What tests can I request from an endocrinologist on the NHS?

[sgodsave]

Hi all, I'm very puzzled. You all seem to have been offered, and given, various blood tests, which I have been advised I have no access to on the NHS via GP. THS is the only level I'm regularly tested for. Was diagnosed as hypothyroid. My levels jump about and I'm very sensitive to slightest change. My surgery changed my brand a couple of years ago. I've now switched, but although I feel better, I've never felt 'myself' or symptom free since being diagnosed 8 years ago. GP said he can't prescribe T3 medication. He's referred me to a consultant. What tests should I push for? Thanks

[SlowDragon Administrator]

Sounds like you may have Hashimoto's also called autoimmune thyroid disease diagnosed by high thyroid antibodies

Low vitamin levels are extremely common especially with Hashimoto's

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)

About 90% of all hypothyroidism in Uk is due to Hashimoto's. Low vitamins are especially common with Hashimoto's. Food intolerances are very common too, especially gluten. So it's important to get TPO and TG thyroid antibodies tested at least once .

Link about thyroid blood tests

thyroiduk.org/tuk/testing/t...

Link about antibodies and Hashimoto's

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

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

Always take Levo on empty stomach and then nothing apart from water for at least an hour after. Many take early morning, on waking, but it may be more convenient and possibly more effective taken at bedtime.

Other medication at least 2 hours away, some like HRT, iron, vitamin D or magnesium at least four hours away from Levothyroxine

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

[sgodsave in reply to SlowDragon]

Thanks so much for all the information. Very much appreciated. I'm not seeing the endocrinologist until November so rather than delaying, I'll have a look at the two you suggested.

Yes, you guessed right. I was switched to Teva. Took me ages to work out that it was the brand change. I've since switched back to Activis. Certainly more stable.

Thanks once again.

[SlowDragon Administrator in reply to sgodsave]

We get hundreds on here have reacted extremely badly to a Teva

[Hidden in reply to SlowDragon]

Not on it, so this is just of academic interest to me, but do you know why? A specific filler or is it low potency or something?

[SlowDragon Administrator in reply to Hidden]

Would suspect poor absorption in gut, but that's just a guess. They are the only UK one that is lactose free

healthunlocked.com/search/p...

All different brands of Levothyroxine are not interchangeable. They all give different level of uptake in different individuals.

Different brands are not bio equivalent

academic.oup.com/jcem/artic...

[shaws Administrator in reply to sgodsave]

Post your results with the ranges onto a new post and members will respond.

[humanbean]

It is likely in many cases that the people quoting blood test results have paid for them privately.

The various companies used on this forum for doing blood tests without having to pay for a doctor are :

Medichecks

Blue Horizon Medicals

Genova Diagnostics UK

Regenerus Labs

There may be others I'm not aware of.

You'll find details about how they operate (they don't all deal with the public in the same way) here :

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

[LAHs in reply to humanbean]

And if you are in the US we have True Health Labs (we have others but this is the main one I use and found them very good). We also have Genova Diagnostics (used them once, they are also very good). You can Google True Health Labs to get to their website - choose your test, fill out their form then go to a draw site and get your blood drawn. You then receive your results via email. It's very efficient and gives you peace of mind knowing where you are without arguing with your doc.