Genova END08 Thyroid Hormones Urine test

[Serendipitious]

Does anybody know whether you should take your Levothyroxine when taking this test?

[SeasideSusie Remembering]

Serendipitious Yes, you take your normal amount of Levo during the 24 hours of the test. You are measuring what is getting into your cells, if you don't take your Levo then you can't measure it.

I've done the urine thyroid test three times now and timing is very important, you must make sure you only take 24 hours' worth of thyroid meds during the test. So if you take, say, 100mcg Levo daily, make sure that you don't take a second dose during the 24 hours.

You need to make sure you start the test with an empty bladder so say you get up at exactly 8am Sunday (change time to suit your own routine) then go to the loo but do not collect that urination. The instructions say to discard it, but just don't collect it.

Collect every urination after that, all through the day and the night until the next morning and collect the last urination at exactly 8am Monday. Even if you went to the loo at 7.30, go again at 8am and squeeze out every last drop.

[fibrolinda in reply to SeasideSusie]

SeasideSusie do you know how to compare the urine test results with blood test results done same time? Sorry to butt in just didn't get any replies when I posted them a few weeks ago.

Linda x

[SeasideSusie Remembering in reply to fibrolinda]

fibrolinda I don't think it's a case of comparing them, I don't think you can because you are measuring different things. It's more a case of seeing what's happening. The blood test is telling you what's floating around in your blood and the urine test is telling you what's happening at celluIar level so it's like comparing apples with oranges.

My understanding is that when optimally medicated the T3 should be over to the right hand side of the scale in the urine test (if that is where you feel best, but of course that's a generalisation as we're all different). The T4 doesn't matter much, because it's being converted to the active hormone T3 so it's the T3 that's important, just as FT3 is the important one in blood tests.

[fibrolinda in reply to SeasideSusie]

Yeah compare was a bad choice of words☺ on T3 only t3 in blood was 6.08 range top 6.80 but in urine t4and t3 were about the same just in bottom of range.

[SilverAvocado in reply to SeasideSusie]

Hi, Seaside Susie, I had one of these tests a few years ago, but no one, including the doctor who ordered it, turned out to know how to interpret.

You are the most knowledgeable person I've ever heard about this. Could you please explain a bit more how the numbers on the rest relate to what is happening in cells? Is this like a blood test where you're looking for a fairly high T3? Is what is being urinated out equivalent to what is actually in the cells, or is this the leftovers getting discarded?

Thanks so much!

[SeasideSusie Remembering in reply to SilverAvocado]

SilverAvocado I don't know everything there is to know about them I'm afraid. It's knowledge I've picked up from someone who does them regularly to monitor and adjust her thyroid hormone and she's been guided by Dr P. She's helped me with my own testing when I wasn't doing well on Levo but my blood tests said I was over medicated.

The urine test confirmed what I suspected from the blood tests ie poor conversion, but the urine test showed that the conversion was a lot worse than the blood test showed. Or rather, the blood test showed conversion wasn't as good as it should be, and the urine test showed that even though the blood test said I was converting FT4 to some FT3 virtually none was actually getting to the cells.

My own hormone practioner explained what the urine test measures and this is how I understand it.

I think we all know that the blood test is a snapshot in time so you're measuring what is in your blood at the moment it is drawn, that's all. It can't tell you what the hormone is doing when it starts circulating and getting into the cells.

The urine test measures what is 'downstream', it measures the metabolites (breakdown products) that are passed in the urine. Metabolites don't accumulate in the cells but appear to have a biological function in the cells. So my understanding is that it's not leftovers being discarded, (that was one of my questions!), but it shows what has passed through the cells. Not sure if that makes sense.

Like the blood test, the T4 is of lesser importance, we need to know what the active hormone T3 is doing, ie if we have enough, if the T4 is getting converted. So we're looking for (generalisation here) a T3 near the upper end of the scale in the urine test if that is where we feel well, just like with a blood test where we (generalisation again) look for FT3 to be in the top quarter of it's range.

I hope you can follow, it makes sense in my head, sometimes it doesn't come out right when you try to explain it!

[SilverAvocado in reply to SeasideSusie]

Thank you Susie, that is super useful!

So the urine test is kind of like a later and therefore perhaps more accurate view of what is reaching cells than the blood test.

I had hoped it could tell us what the cells had taken up and used, but it sounds like that's not it. So it's good to know.

[SeasideSusie Remembering in reply to SilverAvocado]

In a way, it does show what's being used. In my case, originally my urine T3 was showing under range at 690 (800-2500) and T4 half way through range. I gradually added some T3 and lowered Levo and 4 months later my T3 had increased to about 40% through the range. Another couple of tweaks and after a total of 9 months my T3 is over half way through the range so this is telling me how much of the T3 is getting into the cells.

[SilverAvocado in reply to SeasideSusie]

I have the problem that my blood levels get up to looking perfect, but I'm still mostly in bed. So I suspect the problem is in the cells and tissues. But there doesn't seem to be a way of testing that.

[SeasideSusie Remembering in reply to SilverAvocado]

Maybe the problem is somewhere else?

Nutritional deficiencies - are your vitamin and minerals all at optimal levels?

Adrenals - I've tested these, they were part of my problem.

Sex hormones - I've also tested these, also part of my problem.

Reverse T3 - my next test, due to be done in January.

[SilverAvocado in reply to SeasideSusie]

Yes, I've tended to have everything else pretty perfect. But also I'm realising I was much much more ill than other people having similar treatments even from the moment I had my thyroidectomy. So hormone resistence is the next thing I'm looking into. Although weirdly I just got a large improvement from splitting my dose, which I thought was a pretty trivial change.