I need your help in compiling a list of Thyroid Blood Tests that you would like to see in one profile. So far I have the following which will be included, but what supplementary private blood tests would be good?
TSH
FT4
FT3
TT4
TT3
Thyroid Peroxidase Antibodies
Reverse T3
TSH Receptor Antibodies
We have noticed that our patients will often order private blood tests in two or more batches - this can be expensive for them, so any option to reduce that cost by having a comprehensive thyroid profile would be beneficial.
What are your thoughts?
Paul Harris
Blue Horizon Medicals.
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BlueHorizonMedicals
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Please could you also add anti thyroglobulin antibodies to the profile?
When I was first diagnosed with Hashimoto's my TPO antibodies were double the top of the range but my thyroglobulin antibodies were five times the top of the range. It was the latter that convinced my dr to prescribe treatment. And I would like to be able to monitor my antibody levels. Many thanks.
It strikes me that we see quite a few people who have thyroglobulin antibodies but not thyroid peroxidase. (And vice versa.) It might be sensible to have both on the one test.
Might also be sensible to have a "thyroid add-on" which covers iron (not sure which specific tests, to be honest), vitamin D, Active B12 and folate.
Also, how about putting in "when do I do my blood test?" advice. Consistency. Time of day. Fasting? Taking thyroid hormones just before the blood draw. Etc.
Then ones I have seen consistently referred to are: ferritin, folate, B12, calcium, D3, magnesium & zinc. But I am pretty new to all this so someone else will no doubt comment too.
As you probably know, we use 3 main laboratories in the UK to conduct private blood tests - now, in their thyroid profiles, only one gives Thyroglobulin Antibody as standard in their more advanced thyroid profiles. I took this up with the other two Laboratories who stated that thyroid peroxidase antibodies are better, and the thyroglobulin antibody is therefore surplus to requirements, except when monitoring thyroid cancer treatment.
So to cut a long story short, it is available on our Spire and Nuffield linked websites as an extra only- and it's pretty expensive as a standalone test. With our TDL linked websites (blue horizon, london and home) the thyroglobulin antibody is included in the advanced thyroid profile- so no problems there.
Doing some research it seems that although the thyroid peroxidase antibodies is a good jack of all trades in this respect, the thyroglobulin antibody is best for Graves. Any thoughts?
Your list looks good to me. I suffer from hypothyroidism. I don't know if someone with goitre, hyperthyroidism or cancer would have a different list though.
I'd like to make a request on another subject though...
Would it be possible to make up a package of tests for sex hormone testing, suitable for men, pre-menopausal women and post-menopausal women i.e. three different packages? Testing sex hormones is incredibly expensive.
I, personally, don't understand the point of TT4 and TT3 and they wouldn't be on my list of priorities. I think the full panel would be useful for those who can't get their GP to run TFT.
What would be very useful is FT3 solus, FT4 solus, and FT3 and FT4 panel as so many labs take it upon themselves not to test if TSH is in range, even when GP requests it. Additionally, many self-medicate with NDT and T3 without GP awareness and it would help make personal monitoring more affordable.
rT3 solus could be useful too, for those who suspect they have T4 conversion issues, as I'm led to believe NHS don't test it.
The other tests advised on here are VitD3, ferritin, B12 & folate. Again, as a panel and solus would be good.
FT3, FT4 and Reverse T3 are all available as Solus as either private blood tests through hospital attend/phlebotomy kit/home kit with the exception of reverse T3 which is hospital only due to spinning and freezing requirements for transport.
Vitamin D3 is considered to be the most potent and pretty much all of the research out there and there is masses, is referring to Vitamin D3.
