.
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649848 tn?1534633700
COMMUNITY LEADER
Additionally, some other vitamin/mineral deficiencies can also cause symptoms.  You might want to ask to get tested for magnesium (deficiency causes bone/joint pain), which is essential to proper absorption of calcium.  Selenium is essential to the thyroid for producing adequate thyroid hormones and also helps with the conversion of FT4 to FT3.  

I’d also suggest that you get reproductive hormones tested.  Both they, and the thyroid are part of the endocrine system and one part malfunctioning can completely mess up the entire body.  

In addition, you should get tested for the thyroid antibody tests to determine if you have Hashimoto’s Thyroiditis.   Antibodies gradually destroy the thyroid and eventually cause the thyroid to stop producing hormones.  They can also cause inflammation which can cause symptoms, long before one actually becomes hypo.

The antibody tests you need are Thyroid Peroxidase Antibodies (TPOab) and Thyroglobulin Antibodies (TGab).  
Helpful - 0
649848 tn?1534633700
COMMUNITY LEADER
Because of a glitch with MedHelp, I'm posting my response in 2 parts in order to make sure it posts properly.

I just  noticed that you are in UK and we do find that some of our members from UK have a very difficult time getting adequate testing/treatment for thyroid issues, due to the strict guidelines of the NHS.  No, FT3 is not an antibody test, and many doctors refuse to do it and that's the most important, because it's the hormone actually used by the individual cells and is essential for a feeling of well being.

Your thyroid results are "normal", but that doesn't, necessarily, mean normal for YOU.  We're all different and we all need different levels of hormones, even within the ranges.  Your FT4 is, actually on the high side, which would indicate hyper, rather than hypo, though your symptoms certainly indicate hypo.  Unfortunately, there are other conditions that can, often, cause hypo-like symptoms, with peri-menopause being one of them.

While your vitamin B12 is "in range", it may be too low for you.  I have to keep my B12 levels at the very top of the range (my lab uses 200-1100 for a range), in order to feel well.  B12 deficiency can cause the most horrendous fatigue imaginable.  Left untreated, it can also cause tingling/numbness in the hands/arms/feet/legs, as well as brain fog.

Ferritin is a protein that stores iron.  Your level is quite low in the range, so it might be worthwhile to have a complete iron work up. Iron deficiency can also cause many of the symptoms you have.
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Avatar universal
No, is that the antibodies test? I read about antibodies and this being the best test so I asked her about it when these results came back, but she said she would only perform this if the TSH had been low.
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1139187 tn?1355706647
no free t3?
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Avatar universal
Hi Barb, hope this helps, and thank you for taking time to look over these
:-)

SERUM TSH 1.8 Mu/l     0.35-4.94
SERUM FREE T4 14.2   9.0-19.1

serum calcium 2.3 mmo/l
serum albumin 37 gl    35.0 - 50
corrected serum calcium 2.31 mmo/l   2.2 -2.6
serum alkaline 36 /UL       30.0-130

Serum vit b12 353 ng/L 187.0 - 883.0
serum folate 18.7 (abnormal apparently) 1.8 -18.3
ferratin 24.2 ug/L 10.0 - 204.0

vitamin d2 and d3 64 nmo/L

serum sodium 138 mmo/L 1 33-146
Potassium 4.1 mmo/L   3.5-5.3
urea 2.7 mmo/L   2.5-7.8
creatinine 69 mmo/L   50.0 -98.0
GFR MDRD 82 mL/min 60-200

Glucose 4.7 3.00-6.00

Blood count
haemoglobin 15.o gdl    11.5-14.8
total white 4.6   4.5-13.0
platelet 173      140-400
red blood cell 4.8    3.83 - 4.98
mean cell vol 92 84.o - 99.0
haematocrit 0.443  0.36-0.46
mean cell haem level 31.2  27.5-32.5
mean cell haem concentration 33.8  30.9-34.8
neutrophil 2.93    2.0 - 7.5
lymphocyte 1.3  0.8 - 4.0
monocyte 0.2     0.2 -0.8
eosinophil 0.20   0.04 -0.4
basophil 0.00      0.0 - 0.2

Helpful - 0
649848 tn?1534633700
COMMUNITY LEADER
I see a few things that might cause issues, and I have a some comments to make, but before I do, we need to know the reference ranges for all your lab results.  Ranges are usually found next to the result, in parenthesis.  Ranges vary lab to lab, so must come from your own report.
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Avatar universal
I have had to use comment option for this lengthy post, two comments boxes as above are in opposite order, last comment should follow my post and first comment is the final part of post. Sorry for any confusion. :-/
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Avatar universal
so for about seven months of the year I take daily and sometimes nightly anti histamines. I I try lay off the night time ones as this worsens the fatigue, and take non drowsy day time remedies.
I have put on around a stone in weight, tried dieting which I have in the past been quite good at if need be, but lost half a pound only in 8 days, very disheartening.
Over the last three years have begun to suffer from frequent water infections and am now under urology, no apparent cause, and have to take two antibiotics every time I have sex to protect myself. I have had about 15- 20 infections in three years!
My family I.e mother and some of her sisters and now some of my female cousins suffer with thyroid problems (diagnosed) and osteoperosis runs through my mothers family too, my mother has hyperthyroid and osteoperosis in every bone, her sisters all have osteoperosis too , not all as bad as her though. Very unlucky genes I guess.
I have since summer started with another weird symptom, Nausea, sometimes when I am eating, but at othertimes too. I get a sudden urge to retch, and have to run to the toilet if I am eating at the time , if not eating its more of a sick unsettled stomache feeling.
Spoke to one of my female cousins about this and she said she had suffered with the same thing, after a visit to her docs and a blood test they discovered a slightly under active thyroid.
I have for some time wondered about my thyroid and have discussed this before with gp, went back a few weeks ago, and she didnt see any link with the nausea.
However she took blood tests and my results appear 'normal' so I am now at a loss.
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