Re: Can anyone help before tomorrow?

[Guest guest]

Hello ,

First of all an explanation for the term "functional hypothyroidism" ...

http://www.quackwatch.org/04ConsumerEducation/News/wilson.html

's Syndrome

For about ten years, "functional hypothyroidism" has been promoted as "'s Syndrome," a term concocted by E. Denis , M.D., who practiced in Florida in the early 1990s. The syndrome's supposed manifestations include fatigue, headaches, PMS, hair loss, irritability, fluid retention, depression, decreased memory, low sex drive, unhealthy nails, easy weight gain, and about 60 other symptoms. claims to have discovered a type of abnormally low thyroid function in which routine blood tests of thyroid are often normal. He states that the main diagnostic sign is a body temperature that averages below 98.6° F (oral), and that the diagnosis is confirmed if the patient responds to treatment with a "special thyroid hormone treatment." [1]

Triiodothyronine (T3) 364 (low) (ref 592-1850 pomp/24h)Thyroxine (T4) 856 (ref 347-1994)T3:T4 ratio 0.4 (low) (ref 0.5-2.0)The urinary test is, in fact, the most accurate thyroid test there is, even though most doctors will tell you that it is not and that it is not NHS approved; just as doctor's will tell you there is no such thing as `'s Syndrome". For whatever reason your cells do not get sufficient T3, and T3 is the active hormone that keeps us alive and well. Your T4 is not as high as it should be, but it is the T3 that your body needs – and doesn't get enough of.

It is great that you have done both – urinary and blood serum thyroid tests... The urinary test shows a more accurate picture, although in all likelihood this test will be totally dismissed or ridiculed - but your serum TFT shows something you can use to hopefully get diagnosed and treated.... TPO autoantibodies, and lots of them.

The presence of thyroid autoantibodies is diagnostic for Hashimoto's disease (or autoimmune thyroiditis) – regardless of TFT figures - and doctors (should) know this. So let him know that you know..... Genova has a different ref range to most NHS labs – most NHS labs have a ref range for TPO of 0-100.... Genova's equipment is calibrated differently and has a range of 0-35. Your TPO count with them was 387. I don't know if there is any linear conversion, but to my mind, if the NHS range is 3 times that of Genova, then it stands to reason that the antibody count of 387 should be tripled in NHS terms...(at least this is how it worked out with my own TPO count when I had it done on NHS and with Genova) and that, in combination with your clinical symptoms, should suffice to get you diagnosed and at least put onto a trial of Levothyroxine. But there is no guarantee. It still comes down to clinical judgement. Still, knowing that a positive TPO count is diagnostic for autoimmune thyroiditis, I would fight tooth and nail with the doctor and insist that you want to be treated. You have positive TPO and a list as long as your arm with clinical symptoms. In all likelihood the doctor will want to repeat the TFT and antibody test to make sure, but that's ok. Your mum, btw, is very likely right that glandular fever at the age of 17 has triggered your autoimmune thyroiditis.....

CENTRAL THYROID REGULATION & ACTIVITYTotal thyroxine (T4) 83.4 (ref 58-154)TSH 1.96m (ref 0.4-4)Free Thyroxine (FT4) 12.0 (ref 10-22) (this is low – should be nearer 20)PERIPHERAL THYROID FUNCTIONFree T3 (FT3) 4.38 (ref 2.8-6.5)

FT4:FT3 Ratio 2.7 (ref 2.0-4.5)THYROID AUTOIMMUNITYThyroglobulin (TG) 24.1 (Ref 0-40)Peroxidase 387 (high) (ref 0-35)

Good luck tomorrow and let us know how it went. Fingers X

Best wishes,

[Guest guest]

Thank you !

I am very grateful to you, that was so helpful. Your time is precious & I

appreciate such a quick reply at the weekend too.

I read your links. I wasn't sure what TFT meant but gather it is something to

do with the autoimmune antibodies.

I saw a newish GP in our surgery, not my own and she was great, not in knowledge

but in attitude. I showed her the results and she admitted that the NHS did not

train her in these things but she was as cooperative as she felt she was allowed

to be. I didn't say in my post as I forgot, but my dietician picked up

borderline gluten allergy in a stool test (and also occult blood) and she agreed

to retest, plus she had referred me to a local endocrinologist (but felt

uncomfortable referring to Dr Skinner because of the GMC thing but did say she

would still reconsider if I was not happy with the local endo). She agreed to

test my ferritin, magnesium and vit D (I had B12 & folate recently) but she

cannot test for copper or zinc so I'm not sure how I can get those. I asked

about tests for progesterone/oestrogen but she said those cannot be done, only

FSH which is pointless as I am post-menopausal (still flushing though)! Anyway,

I went straight to get my blood drawn so I await results. I explained about T4

& T3 using Sheila's tin of baked beans analogy as she thought that T4 was the

active hormone!!

