So, my ivf was cancelled last week with the following email sent to me:
Abnormal high , TSH 10.75 mIU/L (should be <2.5)
Free thyroxine 15.1 pmol/l (normal between 12 and 22) – low normal.
I was advised to go to the GP, give them the results and get tests done so I could lower my levels. That was on Thursday maybe. Friday I got a GP apt with bloods taken.
Serum TSH level came back : 4.00miul/L normal
Serum Vitamin B12 level 239ng/L [150-900]
Serum Folate 6.5 ug/L [3.1-19.9]
Ferritin 75ng/mL [10.0-210.0]
Renal Tests ok (or at least not 'flagged up' everything else back within range except Liver Function Tests:
Serum GGT level 46iu/L [0/0-37.0] Above range
Serium total protein 83 g/L [60.0-80.0] Above range
Serum Albumin level 51 g/L [35.0-50.0] Borderline
Any idea what this could mean please?
I'm struggling to see how my TSH can jump from 10.75 to 4.00 in a week/ 8 days on the same level of Levothyroxine. I only changed my Levo amounts until after seeing GP with the clinic results.
When I googled Serum GGT it said something about 'alcohol and liver'. I don't understand. I've been Gluten Free for nearly a year, which sadly means abs no real ale, beer, or Gin. I don't drink wine. I'm still taking microgynon daily and now 75mg Levo. Totally confused. Many thanks to everyone in advance x
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High Serum GGT level isn't just caused by alcohol consumption, it's a test for liver disease and other things. But, I don't know the details, I'm afraid.
Did you have both tests done at the same time of day? Do you have high antibodies? Was your FT4 the same in both tests?
Your B12 is rather low. Did anybody say anything about that?
Yes, I had all bloods taken in the morning. I don't like needles, so I said they could take as much as they needed for as many tests as they needed as I didn't want to keep coming back.
Last year I had high antibodes - and was told I was 'Hashimotos'. Have been gluten free since. I haven't had antibodies checked though since - from either the clinic or GP even though I ask. Both say, it's not important. I didn't get a FT3 or 4 result from the GP - at least I didn't see it in the print outs. No, they haven't mentioned my B12. They just said my liver tests were raised and I should call again and speak with GP.
They're right, it's not important - but not in the way they mean! Antibodies are very important, but it's not important to retest because once they're there, they're there for life. You may succeed in lowering them, and in feeling better, by going gluten-free, but you will still have Hashi's.
And it is the Hashi's that causes swings in levels like that. You'd think doctors would know that, but they don't.
If I were you, I would check the B12 symptom list, and see if you tick off many boxes. If you do, you should supplement your B12.
Yeah, that's a tricky one to answer, because the TSH doesn't move very fast - quite how fast, I don't know, but it lags behind the Frees, which react quite quickly. And that's why it's so wrong to test the TSH only. It doesn't tell you anything much. There could be other factors that we don't know about, like human error in the laboratory. But, why split hairs? Hashi's does cause levels to jump around, and your doctor won't know any better than you, so stick to your story.
I'll give them a call tomorrow and ask to speak with the GP. I'll give them a chance to speak first. Just gutted that ivf has taken another blow to the system, after getting ready, paying for sedation and endo scratch and it's cancelled again.
How one lab can be so diff from another in the space of a week is so puzzling. I also took 25mg around midnight (an imbetween 5omg) as I didn't think they would do bloods - just said take meds as normal but no food. I didn't think TSH would move that fast. I can see why the T3, 4 and antibodies etc all need to be done, but it's just mind boggling how these places don't see the need. I know I have Hashi still, and Hypo, and Endo, but I'll see what they say tomorrow.
Many thanks for your advice, and talking/ listening. Quite frustrating getting results that are so different - I thought they would be roughly the same, and by having the 25mg if anything they might come back higher than TSH 10.7.
Taking levo close to the test won't have any effect on the TSH. It doesn't move that fast! But it will affect the FT4 - which you didn't have done, so it doesn't matter.
I can imagine your disappointment, and I'm so sorry. Fingers crossed for your GP call tomorrow. x
Could taking an alternate dose 25/50mcg daily cause the blood test discrepancy? I.e dependent on the last dose you took 24 hours before the blood test?