This is the case against ergocalciferol (vitamin D2) as a vitamin supplement by
Lisa A Houghton and Reinhold Vieth.+
Author Affiliations
1From the School of Nutrition and Dietetics, Acadia University, Wolfville, Canada (LAH); the Department of Nutritional Sciences, University of Toronto, Toronto, Canada (RV); and the Mount Sinai Hospital, Toronto, Canada (RV)
Supplemental vitamin D is available in 2 distinct forms: ergocalciferol (vitamin D2) and cholecalciferol (vitamin D3). Pharmacopoeias have officially regarded these 2 forms as equivalent and interchangeable, yet this presumption of equivalence is based on studies of rickets prevention in infants conducted 70 y ago. The emergence of 25-hydroxyvitamin D as a measure of vitamin D status provides an objective, quantitative measure of the biological response to vitamin D administration. As a result, vitamin D3 has proven to be the more potent form of vitamin D in all primate species, including humans. Despite an emerging body of evidence suggesting several plausible explanations for the greater bioefficacy of vitamin D3, the form of vitamin D used in major preparations of prescriptions in North America is vitamin D2. The case that vitamin D2 should no longer be considered equivalent to vitamin D3 is based on differences in their efficacy at raising serum 25-hydroxyvitamin D, diminished binding of vitamin D2 metabolites to vitamin D binding protein in plasma, and a nonphysiologic metabolism and shorter shelf life of vitamin D2. Vitamin D2, or ergocalciferol, should not be regarded as a nutrient suitable for supplementation or fortification.
Thanks for the references - even if they are Canadian.
I agree with the use of D3 as a supplement, but as a test for levels in the blood I have been advised by our Doctor that whilst matters of parathyroid are best tested by D3 (1,25 Dihydroxy) levels that 25-OH levels are sufficient for thyroid matters.
It will be cheaper too! Patients can always request D3 testing as an addon if they need it.
I have had a number of tests done by blue horizon and been very satisfied with the service. I didn't realise that you gave a discount via thyroid Uk - does this still stand? I have just sent off a medium thyroid profile test today can I use the discount code after ordering?
TG antibodies would be great added to the thyroid parameters.
Vitamin and mineral status.
Hormone panel
Ha the list is endless. X thanks for your support , I will look forward to ordering , the post above have suggested good ideas, also I haven't seen TSI blood test, this is I think for graves desease.
When I was first tested here in Crete - they also tested Anti-M - anti-body. Have not been able to find a great deal about it and wondered why it was tested. Perhaps you could help me understand Have Crohns as well as Hashimotos....but nothing has dropped yet
Could be anti mitochondrial antibody - this is an auto immune antibody associated with primary biliary cirrhosis and could have been looked at while they were investigating what turned out to be your Crohns.
...oh my word - still learning new words at 67 !! Thought Anti-M was anti-microsomal or something like that ! Crohns was diagnosed over 40 years ago whilst suffering ileo-caecal TB...... and Hashimotos diagnosed in 2005. Pleased to report liver holding up well ....
Thank you for responding and good to have a rapport with people like yourselves. I live in Crete where we have loads of walk-in clinics for Haematology and for anything else you care to think of. Our Draculas Den is in the next village - tests done and ready within two days all nicely printed out. We keep our test results/scans etc. and medical records. A system that suits me - at least nothing gets lost in the post !! Greece as you know is broke - but the affordable private healthcare is alive and kicking.....
Anti Microsomal is a reflex test that is run on positive thyroid peroxidase antibody testing so is essentially the same thing. It just gives the numbers in a different format (titre instead of levels in (unit) - now if you ask us you can usually get the antibody level that the titre was based on if you get a microsomal titre result.
I think most of the tests have been mentioned already. From my perspective the antibody tests are important as I was only recently diagnosed with Hashimoto's but they only tested TPO.
The vitamin/mineral tests are also important so Iron, ferritin, B12, Folate and Vit D but also Selenium and maybe Iodine.
I know we get 10% discount with TUK but it can still be expensive to have tests. I wondered about an extra discount for "regulars" i.e. I am thinking about a regular annual full panel of tests! Some literature with the test results that could be passed on to "ignorant" Gp's in the hopes that they might learn something about diagnosis and treatment of thyroid patients. I am just so relieved that Blue Horizon help me feel in control of my thyroid problem and not totally reliant on NHS. Knowledge is power. Thank you
Selenium should be easy enough, iodine is a little trickier. This "Power Bundle" will have a very nice discount for thyroid UK members I assure you. Thanks for your help.
