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Anything I should be asking?

Hi,

I'm looking for some advice please. I went to the dr's about a month ago with the following symptoms:

Increased ocular migraines or regular headaches - having several a week.
Increased hair fall, sore red scalp.
Tiredness.
Struggling to loose weight.
An unexplained skin allergy - A while ago it was pretty severe and required antihistamine tablets and hydrocortisone cream, it was across my face, ears and neck. Managing it at the moment.
Low pulse/blood pressure - resting pulse mid 50's - mid 60's.
Chest pain when pulse rising - usually between 80-100, then the pain eases off.
Red rash on cheeks/spots on chin.
Twitch in one eye.
Problems managing temperature/body temperature usually around 35.9 - usually cold.
Sometimes I have this strange feeling like all the energy has been sucked out of my body.

I did some research before going and suspected underactive thyroid. The dr referred me for blood tests. When I spoke to him he said 'everything came back normal apart from one, the liver enzyme tests which were double what they should be at around 100'. He said I wasn't diabetic and there was nothing detected on my thyroid tests, I asked if they had tests T3 & T4, he said no, only TSH and they wouldn't test the others unless TSH came back abnormal.

He referred me for more blood tests, hep a, b, c, Gamma GT, liver & kidney screen and (this one I'm confused about) paranatal Ab screen(?) <- I have searched for this and it brings up stuff about pregnancy but I'm not pregnant.

I rang and asked for the actual levels of my tests, the ones the receptionist had access to are:

Creatinine - 52 - they said normal range was 60-120 but they class 52 as normal?
Vit b12 - 817 - they said that's quite high but they classed it as normal?
serum folate - 20 - bang on the top end but yeh, they class it as normal!
Cholesterol - 2.4 - they reckon this is a little high but normal?

My TSH, Hemoglobin A1c and Liver function tests were unavailable to her so I have to wait until Wednesday for a call to find out what they are.

My concerns are:

1. If they are saving out of range figures are normal, maybe they're classing out of range TSH results as normal. A dr previously told me out of range readings are ok if they aren't causing any symptoms, as pretty much every symptom can be connected to underactive thyroid, if these levels are out of range, should I be pushing for T3 & T4 tests?
2. The results they are ignoring such as low creatinine and high b12 can be connected to liver issues, if the liver enzyme tests are high, why would they ignore the other results?

I mentioned when I first saw him that there is a family history of Addisons, Fibromyalgia and Lupus, I asked if he could test me for those and he asked if I had the symptoms :-| Is there anything else I should be asking them to test for? I read something about a girl with similar symptoms and they tested for ceruloplasmin, this is a recommended additional test on the patient.co.uk website but I don't appear to have been referred for it.

Just a bit of info about me. I'm 36, female, overweight. I take sugarbearhair vitamins (I understand these could explain the high b12 but with the liver results, it;s best not to presume) and a daily probiotic. I have been doing a low carb, high fat diet on and off but not consistently or strictly enough to properly go into ketosis.

Thanks in advance for any advice.
3 Responses
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1756321 tn?1547095325
When I had untreated Hashimoto's thyroiditis my liver enzymes ALT and AST were continuously raised for years (went back to normal when I started thyroid medication).

When I first suspected I had Hashimoto's thyroiditis I requested TSH, free T4, free T3, thyroid peroxidase antibodies (TPOAb) and thyroglobulin antibodies (TgAb). At the time my TSH had risen into the 2's (not my normal which was in the mid 1's and had been for decades) and both antibodies were positive. It took 4 years before my TSH rose to 6 and was finally given thyroxine.

My cholesterol was low to start with before hypothyroidism showed up so when these levels rose due to Hashimoto's thyroiditis it never went out of range as I started thyroxine before that happened. My body temperature was in the low 35 C range.
Helpful - 1
2 Comments
Thank you for your reply. I too suspect it's thyroid related, and have since my initial doctors visit. Unfortunately, I'm in the UK so it's not easy to get the doctors to do the tests I think I should be having and my doctor is of the opinion that he knows best because he went to medical school. He said because my TSH levels were within range (2.2) that he wouldn't refer me for FT3 and FT4 tests, even though the patient.co.uk website (a website for doctors) states that TSH isn't always sufficient to diagnose thyroid issues and that the FT3 and FT4 tests should also be requested.

I'm going to see a locum doctor on 5th September and will ask them if they can refer me for the FT3, FT4, thyroid peroxidase antibodies, thyroglobulin antibodies, ceruloplasmin, ANA's an SMA's. The other doctor thinks because the second set of tests came back clear, that is the end of it and I should just go away now, but none of my original symptoms have been addressed, he's only added increased liver enzymes and low creatinine to the list!
I was in the same boat. If your TSH is normal then they don't think anything is wrong!  An interesting home test to try out is called the myxedema skin pinch test. There is a youtube video you can watch to see how it's done: Hypothyroidism Type 2: Myxedema Symptoms.
20625445 tn?1502219281
Could be Fibromyalgia.  Difficult to diagnose.  You must get your weight down to a comfortable level.  Slowly does it, no bread and reduce carbohydrates.  Fasting a couple of days a week will help and incorporate exercise into your life every day.  
Helpful - 1
1 Comments
Thank you, I am doing low carb again to try and get my weight down so hopefully that will help :)
1756321 tn?1547095325
I forgot to add my TSH range: 0.2 - 4.0 mU/L.
Helpful - 0
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