Blood test results

[Bagster]

I recently had a blood test with medi checks prior to booking an appointment with my GP. A week later I had a BT at my GP surgery. In both cases I fasted and had been without any medication for 24 hours. My private blood test result was TSH 4.5 (0.02 - 4.2), T4 14.5 (12 - 22), T3 3.7 (3.10 - 6.8). The GP result was TSH 2.9, T4 13.4 (same ranges). My GP ignored the private BT results saying 'levels go up and down' (!!!) and said I didn't need any increase on the 50mcg I am currently on. She doesn't want to re-test for 3 months and was less than encouraging about private blood tests. About 3 hours before I had the GP test I had a black sugarless coffee (just wasn't thinking). Could this have affected the TSH/T4 levels? I am thinking of just increasing my dose myself. Perhaps taking an additional 25mcg on alternate days and gradually increasing to 75mcg a day. I'm definitely feeling better but still suffering breathlessness and dry flaky skin as well as falling asleep inconveniently. Any advice gratefully received.

[Clutter]

Bagster,

Were both tests done at the same time of day? TSH drops after eating and drinking so drinking the coffee may also have reduced TSH.

If you have sufficient Levothyroxine you could increase dose to 75mcg to see whether symptoms improve. I think your GP was wrong not increase dose when TSH was 2.9. As for comment about private thyroid tests she's spouting rubbish. As long as accredited labs are used the result should be the same whether it is paid for privately or ordered via NHS.

The goal of Levothyroxine is to restore the patient to euthyroid status. For most patients that will be when TSH is 1.0 or lower with FT4 in the upper range. FT4 needs to be in the upper range in order that sufficient T3 is converted. Read Treatment Options in thyroiduk.org.uk/tuk/about_... Email [e-mail] if you would like a copy of the Pulse article to show your GP.

[Bagster in reply to Clutter]

Thanks for your response Clutter. Both tests were at a similar time of day - around 9 - 10 am, the only difference was the black coffee. I have a box or two of 25mcg left over so I'll try 75mcg for a while. I don't think my GP can be persuaded to revise her opinion. I'll try my luck with another GP in the practice when I make my next appointment. Many thanks again for your wise advice. All the best

[shaws Administrator]

Breathless is a clinical symptom. Doctors don't know this - as they only take notice of the TSH and don't know any symptoms at all. Even disabling ones like breathlessness, it would appear.

The aim of taking thyroid hormone replacements is to resolve all clinical symptoms, not to give us more which is most likely with too low a dose.

I think an increase wouldn't go amiss and I am not medically qualified but had undiagnosed/untreated hypothyroidism.

The following is important.

web.archive.org/web/2010103...

[Bagster in reply to shaws]

Thanks for your response Shaws. The article is interesting. Pretty similar attitude to my own GP. What I found most disturbing is that she didn't ONCE ask how I feel. And this is the first time I have actually seen this GP. The one who initially prescribed Levo was a locum. I'm raising my dose to 75mcg and will try out other GPs in the practice in future.

[shaws Administrator in reply to Bagster]

It's is not right that we have to go onto a forum to know what should be done. Thank goodness we are now able to communicate and pass on and accept information from others who are/were in the same boat.

This is another good link from the same deceased doctor and he only took a blood test for diagnosis and not thereafter. It will be explained here, i.e. the patient's effect of a dose was more important than a blood test, once on thyroid hormones.

web.archive.org/web/2010103...

[Bagster]

Thanks for another excellent link shaws. My temperature and pulse rate have always been quite low - as has my blood pressure. Nothing seems to have on impact on those markers. I'm very grateful for this forum, but very dispirited by the failings of NHS doctors to treat. All this talk of the necessity to make cuts makes me fume. (Hobby horse alert!) We spend less on health care in this country than almost any other country in the developed world. The US spends 17% of its GDP on healthcare, we spend just 9%. Less than Ecuador! Most European countries spend upwards of 10%. Rant over. Thanks again for your helpful comments.