What tests should I be asking for?

[Dbe447]

Many Hypothyroid symptoms. Test Results:

16/02/2017 TSH 8.01 mu/L Range 0.35-5 mu/L

Drs comment - Change in TSH method 20/06/2016. No significant difference seen on evaluation. Slightly raised TSH with previously negative thyroid Ab - UK Thyroid Guidelines recommend monitoring TFT's every 3 yrs unless new symptom's develop.

27/04/2011 TSH 8.29 mu/L Range 0.35-5 mu/L

Serum free T4 .10.9 pmol/L Range 7-20 pmol/L

07/01/2004 Thyroid peroxidase antibody level 7 iu/mL Range <70 iu/mL

TSH 6.78 mu/L Range 0-5 mu/L

Only Vitamin tests done are Vitamin D

07/08/2017 Total Vitamin D 28 nmol/L Range 50-150 nmol/L

05/07/2013 Total Vitamin D 33 nmol/L Range 50-150 nmol/L

Thank you.

[Nanaedake]

Your Vitamin D is under range, what is your doctor doing about it? Could you make a list of symptoms and go back to the doctor and ask for tests for vitamin B12, folate, ferritin and a full iron panel? Check on Thyroid UK website for a checklist of hypothyroid symptoms you can use to take to your doc and discuss treatment. Also, check on the BTA website for updated guidelines on treatment of hypothyroidism. I think the range given is something like 4.0 to .02 and you could point that out to your doctor.

british-thyroid-association...

This is an excerpt from the linked document, "For serum TSH, the reference population shows a log normal distribution and has a diurnal variation with the reference range in thyroid disease free individuals typically cited as between 0.4 and 4.0 mU/l."

[Dbe447 in reply to Nanaedake]

Dr refused to do a Vitamin D blood test I had to pay for privately. Did the same last time, when I gave result to them las they time they said private was unreliable and redid the test. Am trying to get an appointment re new results but all appointments are gone by the time I get through.

Elevated TSH for 13 years and when I asked for new free T4/T3 and antibodies they said no not required as TSH is not over 10 mu/L.

[Angel_of_the_North in reply to Dbe447]

Get a new GP, yours is never going to make you well. The private vit D tests that TUK direct you to are done by an NHS lab in Birmingham so how can they be "unreliable"? That's probably legally scandal (or libel if the GP wrote it down) as it is suggesting that the lab is not properly certified. Doctors really should be more careful and less arrogant.

[SlowDragon Administrator]

Look up your local CCG. Once on the site look up vitamin D. There will be guidelines on how to treat.

Print out, take along and ask GP to treat according to the guidelines.

Ask to also test folate, B12 and ferritin.

What time of day was the last thyroid test blood drawn? Best way to get highest TSH (all many doctors look at) is to get blood test done as early as possible in morning and fasting.

[Dbe447 in reply to SlowDragon]

Thank you. Have looked at local CCG but they have nothing re Vitamin D. Will ask for the tests you suguest as Dr has only asked for TSH on next test.

Blood test is at GP'so and because TSH is not technically a fasting test they won't give me an early blood test. Closest I managed to get was 9.50am.

[SlowDragon Administrator in reply to Dbe447]

Here is Oxfordshire CCG guidelines

oxfordshireccg.nhs.uk/profe...

You can see recommended that take 1600iu daily and retest at 6 months

You can buy your own vitamin D. "Better You" vitamin D mouth spray widely available and easy to use.

Could do 2 x 1000iu spray daily and retest after 3-4 months

Vitamindtest.org.uk - £28 postal kit

[SlowDragon Administrator]

Or you can get full Thyroid and vitamin tests privately.

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

Medichecks Thyroid plus ultra vitamin or Blue Horizon Thyroid plus eleven are the most popular choice. DIY finger prick test or option to pay extra for private blood draw. Includes vitamin D.

[shaws]

If you are in the UK, I know the recommendation by the BTA is not to precribe until the TSH is 10. Which is really ridiculous as other countries prescribe when the TSH is 3_ with symptoms. I shall give you a list of symptoms and tick off the ones you have and say you've taken advice from the NHS Choices for dysfunctions of the thyroid gland and you've been recommended that the GP begins with 50mcg of levothyroxine and an increase of 25mcg every six weeks until TSH is 1 or lower and a T4 and T3 towards the upper part of the range.Your FT4 is bottom and you will then not be able to produce the only Active Thyroid Hormone required in your receptor cells, T3. Ask him to test FT4 and FT3 and I'll give you another link which you can also show to him. They are very poorly trained and the patient suffers unnecessarily.

when you have a blood test for thyroid hormones it as to be the earliest possible, fasting, you can drink water. If on thyroid hromones you'd allow a gap of 24 hours between the last dose and test and take afterwards.

thyroiduk.org.uk/tuk/about_...

You will see from the link below you should be on thyroid hormone replacement. Tell GP if untreated you can develop other unpleasant illnesses. He should start you at 50mcg of levo with a blood test every six weeks with a 25mcg rise in levothyroxine until your TSH is 1 or below.

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

Ask for Vitamin B12, Vit D (both are essential pro-hormones and need to be top of range).

iron, ferritin and folate. I shall give you a link by SeasideSusie who will give her usual good advice.

This is from an earlier post and cursor down to you come to SeasideSusie's response.

healthunlocked.com/thyroidu...

[Dbe447 in reply to shaws]

Thank you so much. Just looking at the syptom list makes me feel so angry. My GP/other medical practitioners have diagnosed so many conditions on that list based on symptoms also on the list.

The indication by SeasideSusie of where optimal is likely to be re vitamin levels will be so useful. If I can't get my GP to do the tests I will look at paying privately I am just so tired of feeling sick and tired.

[shaws in reply to Dbe447]

The NHS must pay out a fortune on unnecessary prescriptions for the clinical symptoms of hypo, rather than an optimum dose of levothyroxine or T4/T3 (I know they've suspended T3 which is a catastrophe for many). Not taking into account how unwell patients feels when not treated optimally for relief of all symptoms.