My first post: advice ahead of repeat tests

[Saraband]

Hi there, I've been reading and trying to absorb the excellent information here - mostly struggling on that due to brain fog and memory issues! Also, before I forget (due to said memory issues), I am so impressed by the knowledge, time and patience of those replying to newbie posts. I'm not sure yet that there's much to be offered in my case since I'm still at a very early stage but nonetheless I appreciate all that must go into these replies. You are doing a great job

I can provide more background in terms of symptoms etc if needed, but to keep things brief here are some figures:

April 2014 Plasma TSH level (XaELW) 3.44mU/L (0.35 - 5.5)

Mar 2015 Plasma TSH level (XaELW) 2.84mU/L (0.3 - 4.2)

(Both the above part of wider basic tests by gp in response to fatigue etc. No further treatment)

Apr 2015 - TSH 2.92mlU/L (0.27 - 4.2)

FT4 12.0pmol/l (12.0 - 22.0)

(These results formed part of a private health screening by Bluecrest. Both were marked as fine. I didn't follow it up.)

April 2017 - Serum free T4 level 12.0 pmol/L (U 9 - 19)

Serum TSH level 5.9 miu/L (U 0.35 - 4.94)

Vit D 147nmol/L (I supplement.)

The clinician has noted: Elevated TSH; causes include the side effect of non-thyroidal illness, subclinical hypothyroidism and medication including anti-convulsants, amiodarone, beta-blockers etc. Suggest repeat in 3 - 6 months, after excluding non-thyroidal illness and drug effects. (I take no drugs on a regular basis.)

These were tests requested by my new gp (we moved house last year) again along with other tests, which I can supply if it helps.

My gp (who has seemed very sympathetic thus far) has asked for a repeat of the tests now rather than in 3 - 6 months’ time. (I would have pushed for that but am thankful that it wasn't necessary.)

The tests are being repeated on Wednesday and she is phoning me tomorrow, presumably to explain why they are being repeated as she won't know that I have a copy of the print out.

Is there any advice you can offer regarding anything I might raise with the gp ahead of the tests? Are there other tests I could try asking for? I am willing to have tests done privately but there seem to be such a range of options it's difficult to know which is the best choice.

(My father has hypothyroidism and type 2, insulin-controlled diabetes. I maintain prediabetic levels through low-carb, high-fat diet and have done for the last 3years+. )

Thanks for any advice you can offer.

[greygoose]

Well, there's really not much point in testing now, rather than in three months time, because, if your high TSH is caused by a virus, for example, it won't have had time to go down again. That's the reason for the protocol.

Make sure you have an appointment early in the morning - before 9 am - and fast over-night. That way, you will catch the TSH at its highest.

Were all the other tests done at the same time of day?

[Saraband in reply to greygoose]

Yes, I had wondered about the point of testing again so soon. On the other hand I really don't want to drag through another 3 months with nothing happening. I will ask the gp for her thinking behind this repeat test and perhaps learn more.

Thanks for the advice about fasting which I hadn't realised. The most recent previous test was at 4pm. Those from other years were certainly morning for the gp tests. The private health screen test was about 2pm and was fasting.

[greygoose in reply to Saraband]

The reason for the wait is that you don't want to be taking levo if you don't need it.

For the future, always try to do your tests at around the same time of day, otherwise, you can't compare them.

If your TSH was 5.9 at 4 pm, it would have been much higher at 8 am!

[Saraband in reply to greygoose]

You are right of course, greygoose, and I accept that I'm impatient. I feel this has been going on for so long - years - and this year seems worse than ever. I shall see what comes from the gp's call tomorrow. The repeat test is currently booked for midday. I can easily fast until then but are you saying that even with fasting through the morning, the levels will already be dropping anyway?

I am wondering if investing in Blue Horizon's thyroid check plus 10 is worth considering. bluehorizonmedicals.co.uk/t...

I shall certainly make sure any future tests occur at the same time of day too.

[greygoose in reply to Saraband]

TSH is highest early in the morning, and decreases throughout the day. So, yes, even with fasting, the TSH will be low. I don't know if doctors do that deliberately, or if they really don't know.

I think it would be worth doing the BH 10, if only for your own satisfaction. But, there's no guarantee that your doctor would accept those results.

[Saraband in reply to greygoose]

You've been so helpful. Thank you, greygoose.

[greygoose in reply to Saraband]

You're very welcome.

[shaws Administrator]

If your GP wants a test now. It has to be the earliest possible, fasting (you can drink water) and if you were taking thyroid hormones you'd allow a 24 hour gap between dose and test and take hormones afterwards.

Always get a print-out of your results. You can post if you have a query. This is from TUK:

thyroiduk.org.uk/tuk/testin...

[Saraband in reply to shaws]

The link is helpful, shaws, thank you.