Judging by what you’ve said above it sounds unlikely tsh would react that quickly ...
No, it wouldn't affect the TSH. It's the monthly/weekly total that has an effect, not the individual days. As you said, the TSH doesn't move that fast.
So, I just had a 'call back' from GP regarding my bloods. She couldn't wait to get off the phone. I would say she was on there for possibly a minute tops. She said "everything was fine". My kidney function was ....errrr and possibly I wasn't drinking enough water. I replied I drink a lot of water, and had done that morning as I didn't want to be told they couldn't find a vein.
She said my GGF levels and protein were due to alcohol and I should cut down. I just laughed at her and said "I have Hashimoto's since last June". I haven't had any alcohol at all.
She didn't have a reply. I could just hear her tapping away on the keyboard, probably writing "Hashimotos' and Gluten intollerant" in my notes. I mean, by now you would think they would be all over my notes anyhow. Enquiring on my TSH, she said "it's 4. You're fine, go back and tell your clinic you can start". I told her they needed it to be lower than 1 to start, and asked why it was 10.7 and jumped to 4. She said "I don't have answers for these labs".
End conclusion: Cut out alcohol, which I haven't drunk in a year, come back in 3 weeks time to see if my bloods were a 'blip'. What a waste of time. She it completely useless. Am so angry.
Yes, I'm afraid most of them are pretty useless. I can understand your anger. A TSH of 4 isn't fine for anybody, but she knows so little about thyroid that she's totally lost. Is she going to give you an increase in dose? If not, I think I would write to the practice manager, if it were me, and complain about her incompetence.
No, she wants to leave me on 75mg. To be honest, I was on 75mg in Jan/ Feb until a medical review, and have been around 50mg, so I guess it is 'going up' 25mg back to what it was.
She is totally useless. I wish they would just say 'I don't know, but I will make a referral for you'. The problem is, everyone has left the practice with the exception of the receptionists. One of the GPs died and mine decided to retire. Since then we have had locums, including locum nurses for maybe 2-3 years. There is nobody really consistent there. I think my oh and I need to look into trying to get a referal to an Endo at the hospital or pay private, otherwise ivf may not happen, or it could go horribly wrong if it works. Thank you so much for all you advice. Nice to hear the truth from someone who is informed and cares. Blaming the labs... really lol.
Yes, I think private might be the only intelligent way to go. But, research your endo carefully before choosing. Do you have the list of patient recommended endos? If not, email
dionne.fulcher@thyroidUK.org
But, I would still make that complaint, if I were you. That GP is not fit for purpose!
No, I don't have a list of recommended endos. I've just tried to googling online to no avail. I will email dionne. Thanks for all your help. I will email and see if she can recommend or provide a few possibilities, and then discuss with my OH what we should or could do next - make a complaint, wondering what to say to the clinic etc. It's hard when they both blame each other and yet the clinic continues to take money each time you chat with them (even when they don't know about bloods, TSH etc.) Will email her now for list x
Gosh that is quite a shock- but since ivf was cancelled after first blood test did you stop taking all the ivf hormone meds? Maybe the time between blood tests and without hormones may have brought tsh down.
I’m convinced ivf meds have a significant effect on thyroid. My tsh jumped up massively with ivf. as soon as I started the meds I put on half a stone in a weekend and felt very sluggish! I thought it was just side effects from the hormones but now my thyroid results show why.
I would in your case push your GP to lower your tsh to 1 or lower - so that even if you’re tsh does spike a bit during ivf it will have a relative buffer in range. And check it within a couple weeks of starting ivf meds/pills
So, I just had a 'call back' from GP regarding my bloods. She couldn't wait to get off the phone. I would say she was on there for possibly a minute tops. She said "everything was fine". My kidney function was ....errrr and possibly I wasn't drinking enough water. I replied I drink a lot of water, and had done that morning as I didn't want to be told they couldn't find a vein.
She said my GGF levels and protein were due to alcohol and I should cut down. I just laughed at her and said "I have Hashimoto's since last June". I haven't had any alcohol at all.