Said what would I do if I got nowhere with the endo & said she was just playing

devil's advocate. I said I have raised antibodies which are evidence (thank

you!) and that I would self treat! I hope it doesn't come to that though.

Could I ask, with having a conversion problem from T4 to T3, what would likely

be the best treatment, as you mentioned a trial of thyroxine (T4?), wouldn't I

be better with T3 only or a combination?

All the best to you

Many thanks,

>

>

>

>

> Hello ,

>

> First of all an explanation for the term " functional

> hypothyroidism " ...

>

> http://www.quackwatch.org/04ConsumerEducation/News/wilson.html

> <http://www.quackwatch.org/04ConsumerEducation/News/wilson.html>

>

> 's Syndrome

>

> For about ten years, " functional hypothyroidism " has been promoted as

> " 's Syndrome, " a term concocted by E. Denis , M.D

> <http://www.quackwatch.org/01QuackeryRelatedTopics/fad.html#wilson> .,

> who practiced in Florida in the early 1990s. The syndrome's supposed

> manifestations include fatigue, headaches, PMS, hair loss, irritability,

> fluid retention, depression, decreased memory, low sex drive, unhealthy

> nails, easy weight gain, and about 60 other symptoms. claims to

> have discovered a type of abnormally low thyroid function in which

> routine blood tests of thyroid are often normal. He states that the main

> diagnostic sign is a body temperature that averages below 98.6° F

> (oral), and that the diagnosis is confirmed if the patient responds to

> treatment with a " special thyroid hormone treatment. " [1]

>

> Triiodothyronine (T3) 364 (low) (ref 592-1850 pomp/24h)

> Thyroxine (T4) 856 (ref 347-1994)

> T3:T4 ratio 0.4 (low) (ref 0.5-2.0)

> The urinary test is, in fact, the most accurate thyroid test there is,

> even though most doctors will tell you that it is not and that it is not

> NHS approved; just as doctor's will tell you there is no such thing

> as `'s Syndrome " . For whatever reason your cells do

> not get sufficient T3, and T3 is the active hormone that keeps us alive

> and well. Your T4 is not as high as it should be, but it is the T3 that

> your body needs – and doesn't get enough of.

>

> It is great that you have done both – urinary and blood serum

> thyroid tests... The urinary test shows a more accurate picture,

> although in all likelihood this test will be totally dismissed or

> ridiculed - but your serum TFT shows something you can use to hopefully

> get diagnosed and treated.... TPO autoantibodies, and lots of them.

>

> The presence of thyroid autoantibodies is diagnostic for

> Hashimoto's disease (or autoimmune thyroiditis) – regardless of

> TFT figures - and doctors (should) know this. So let him know that you

> know..... Genova has a different ref range to most NHS labs – most

> NHS labs have a ref range for TPO of 0-100.... Genova's equipment is

> calibrated differently and has a range of 0-35. Your TPO count with

> them was 387. I don't know if there is any linear conversion, but to

> my mind, if the NHS range is 3 times that of Genova, then it stands to

> reason that the antibody count of 387 should be tripled in NHS

> terms...(at least this is how it worked out with my own TPO count when I

> had it done on NHS and with Genova) and that, in combination with your

> clinical symptoms, should suffice to get you diagnosed and at least put

> onto a trial of Levothyroxine. But there is no guarantee. It still comes

> down to clinical judgement. Still, knowing that a positive TPO count is

> diagnostic for autoimmune thyroiditis, I would fight tooth and nail with

> the doctor and insist that you want to be treated. You have positive TPO

> and a list as long as your arm with clinical symptoms. In all likelihood

> the doctor will want to repeat the TFT and antibody test to make sure,

> but that's ok. Your mum, btw, is very likely right that glandular

> fever at the age of 17 has triggered your autoimmune thyroiditis.....

>

> CENTRAL THYROID REGULATION & ACTIVITY

> Total thyroxine (T4) 83.4 (ref 58-154)

> TSH 1.96m (ref 0.4-4)

> Free Thyroxine (FT4) 12.0 (ref 10-22) (this is low – should be

> nearer 20)

>

> PERIPHERAL THYROID FUNCTION

> Free T3 (FT3) 4.38 (ref 2.8-6.5)

>

> FT4:FT3 Ratio 2.7 (ref 2.0-4.5)

>

> THYROID AUTOIMMUNITY

> Thyroglobulin (TG) 24.1 (Ref 0-40)

> Peroxidase 387 (high) (ref 0-35)

>

>

>

> Good luck tomorrow and let us know how it went. Fingers X

>

> Best wishes,

>

>

>

[Guest guest]

>>>(but felt uncomfortable referring to Dr Skinner because of the GMC thing<<<

I wonder if Dr. Skinner could bring a case against whoever reported him to GMC because it seems from cases like this one, that doctors are still reluctant to refer patients to him because of it.    This means that even though he has been exonerated it is still causing him to lose income.

