Time of day for thyroid bloods

[Suin]

I've always read on healthunlocked that thyroid bloods are best taken in the morning, fasting, and no meds 24hrs before.

My recent endocrine appointment was at 5.45pm, I hadn't taken meds and wasn't fasting.

Will these results be a true reflection? Thanks, for any advice in advance 🌸

[greygoose]

Your TSH will be a lot lower than it would if the blood had been taken at 8.0 am and fasting. It could mean the difference between getting a dose increase or a dose reduction. I often wonder if doctors do this deliberately, or if they just don't know...

[Suin in reply to greygoose]

Thank you greygoose,

yes and I'm blooming paying for him, it was private endo appoint. He said T4 would have wained off by 6pm, which didn't matter as if none frm the day before.

I'm going to try to get my gp to do them,

in the morning, as they have done in the past for NHS endo. All crossed 😰

[greygoose in reply to Suin]

Well, it all depends... How keen is this private endo on the TSH? If he ignores it - and there are some that do - then it doesn't matter. It's just for the TSH that you should get tested earl and fast.

[Suin in reply to greygoose]

Ah, then that changes things, as he goes as much on symptoms as blood results.

I've been feeling less well lately, like I've hit a brick wall and not sleeping 🙈 Whereas I was really well in March

He's suggested upping my t4 from 100mg to 125mg and leaving t3 at 30, 🌸

[greygoose in reply to Suin]

Did he test the FT3? Do you know how well you are converting. It's not a good idea to increase the T4 if you're a bad converter.

If he mentions the TSH, just tell him that it gets lower as the day goes on - it's possible he doesn't know! However, blood tests should always be done at the same time of day every time. Otherwise, you can't really compare them.

[Suin in reply to greygoose]

Yes he tested t3, I've not changed the dose yet, as last time my t3 wasn't up, I was going to wait for results and post on here. I've been read about "pooling" and "RT3"

I thought it sounded like me. 🌸

[greygoose in reply to Suin]

125 mcg T4 sounds like a lot with 30 mcg T3. Do you have an absorption problem? Are all your nutrients optimal? Do you consume any unfermented soy?

If you can't convert all that T4 to normal T3, the body will convert it to rT3 to get rid of it. Do you have any FT4 and FT3 results from before you started the T3?

[Suin in reply to greygoose]

He tested my b12, ferritin and vit d, and I do think I may have an absorption problem, as these were all low but within range last August. I try to avoid soy, and gluten free has helped 🌸

[Suin in reply to greygoose]

Pre T3

August 2015 results

T4- 18.3 range(12-22)

T3- 4.0 range(3.1-6.8)

TSH - 0.65 range(0.27-4.2)

B12and FOLATE

B12- 303ng/l range (191-663)

Folate- 10.7ug/l range (4.6-18.7)

Bone profile

Calcium- 2.38mmol/L range(2.10-2.60)

Phosphate- 0.76mmol/L (0.8-1.5)

-Flagged as LOW

APL-54 U/L range(30-150)

Albumin-44gl range (35-50)

Adjusted calcium-2.38mmol/L range(2.20-2.60)

VIT D test

Vit D-97nmol/L

>50nmolL sufficient

30-50nmol/L vit D

Insufficiency

<30 nmol/L vit D deficiency

(Using Nat osteo society guide 2013)

IRON profile

Serum iron-14umol/L range(10-30)

Transferrin-2.30g/L range(2.0-3.6)

Ferritin-30ug/L (FER)- pre-menopausal (13-150)

Transferrin saturation -24%

LIPID PROFILE

Cholesterol -3.9mmol/L range (<5)

Triglyceride-0.79mmol/L range(<1.7)

HDL-cholesterol -1.1mmol/L (>1)

LDL-cholesterol-2.4mmol/L (<3)

Non-HDL-cholesterol -2.80mm/L

Chol/HDL ratio- 3.55

LIVER PROFILE

T.bilirubin-8 (<21)

Alp-54 (30-130)

Ast-14 (5-40)

Ggt-31 (6-42)

Alt-8 (4-33)

Albumin-44 (35-50)

MAGNESIUM

Magnesium - 0.86 (0.7-1)

UREA & ELECTROLYTES

Sodium-137 (135-145)

Potassium-4.7 (3.5-5.3)

Chloride-105 (95-108)

CO2-18 (22-29) Flagged As LOW

Urea-4.1 (2.5-7.8)

Creatinine-69 (40-110)

eGFR->60

[greygoose in reply to Suin]

OK, so you're not converting at all well. I don't think increasing the T4 is a good idea. if your FT3 was low, then it's the T3 that should be increased.

