Thyroid UK
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Which recurring blood tests do I need

I have hypo. Diagnosed 3 months ago. I am on Levo (112.5mcg) and things have improved. I'm not there yet. What are the recurring blood tests I need to have and why for each? Seems that once hypo diagnosed NHS drops to TSH test and that's it and once in range they are reluctant to do anything further. I am due for another test and want to push for as much as I can get.

6 Replies

If you are still experiencing symptoms then the TSH is not much help ! You need to know the FT3 as well as the FT4 result - so you can see if the tablet you are taking is converting adequately into the ACTIVE thyroid hormone T3. You are only over medicated if your TSH is suppressed and the FT3 is over range.


You are so right - once the TSH reaches a level the 'job is done' for most doctors. No account of remaining clinical symptoms are considered. Even if the GP requests other than the TSH some labs wont do it. You might have to get a private test.

Usually, a blood test is every 6 weeks is necessary till you feel much better (not according to the TSH). When your next test is due request a Free T4 and Free T3 blood test, as it is T3 which is required in our receptor cells. T4 (levo) is supposed to convert to sufficient and sometimes it doesn't or the dose is too low. Some doctors think it's o.k. if TSH is anywhere in range but we feel better when it's around 1 or lower.

Always get a print-out with the ranges of your blood test results for your own records and so that you can post if you have a query.

If you've not had Vitamin B12, Vit D, iron, ferritin and folate tested ask for these to be done as we are usually deficient.

Once the TSH is anywhere in the range some doctors do not increase dose of levo which can mean the patient still may have troubling symptoms and is then given 'additional' prescriptions for the symptoms rather than an increase in levothyroxine.

Any time if you get symptoms ask for a blood test for your hormones. Make the appointment at the earliest and fast (you can drink water). Leave about 24 hours between your last dose of levo and the blood test - this allows the TSH to be at it's highest as it varies throughout the day.

Take any other medications about 4 hours apart from levo and some things can affect the uptake of levothyroxine. Levo has to convert to T3 which is the active hormone required in all of our receptor cells in order for us to function normally.

Levo should be taken first thing with a glass of water and wait approx 1 hour before eating. Vitamin C helps the conversion of T4 into T3.

When we are stable and feel well a blood test is usually yearly unless symptoms reappear.


Just had conversation with my doctor and once on medication they can't (so she says) dictate the tests carried out to the lab! They just state that I'm on medication for Hypo and it's then down to the lab. So, TSH by default and anything else if they feel necessary depending on the TSH result.....which means just TSH if within range.


Yes, you're right. TSH only and 'tough' if you are somewhere in the range. I doubt you will be given an increase in levo despite if you have clinical symptoms still.


I'm now looking at private blood test. There's one via this website that sends kit out and can perform 10 thyroid related tests - all done using a finger prick sample! Can that really be done and any one used similar?


Quite a few of our members have done so. If you put up a new post headed Pin-prick Blood tests those who have done so will respond. If you also put a code when you order you get a small discount and Thyroiduk also get a few pennies for their diminishing coppers for their website.


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