Advice for blood tests please

[Liam12]

Hi there everyone, I had a total thyroidectomy last November after being diagnosed with thyroid cancer and have since been on levothyroxine to replace it (I didn't have radioactive Iodine as I was classed as a low risk case) I am still trying to get my dosage right but am not happy with how I'm being dealt with at the hospital so have eventually realised I need to take control myself, I'm due a blood test next week and wondered if anyone can give me a list of exactly what I need to be tested for (plus any other info that may be helpful) If they won't do it all then I'll be happy to pay private , any recommendations for that would also be greatly appreciated,

Thanks Donna

[SlowDragon Administrator]

For full Thyroid evaluation you need TSH, FT4, FT3 plus TPO and TG thyroid antibodies and also very important to test vitamin D, folate, ferritin and B12

Private tests are available. Thousands on here forced to do this as NHS often refuses to test FT3 or antibodies or vitamins

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. Both companies often have money off offers.

All thyroid tests should ideally be done as early as possible in morning and fasting. When on Levothyroxine, don't take in the 24 hours prior to test, delay and take straight after test. This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip, GP will be unaware)

How much Levothyroxine are you currently taking? And what were your most recent results and ranges?

Presumably your GP explained....Always take Levo on empty stomach and then nothing apart from water for at least an hour after. (Vitamin D, magnesium, iron, HRT or calcium must all be minimum of four hours away from Levo)

Many take early morning on waking, but it may be more convenient and possibly more effective taken at bedtime

verywell.com/should-i-take-...

Many people find Levothyroxine brands are not interchangeable. Once you find a brand that suits you, best to make sure to only get that one at each prescription. Watch out for brand change when dose is increased or at repeat prescription. Many patients do not get on well with Teva brand of Levothyroxine. Though it is the only one for lactose intolerant patients

[greygoose in reply to SlowDragon]

I don't think that TPO/Tg antibodies will be very a helpful tests for someone with no thyroid. When the thyroid goes, so do the antibodies.

[SlowDragon Administrator in reply to greygoose]

Whoops sorry...yes though in private thyroid testing bundle they will get checked regardless

But not point asking GP or endo to test antibodies

But I understand the antibodies can remain even after Thyroidectomy

[greygoose in reply to SlowDragon]

I thought that was Grave's antibodies. Even so, the antibodies won't be doing anything with no thyroid and will likely be in-range. Be interesting to see.

[JacquieCB in reply to SlowDragon]

I have been educated that Levo keeps people awake. What do you think?

[SlowDragon Administrator in reply to JacquieCB]

JacquieCB

It varies from person to person

Personally I found it MUCH better taking Levothyroxine at bedtime. Quite a high percentage on here prefer it

Others try it and don't get on with it

I also take split dose T3 - 10mcg just before bed and 10mcg about 6am. I always sleep extremely deeply immediately after taking both these

Low vitamin D and/or low B vitamins can affect sleep

I found Dr Gominack website extremely helpful

drgominak.com/sleep/vitamin...

[Liam12]

Thank you so much for your answers and tips, I'll make sure I don't take my tablet in the morning as I've actually got a blood test first thing tomorrow at my doctors then another next week with my endo (shows they're not working together)

I'm currently on 112.5mcg (100 one day and 125 the next)

My last test was in May this year but I have no idea what dose I was on at the time as they have changed them so many times.

Am I right to say I should ask the dr tomorrow to test for: TSH, FT4, FT3, VIT D, FOLATE, FERRITIN AND B12 and not TPO and TG antibodies? and if they won't do them all I will get them done private, I'll then post the results for you to look at if you'd be so kind and I'll take it from there,

Donna 🙂

[SlowDragon Administrator in reply to Liam12]

Yes, that list of tests to request is correct

See what you can get from GP, then get anything else needed privately

Take your dose of Levothyroxine immediately after blood test, and then wait at least an hour before eating

[Liam12 in reply to SlowDragon]

Ok will do, Thank you so much, I'll post the results when I get them.