Lilian 

[Guest guest]

I believe Dr Myhill did... article here...

http://www.romfordrecorder.co.uk/news/queen_s_scientist_disciplined_after_making\

_inappropriate_commments_about_gp_1_1170928

.... but, as she says, " mud sticks " .

Jacquie

> I wonder if Dr. Skinner could bring a case against whoever reported him to

> GMC because it seems from cases like this one, that doctors are still

> reluctant to refer patients to him because of it. This means that even

> though he has been exonerated it is still causing him to lose income.

>

> Lilian

>

[Guest guest]

Hello ,

It's good to hear that you hit on a reasonable GP and that she agreed to check Ferritin, Magnesium and D3.... – have you got the figures for Folate and B12 – whereabouts are they in relation to the ref ranges? Both should be at the upper end of the ref range. B12 is best around the 1000 mark (so slightly over the top). Don't worry about Zinc and Copper for now, perhaps at a later date the opportunity will arise and you'll get it checked by an endo. Zinc or copper deficiencies are not the most common.... ferritin, D3, B12 and magnesium are the ones that are most often too low. You have done well to get all the other tests.

Could I ask, with having a conversion problem from T4 to T3, what would likelybe the best treatment, as you mentioned a trial of thyroxine (T4?), wouldn't Ibe better with T3 only or a combination?

Yes, it would be better, and natural desiccated thyroid (NDT) like Armour, Erfa or one of the others would be much better still .... but one step at a time. The most important thing for you right now is to get a diagnosis of Hypothyroidism established – with whatever treatment that is offered. Even with your high TPO count and all your clinical symptoms it is far from certain that an endo would diagnose and treat you because your TSH is "normal" and your FT4 – although low-ish – is also classed as "normal". So the best you can hope for is probably a "trial" with Levothyroxine. Once you are diagnosed and offered treatment, you are relatively safe and you can then decide which medication suits you best – buy your own, if necessary.

In an ideal world, I agree, you should be offered T4/T3 treatment – but this is unlikely to happen straight off, if ever. In my personal view there is no better thyroid treatment than NDT, but even that does not suit everyone. We are all individuals and have our own requirements. A T3-only treatment, however, is in my opinion a last resort for people who can't tolerate any T4, be is synthetic or natural. It happens, but not very often. T3-only therapy can be tricky. You'd have to multi-dose throughout each day for the rest of your life; when taking NDT or – when tolerated – Levothyroxine, it is much easier to keep thyroid levels on an even keel as you "top up" once or twice a day and there will always be some T4 in readiness to be converted into T3.

With best wishes,

[Guest guest]

Unfortunately the malicious culprits are protected by the disclosure rules so

they get away scott free!!

Its appalling but there is no way unless Dr Skinner decided to take up a civil

suit against the one who reported him - thats if he knows who it is!!! The GMC

are under no obligation to tell Dr S any of the details, which I think is

appalling as a doctor has no comeback or defence.

Glynis

> I wonder if Dr. Skinner could bring a case against whoever reported him to

> GMC because it seems from cases like this one, that doctors are still

> reluctant to refer patients to him because of it. This means that even

> though he has been exonerated it is still causing him to lose income.

>

> Lilian

>

[Guest guest]

Hi there, you have hashimoto`s thyroidits, and glandular fever can trigger this disease in people with a genetic link in the family.dos anyone in your family on the female line have autoimmune problems? if so then again this confirms that you are hypo or hyper.my mum`s was triggered by menangitis and glandular fever aged 21. but she never got a diagnosis. my gran also had an autoimmune condtion auto-antibodies attack the bodycausing it to die slowly. read all you can about it and be in charge of your own health as many doctors don`s understand aboutbeing hypo while still in the reference range, it is a reference range not a normal range which causes them much confusion.Angel.

[Guest guest]

Hi ,

You have answered my queries so clearly - it is so helpful to even be understood

and to have answers that are so helpful and practical is brilliant. Once again

thank you!

>

– have you got the

> figures for Folate and B12

YES, ON 22/12/11 MY B12 WAS 408ng/L (ref 246.0-911.0) I guess this is quite low

then in relation to poor thyroid function.