Your B12, folate and ferritin are much too low. Are you supplementing them? They could have an effect on the conversion.

Vit D is fine, as is calcium. No point in testing magnesium, it will always be in range, just take some, anyway.

You can also just take vit C, zinc and selenium without testing, they will also help your conversion.

[Suin in reply to greygoose]

I've been supplementing since October

b12, vit c. Iron,vit d, fish oils, b complex and on the Brazil nuts

Will see what the latest result it within a few days I hope. Thanks 🌸

[greygoose in reply to Suin]

How much vit B12? Does your B complex have methylfolate or folic acid?

How much vit d3? Are you taking vit K2 with it? Vit D3 works with magnesium and zinc, so might be a good idea to add in a little of those, too.

Be aware that you might not be getting much selenium out of your Brazil nuts, as pleasant as they are. There's no way of knowing how much is in them, and it could be very little.

[Suin in reply to greygoose]

I'm take 5000 vit d3, I'm not on k2, magnesium nor zinc, supplementing is So SO expensive along with private endocrine 😐

[greygoose in reply to Suin]

Yes, it is. But, you can't put a price on health, can you. At least take the K2, because supplementing D3 means that calcium will rise, and you need it to go into the bones and not the tissues.

[Suin in reply to greygoose]

I'm on jarrow 5000 methylcoalamin

The b complex has 400ug folic acid (as pteroylmonoglutamic acid)

5000 vit d3

2 x 210mg ferrous fumarate daily

3x 1100mg of lamberts pure fish oil

3x1000mg of lamberts time release vit c

I sometimes take 1 nutri adrenal extra if I mange it before 1pm

Thanks for all your help 🌸

[greygoose in reply to Suin]

You'd be better off with a B complex containing methylfolate, rather than the synthetic folic acid, which isn't well absorbed. Your folate needs to come up.

.

[Suin in reply to greygoose]

I'd been on the Thorne b complex till now, it's shot up to £26 on Amazon now, I need b's for the folate?

[greygoose in reply to Suin]

You need a B complex, when you are taking B12, to balance the Bs. Because they all work together. But, as your folate is low, taking one with methylfolate, will bring the folate up.

How about this one :

amazon.co.uk/Country-Life-C...

It's cheaper but still has the methyl versions of folate and B12.

[Hidden in reply to Suin]

greygoose is soooooo right about the K2. x

[Suin in reply to Hidden]

Any type of k2? Isn't that a mountain ? I feel like I'm stuck on it. I'd 2 hours sleep last night 😭

[greygoose in reply to Suin]

You want the MK4 type vitamin K, or

Menaquinone-4.

I use the one from NOW.

[Hidden in reply to Suin]

Hi Suin, it is a mountain but hard to swallow lol. The K2 recommended to me and now take is K2 MK7. x

[Suin in reply to Hidden]

Many thanks mango, some of the tabs are big enough, never mind mountainous😱 Xx

[Hidden in reply to Suin]

I know the feeling x

[SlowDragon Administrator]

Apparently Brazil nuts vary widely in selenium content, depending where they are grown. Supplementing selenium might be more consistent.

Have you added magnesium?

[Suin in reply to SlowDragon]

I'm not take magnesium, can you suggest any you find to be agreeable thanks

[Suin]

I may check my vit bottles, and get some selenium, I'd been supplement magnesium, but then have been order 25kg of Epsom salts and having 12 min bath x3 a week with 2 cups in it 🛀🏼

[greygoose in reply to Suin]

20 mins would be better.

[Suin in reply to greygoose]

Thanks greygoose you've opened my eyes today. 20mins will be no problem 😊

[Suin]

Thanks bjdame

I've results on paper in a heap 🙈