Hi there, I hope it is alright for me to post this here. I have a long awaited appointment with an NHS endocrinologist in two days time with what I feel is suspected Hypothyroidism or Hashimoto's.
I am wondering what tests I would need to ask for. I have seen so many posts about inaccuracies and how hard these conditions are to diagnose - and how sometimes the bloods can come back fine, when really the NHS aren't looking at the bigger picture (something to do with secondary hypothyroidism, and autoimmune hypothyroidism/Hashimoto's among other things?) So I'm just wondering if anybody here could help me with their own experience and what I should ask for, and what I should insist they look at and how they can look at the whole picture in the best possible way - especially when it comes to autoimmune thyroid issues. I can't afford to go private so this is my only chance. Any help would be very much appreciated. Many thanks in advance. Lorna
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Thyroiditis86
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Have you had blood tests done by your GP? If so, if you type the results here along with the laboratory ranges people might be able to give you good advice about what to ask the Endocrinologist for.
Sadly no blood tests yet I think they'd do it there (at the hospital) and then diagnose (or misdiagnose) later!
Hello and welcome to the site!
From what I've seen here the NHS is fairly spotty in providing the tests you need. Free T3 seems to be neglected a lot here and it's important to get the results of that. So ask your GP/Endo for thyroid antibodies tests - that is TG and TPO (which only establishes that you have Hashi's), then if possible the aforementioned free T3, free T4 and TSH. The following nutrients are also very important to get results for: folate, ferritin, B12 and Vit D - as they are quite often deficient. These deficiencies affect how well our dosage is (or isn't) converted. Another important note: always have blood drawn first thing in the morning after fasting (water OK), and if on Levo leave dosage for 24 hours prior to testing. This gives the most accurate results for thyroid, but your GP won't know anything about that so don't bother asking 😏 . Results come back with your level (and then the range posted in brackets) this range is fairly broad and effectively eliminates a wide swath of people who are "sub clinical" - don't let that deter you. Once you have your results in hand create a new post here with each result printed line by line (followed by the range) - you will get the feedback you need here based on your numbers. Best of luck!
It sounds to me like you are more than equipped to deal with what's ahead, and very proactive - excellent! 👏👏. So many new arrivals post here utterly deflated and unaware of anything to do with thyroid - so you are well ahead of the game, and already collecting vital information. Good for you!
It would be helpful if your GP ordered TSH and FT4 in time for your endo consultation. Not much to discuss without blood results.
TSH over range means you have primary hypothyroidism. FT4 will usually be in normal range unless TSH is very high. FT3 is rarely tested unless TSH is suppressed <0.1. If TSH is over range thyroid peroxidase antibodies may be ordered.
Central hypothyroidism is diagnosed when TSH is low-normal but FT4 is very low. Central hypothyroidism is usually due to pituitary dysfunction (secondary hypothyroidism) or hypothalmus dysfunction (tertiary hypothyroidism).
These were my online results from Medichecks. I am not sure if there is anything worth pursuing here? As I have said, I suffer from aspergers so find a lot of this quite confusing so any help would be most appreciated. Many thanks. xx
TSH 0.939, Free Thyroxine (FT4) 15, and Free T3 (FT3) 3.47 are unequivocally normal (euthyroid) for someone not taking Levothyroxine and do not indicate primary or secondary hypothyroidism. You could supplement 100-200mg selenium daily which can improve thyroid function and may improve conversion of FT4 to FT3.
Thyroglobulin and thyroid peroxidase antibodies are negative for autoimmune thyroiditis (Hashimoto's).
Active B12 is good. It is very unlikely there is deficiency when level is >35.
Folate is optimal halfway through range. You could supplement folic acid or methylfolate for 2-3 months to raise folate.
VitD 34.3 is deficient. Your GP can prescribe vitD but make sure GP doesn't fob you off with 800iu which is insufficient to treat deficiency and refers to local guidelines or the NICE CKS recommendations for treating vitamin D deficient adults cks.nice.org.uk/vitamin-d-d...
Alternatively you can buy vitamin D3 without prescription. I suggest 10,000iu daily x 6 weeks and then reduce to 5,000iu daily and retest in 3-4 months. If you buy on Amazon please use the affiliate link healthunlocked.com/thyroidu...
Well, it was a waste of time. She was about 26 and didn't listen to a word I said. Was smirking mostly and said I had a test last year and I was fine and didn't require another. She gave me these levels only and I am unsure what they mean, any help would be gratefully received. So upset at the moment.
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I think they'd do it there (at the hospital) and then diagnose (or misdiagnose) later!
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