FOLATE 7.8 ug/L (5.4-20.0)

nb I did have very high homecysteine and took folate but I'm sure it made me

even more depressed. I'd give it another go if you think it might help though.

Both should be at the upper end of the ref range. B12 is

> best around the 1000 mark (so slightly over the top).

>

>

The most important thing for you right now is to get

> a diagnosis of Hypothyroidism established.

THANKS FOR HELPING ME TO UNDERSTAND WHERE TO FOCUS AS MY HEAD IS GOING AROUND IN

CIRCLES!

I FORGOT TO SAY I HAD TEST ORGANISED BY MY DIETICIAN, THAT SHOWED BORDERLINE

GLIADIN Ab SIG (SALIVA) - 13 (REF BORDERLINE 13-15 U/ml) Positive :>15 U/ml IE

A POsSIBLE GLUTEN INTOLERANCE (ALSO OCCULT BLOOD IN STOOL TEST).

All good wishes to you

[Guest guest]

High Angel,

Thanks for taking the time to reply to me.

>

> Hi there, you have hashimoto`s thyroidits, and glandular fever can trigger

this disease in people with a genetic link in the family.

> dos anyone in your family on the female line have autoimmune problems? if so

then again this confirms that you are hypo or hyper.

IN THE FEMALE LINE MY FATHER'S SISTER HAS RHEUMATOID ARTHRITIS. MY FATHER HAS

VITILIGO AND SO DO I. HE ALSO HAS DIABETES AND SO DID HIS FATHER DESPITE BEING

VERY THIN (HAD TOTAL GASTRECTOMY FOR CANCER). I THINK MY MOTHER'S LINE WAS OK

ALTHOUGH HER FATHER HAD LEUKAEMIA. I SUSPECT THOUGH THAT ALTHOUGH MY FATHER IS

90 NOW (!) HE HAS SYMPTOMS THAT COULD BE HYPOTHYROID BUT DON'T REALLY KNOW.

ALL BEST WISHES TO YOU ANGEL,

JULIE

[Guest guest]

Hi ,

You're very welcome

With a B12 around 400 I would supplement B12 sublingually with Solgar's nuggets

http://www.solgar.co.uk/product/vitamin-b-12-1000ug-nuggets-250-E3230.html

You pop one under your tongue every night. They dissolve in seconds. B12 is very difficult to supplement with tablets, because the stomach acids destroy most of the B12 – you would have to take vast amounts in the hope that some makes it `through'. Taken sublingually you bypass the stomach. The Solgar nuggets do work well.

I did have very high homecysteine and took folate but I'm sure it made me even more depressed. I'd give it another go if you think it might help though.To reduce high homecysteine SAMe works well.... but it is not a cheap option in the long run. I take SAMe for my Osteoarthritis and it helps a great deal (don't have to take NSAIDs for the pain any more). SAMe has a lot of positive properties, please read :

http://www.biopsychiatry.com/sameart.html

Don't be put off by the flippant remark at the end that Vit B complex would do the same... it doesn't. B-complex is very useful, but it does not have the same effect as SAMe. The downside of SAMe is price and it takes about 6 weeks to fully saturate the system (I take 800 mg per day – 2 tablets). I buy mine from Vitacost in the US (cheapest place and very good... but takes a long time to arrive - 4 weeks).

http://www.vitacost.com/productResults.aspx?ntk=products & ss=1 & Ntt=same%20400

For some stupid European law the sale of SAMe is prohibited in the UK. Don't be tempted to buy some cheaper SAMe in a bottle – they are useless. SAMe needs to be enteric coated and individually airtight foil packaged. Mixed with oxygen the tablet dissolves and actually becomes toxic. I buy either "Dr. Best, or NSI 400 mg"- they are both equally good.

Oh – and if you could go gluten-free, that might help too... it will reduce the antibody attacks, as thyroid autoantibodies mistake gluten molecules for thyroid molecules (they are nearly identical) and then there is warfare in your gut. So by cutting out gluten from your diet you might reduce the attacks and have less problems with your GI tract.

With best wishes,

[Guest guest]

Thanks for all the info re B12, folate and SAMe,

I going to try and order tonight. I wondered though about DHEA, I plan to buy

that too but after reading that part of Dr Peatfield's book I wonder if I could

find the Keta 7 version? Also do you think it is ok even though I have lots of

missed heart beats? ECGs never show it up but it is intermittent, usually when

I am relaxing I think (when my pulse is very slow too.

Thanks

>

>

>

> Hi ,

>

> You're very welcome []

>

>

>