I have iodine deficiency based on a 24hr urine collection ('challenge') test - is it reliable/feasible from blood sample, as you describe it 'trickier'?
Paul when you have collated a list of blood test, that involve all or most that have been mentioned here, would you kindly drop me a email so I can order please at your earliest.
Gosh any chance someone could explain all this to me I'vebeen over and now after radio active iodine under active for some 35 years almost. I take my thyroxine first thing everymorning and get a blood test twice a year and I'm really doing well, so just wonder if a few people are just overpanicing and then putting fear into others. I've just had plaurasy and really had the best treatment from my GP surgery that the NHS can give. Really guys take the meds learn to relax and have exercise and a healthy diet and you'll all be fine
Whoops ok I didn't mean to upset anyone at all so if I did I am sorry, I was merly hoping to point out that even when youve had this for as long as I have problems can arise but fortunatly you also learn to spot them and with a good supportive GP (I know I'm the lucky one not all are) you can move on fairly fast. I joined in on the site because I came across it whilst looking for something else for my sister. I really do understand some people can't do exercise I myself have a genetic cerabal leision and several food allergies one of which is nuts and another cheese.
Anyway we all have to just do what we can today and leave the rest for tomorrow good luck all
Hope you dont mind me buttin in here, but I was wondering the same thing myself! Sounds to me a little like the " pull yourself together brigade", but thats only my own thought. Very glad that you are keeping so well rOd3r.
Did you have the pleurasy shortly after a flu jab? I'm asking as a family member who has a yearly jab seems to get chest infection afterwards and at worst it was pleurasy. thank you.
No I didn't I've had it twelve weeks now and was to ill to have the flu jab at the time. So far I've had two chest exrays and a scan 7 lots of antibiotics and seven of statins. I've been ok for 8 days now so fingers crossed I'm over the worst. Plaurasy though is fluid on the llung under the plaural lining . Hope you relative soon feels a whole lot better
Thank you r0dg3r, she didn't have that this year, but I was wondering about a link between flu jab and lung problems. You have been very unwell yourself, so glad to hear you have been getting better for over a week now. Take care.and keep well.
I am glad that you are one of the very lucky ones, and that's how you really should consider yourself - very, very lucky. There are many out there who can't even get a diagnosis, have tried all the stuff you suggest, have had horrible experiences with their GP and will really find your comments patronising.
I know far more about thyroid illness than any of the GP's at my surgery because I've been forced to find out about it, so please show a little empathy for all of us who have to go it alone. Jane x
whoo when I first got it as an overactive thyroid 35 years ago it was following a miscarriage and took two years to diagnos because the dr's then kept thinking I just had an eating disorder so please I do know what I am talking about I've spent lots of time being very ill and was then given an overdose or radio active iodine. In those days evan I had to go it alone as it was early days for some of the treatments available now. \The result of that overdose then distroyed my overies and I ended up having a hysterectomy at the grand age of 28 and have suffered the consequences since. We all have problems to deal with thats why the site is hear.
You are obviously one of the lucky ones for whom levothyroxine works. I have an entirely different story, like many of us on this form, with no success with levo whatsoever.I am well now, thanks to Thyroiduk.org, and alternative medication. So many thousands are kept unwell - told they have 'this, that or the other' when in fact they are kept either undermedicated or not given the chance to try an alternative. They would dearly love to be free of pain and be able to walk, never mind exercise.
I too am doing pretty well, but in my case it is not down to "taking the meds, relaxing, exercising and having a healthy diet". If I had left it to the NHS and just followed your advice, then I doubt I would be here now. It is mainly thanks to TUK that I found out about Armour Thyroid, adrenal issues, vitamin and mineral deficiencies and am now able to live a normal life. My GP has been great going along with what I have found out for myself, but there is no way on earth that he would have gone down this route without me doing my own research.
You are obviously one of the lucky ones for whom thyroxine works just fine. I hope that continues for you, but if not at least you know where to come for some amazing help and advice
Lots of us are here to learn new things....and to help others. How is your VitD - sounds as if it may well be LOW if you have suffered pleurisy. Being low in vitamin D could well lead to other things - even if you are relaxed, well exercised and eating good food. Perhaps you would like to share your lifestyle with others - diet, exercise, relaxation techniques etc....now that would be so positive....
