Thyroid UK
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What to ask gp??

This may sound silly but my second blood test is due next week (3 months waiting after first) one test is for the thyroid function the other is thyroid peroxidase antibodies. Originally my TSH was slightly raised, hence follow up

When I speak to the doctor I'd like to know what I'm talking about but at the moment I'm clueless as to what exactly gets tested, can anyone enlighten me please? I've seen lists of levels people add, vit d etc is this covered in these tests ?

Thanking you in advance.

3 Replies

The most common form of hypothyroidism is autoimmune primary hypothyroidism (Hashimoto's). This is when an autoimmune response attacks the thyroid gland which gradually fails. The pituitary puts out a hormone TSH which stimulates the thyroid to produce thyroxine (T4) and a little triiodothyronine (T3 - called 'liothyronine' in tablet form). The body converts the T4 to T3 as and when it needs it. T3 and T4 are mostly bound to transport proteins but a small fraction are unbound or 'free'. It is these free hormones 'fT3' and 'fT4' that are relevant.

The pituitary detects the fT3 and fT4 in the blood and as these levels falls it releases TSH, TSH rises dramatically as fT3 and fT4 fall. Thus, TSH is considered a sensitive marker of an individual's thyroid hormone status. This is true, but in some cases other conditions can reduce the pituitary output and the TSH assay is not always reliable.

The thyroid function test usually measures TSH, fT3 and fT4 (usually a GP can't get the fT3 assay done). If your thyroid gland is failing the TSH will be high and fT4 will be low. If the antibodies are high this shows you have autoimmune thyroid disease which is very common.

When you see your doctor ask for a copy of the blood test results. More important describe your symptoms and how they affect your life. Ultimately, if you have signs and symptoms of hypothyroidism it is important to ask for a trial of levothyroxine. The signs and symptoms are more important than the blood tests, unfortunately doctors tend to give too much weight to the blood tests.

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Thyroid function usually includes TSH and FT4 but sometimes only TSH. Thyroid peroxidase antibodies over range means you are positive for autoimmune thyroid disease (Hashimoto's) which causes 90% of hypothyroidism. Ask your GP receptionist for a copy of your results with the lab ref ranges (the figures in brackets after results) and post them in a new question for advice.

There is nothing else included in those tests. Ferritin, vitamin D, B12 and folate are separate mineral and vitamin tests.

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Thank you for your replies. I'm looking forward to seeing the gp next week as I'm taking a lot of pain medication for plantar fasciitis and severe knee joint pain which she has said is anterior knee pain. I have many symptoms listed but also my eye muscles are now not coordinated which an optician referred me to a dr for as it causes double vision-especially with patterns. My weight gain had been steady and it doesn't matter how hard I try I simply can not stick to the LCHF diet. If my levels are the same or higher next week I'm going to beg to be put on some form of medication as I can't keep taking pain meds. After 6 months on them I'm becoming addicted and I've had plantar fasciitis for nearly 2 years and it's getting worse and so painful to walk. I'm 43 going on 86! My mother is hypo which is why I'm being tested for autoimmune. I have a home gym but I can't get proper use out of it due to muscle fatigue. I'm not one to give up but frustration is making me tearful.

Thanks for listening to me rant but no one around me understands and I am not in contact with my mother.


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