She didn't have a reply. I could just hear her tapping away on the keyboard, probably writing "Hashimotos' and Gluten intollerant" in my notes. I mean, by now you would think they would be all over my notes anyhow. Enquiring on my TSH, she said "it's 4. You're fine, go back and tell your clinic you can start". I told her they needed it to be lower than 1 to start, and asked why it was 10.7 and jumped to 4. She said "I don't have answers for these labs".
End conclusion: Cut out alcohol, which I haven't drunk in a year, come back in 3 weeks time to see if my bloods were a 'blip'. What a waste of time. She it completely useless.
😱☹️🧐😡🤣😔😢🤦🏻♀️🤦🏻♀️🤦🏻♀️🤦🏻♀️🤦🏻♀️🤦🏻♀️< literally the sequence of emotions I had reading that !
What a joke. Makes me so mad- they fully admit they don’t have A clue but then will not be open to finding out any answers or information you can provide either.
The alcohol one made me laugh- goodness me. Have you been unwell at alll recently ?
A liver detox can help- especially with all the vitamins etc we’re taking. Dr izabella wentz’s liver protocol is supposedly quite good. Not sure what those elevated liver tests mean - but combined with iffy kidney ones it could point to stress/inflammation/infection possibly?
I felt like death on microgynon (even though I took it on my 20s for years) it was the cause of my b12 deficiency being exacerbated. I wonder if your clinics labs were a blip.... your tsh needs to be below 2.5 for fertility but hypothroid sufferers feel better around 1 generally. You could ask your clinic to top up the thyroxine dose from your GP in meantime if you’re not getting anywhere with them. P.s every tsh range comes from 0.27ish-4ish
So why are GPS so reluctant to increase dose when you can still be in the ‘normal’ range.
I wasn't on any ivf hormones, I was just on the pill (microgynon) , had the blood test the same morning of my Endo scratch under sedation. A week later when I was due to start taking the ivf drugs I get the email telling me to stop and it wouldn't go ahead as I was 'abnormally high' and get to the GP asap. I'm still on the pill now. I didn't increase the Levo until I had that GP apt after my blood were taken.
Totally confused, a little upset kind of as I was expecting my TSH to be around 11 ish - accounting for the 25mg I took the night before the test (which I though would make the TSH higher).
Puzzled.... why does my body or the clinic lab hate me. Grr. Will keep you posted after I speak with GP. I do agree that I need that 'buffer' though incase I spike again. Totally confused. ????
Yes, 25mg midnight before test. Was told to take all meds as normal - even microgynon with water at 6am. Decided on 25 rather than 50 as I wasn't told they would do the blood test.
Yes do have Hashimotos - was diagnosed last year June with high antibodies. Have been GF since.
Have been put back on 75mg for another 5+ weeks until next blood tests with GP
Thanks, our parents are no longer with us. Both had cancer, my brother has Non Hodgkins cancer. He doesn't know about me. I'm assuming if that's lymph system maybe it's genetic. Don't have family to ask any more. I did have TSH of around 1 in Jan, but the GP was going to take the Levo away altogether saying I was "now borderline Hyper and overmedicated". I had to pursuade her I would go down to 50 which she agreed to. I was feeling really good at 1. Bit of a nuisance when GP's don't test T3 or T4. Thanks for your advice x
I had a 'medical/ drugs review' so I couldn't tell you if she was a GP or someone higher, but she 'prescribed drugs'. I did tell her I felt really good where I was in Jan, on 75 but I got the impression she was worried about costs. I even offered to pay lol. I was then worried I might turn hyperthyroid and have different symptoms and still feel rough. It has been a really steep learning curve and I will never lower my dose again. I would just be worried if they did stop prescribing though or lowered the dose themselves. Maybe hypo and Non Hodgkins are linked? I've read of other people who have both in their families. Am so greatful all of you on this site know so much more than GP/ locums and clinics. I think otherwise unless you're linked to an Endo specialist at the hospital you stand no chance.
Hmmm, tightly controlled. They are generally all nice at my GPs but have little to no understanding of how to monitor and what T3, T4 means etc. Will update you all after I have call with GP.
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