Perhaps you should read the questions and posts on the forum for the explanation you require. You'll get a feel for the problems people experience attempting to get a diagnosis and the difficulties they face in order to regain their health. It might also help you avoid giving offence by posting patronising rubbish out of ignorance, too.
You have been very lucky with your experiences and I hope you appreciate this. As mentioned, please read posts on this site to understand some of the battles that other people are fighting. Some stories are truly heartbreaking. And this is not just an NHS vs private thing, this is an endocrinology-wide problem which makes it all the more difficult. World wide in fact. Of course, I'm sure I speak for all of us by saying that we are so pleased that you have managed to find a solution to your health problems, but please realise that for many people things are bloody hard.
likewise as a result of appaling treatment and taking two years to be diagnosed I know need to use crutches and a wheelchair so honest really I do understand what it is like to be that ill
Hi Paul, could I ask if it would be possible for Nuffield hospitals to offer the comprehensive plus V blood test which Spire hospitals are currently doing for £115? I am particularly interested in the Vit D, Vit B12, CRP, Folate and Ferritin which are important in thyroid problems. I live in Cornwall where our local hospital is Nuffield Plymouth.
The Comprehensive plus v blood test is a profile that we have set up and trademarked. Spire have been able to give it to us at a good price and are we are able to offer it for the time being at around £115. The same profile of private tests done through the Nuffield through ourselves we would have to cost up at no less than £200ish - I'll look into it for you tho if you are interested - it shouldnt be too difficult to set up on our Nuffield link site as a bundle.
Thank you very much for your post! I thought that the thyroid panel I had had done (The Doctors Laboratory in London) was 'complete', but from those you mention I have not had TT4, TT3 and Reverse T3 done!
A viral panel i.e. EBV, CMV, Coxakie A and B, Echo virus A and B, etc might be useful for many, as dormant EBV/CMV that has reactivated can sometimes explain certain problems, or maybe Aspergillus for testing if moulds causing problems.
In practise, I believe the cold nodule in my neck is a result of gladular fever that I had in my 20ies, I had high titres of CMV/EBV IgG few years ago (reactivated previously dormant viruses), my chronic lyme disease causes lymphadenopathy and iodine deficiency among other things - impacting on thyroid, and 'my' LD co-infection bartonella henselae also 'likes' glands (and red blood cells and bone marrow)... so I have permanently swollen glands in neck, I guess what I'm trying to say is that thyroid problems in certain (in my view in many) cases are 'just' part of a bigger picture of MSIDS (multiple systemic infectious disease syndrome) that is missed by consultants who only look (if that) some blood tests of their field and fail to take detailed medical, travel etc history and what a patient tells into account. Thank you for your work.
The home blood test range is brilliant in its simplicity and ease of use, but as soon as you are looking at a large profile it is best to look at vacutainer postal options or visiting one of the hospitals or labs we use.
Not wanting to post a link to our home blood tests website - but you can browse the range by using the menu on the left. Let me know if you have any questions.
I would really like to see tests for TSI (thyroid-stimulating immunoglobin) available so that would be my choice! I strongly suspect I have an autoimmune issue but don't know which,so need to try the all the antibody tests. TSI is as far as I understand better for Graves, TPO for Hashi's, and TG Ab for both but to a lesser degree.
I had a Biolab mineral profile done which I think would be really great for thyroid sufferers, includes:
Hi Paul, had good experiences with Blue Horizon v's some others An active B12, MMA and Homocysteine would be a good package. And I agree with Hampster on above test.
We have a pernicious anemia profile with our privatebloodtests.co.uk (admin - please delete link if you need to and insert " our spire linked site ") which has B12, MMA and Homocysteine in.
I would second the request to include the TSI (otherwise called TSAb) because I have just found out from an eye specialist that my TSI is raised even though I had a TT 30 years ago for Graves'. My enlightened GP 'does not believe in' Graves' antibodies! - I take it he won't test for it then!
I have certainly read that when TSH receptor antibodies are detected, they look at thyroid hormone levels. If you are hyper, they must be stimulating!
However it does seem desirable to be sure. I certainly don't have any idea how many people have stimulating, blocking or binding and how often they occur together, and so on.
The idea that two or even all three types of TSHRab might be able to co-exist has rattled around my brain many times. I have not the slightest idea what the upshot would be.
If you are thinking that this might be a cause, well, if you can afford it easily, it would be interesting to find out. But I would not be holding my breath in anticipation of that being "the" answer.
Swinging between hyper and hypo is a very well-known occurrence in Hashimoto's sufferers.
Is it possible to see the hypothalmus/pituitary/adrenal options/testing as many of us are rendered speechless when visiting GP's. It appears now there is a genetic link as my 37year old daughter has Hashi's, diabetes 11, liver/kidney microsomal antibodies and recently diagnosed with Hughes. I am personnaly fading fast but can't visit ant NHS GP beause of past traumas.
My brother sadly died aged 48 years with sudden death/MI so it is possible that there is a clear genetic link.
Any ideas Paul ? for bundles for genetic conditions.
So sorry to hear of your family health problems. Genetic tests we do through TDL, and unfortunately the tests are not cheap - each one can cost several hundred pounds. It is worth talking with your GP about testing if there is a familial link (this will often trump the lab "no"), otherwise things will start to get expensive quickly.
I'll hopefully get my Son's tested but I cannot go to NHS GP.
My family history has been deleted from my GP records. I don't have the emotional strength/trust anymore to try and explain to another NHS proffesional. I had some blood tests last year but the proffessional denied having tested more than thyroid. On my second request from labs for missing lab tests copy records, I received the results (of blood tests he had denied doing) I also noted this same proffessional had tested more than thyroid and had requested various tests for exhaustion etc. Very long story but thank you
Thank you very much for your input in this matter. When looking at a new private blood test profile we have to weigh inclusions against eventual costs and clinical benefit. This is difficult to do, especially as everybody is an individual, so we will try to stick to thyroid related tests as closely as possible, although I appreciate that most tests mentioned above have a certain degree of clinical relevance.
To recap - this is a top level profile we are looking at - we offer the following already
(Spire profile take out thyroglobulin antibodty and TT4)
Will work on the top level profile over the next few days at the best price possible for thyroid UK members and readers, but we do have a problem - what do we call it?! Any creative ideas gratefully received!
Reverse T3 is an expensive test to include, so we will probably construct a profile with reverse t3 and without reverse t3, therefore making it up to the individual to choose.
Any extra private blood tests would be available to request as an extra, but the tests below are probably going to go in it.
TSH
FT4
FT3
Thyroid Peroxidase Antibodies
Reverse T3 - Options with and without.
TSH Receptor Antibodies
Total T4
Total T3
Thyroglobulin antibodies
B12
Folate
Ferritin
Vitamin D (25OH)
Magnesium
Zinc
The bundle will be made available through the Spire Network website , and also through TDL as a walk in using the London service, as well as a postal pathology pack through our original blue horizon website.
If bought separately on any of our websites the cost of all of these tests is well over a thousand pounds, so I am hoping to chop a significant portion of this off and am talking to the labs today. Wish me luck!
Paul.
Also look out for my 'good news on reverse t3' post.
Hi Just wanted to say how grateful I was to have the bundle of tests done a couple of months ago. They provided a great deal of information, especially relevant to me were the TPO and TGO antibody tests and also the TSH Receptor antibody test. I now understand why I feel so unwell on T4, and why I am now vascillating between Hypo (my original diagnosis) and hyper. Just need an expert on Hashis and autoimmune disease nnow.
Glad the profile was useful for you. As mentioned previously, it's expensive but covers a wide range of parameters. Luckily for you it has helped to explain a lot of things, whilst some people are fortunate enough to find out what is going on with a much simpler profile.
Once again, Happy to help. We always start the day here at Blue Horizon Medicals by saying that we want to enable as many patients today as possible.
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