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Newby - question about thyroid tests.

zepo profile image
zepo
26 Replies

I have all the hypo systems but GP says TSH is normal and won't look any deeper. Lots to read on the web sites, so I'm trying to cut to the chase here. May I ask if Blue Horizon, Medicheck and Geneva are all able to interpret the thyroid blood tests or do I need to find someone to do that? If they do read them, is there an extra charge for the service?

Thanks.

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zepo
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26 Replies
SeasideSusie profile image
SeasideSusieRemembering

Zepo

Blue Horizon and Medichecks have the option for Doctor's Comments at no charge. Personally, I would say you will get a better interpretation of your results if you post them on the forum and let members comment. Between the many experienced patients here we have a much better understanding of results than doctors. The reason being is that the doctors who do the comments on BH and Medichecks tests are NHS trained, so they will say the same as a GP, and most don't understand thyroid results and will only go by TSH result and ignore FT4, FT3 and antibodies.

Genova don't deal direct with the public, you need a "practioner" (ThyroidUK acts as your practioner when you order your test, and results go to ThyroidUK who then send them on to you), so they just provide the results then say to discuss with your practioner.

zepo profile image
zepo in reply to SeasideSusie

Thanks SeasideSusie. I guess it does not matter who does the test, NHS or Priavate. I guess it is all about who interprets them then. I was speaking to a private doc in my home town yesterday and he said he can draw the blood, send it to NHS lab and interpret the results for me. I guess that would be equal to going to BH or Medi and then to get the final opinion on this forum then?

SeasideSusie profile image
SeasideSusieRemembering in reply to zepo

zepo

I wouldn't pay the private doctor just to interpret the test. He will have been trained by the NHS and will have the same opinion as any NHS doctor and will probably only go by TSH.

Is this private doctor going to charge for drawing the blood? If so, compare the cost to Blue Horizon who can arrange for a phlebotomist to come to your home for £49. Or you can get blood drawn elsewhere, I think they have clinics (depending on where you live) but I don't know the charge. Medichecks can also arrange blood draw and I think may be cheaper than Blue Horizon. You can also do a fingerprick test with BH or Medichecks so no cost involved with that option.

Also, bear in mind that the NHS will only do certain tests if going through a GP, not sure if it's different if a private GP orders the tests.

Generally the NHS tends to only test TSH and maybe FT4. For a complete picture you really need:

TSH

FT4

FT3

Thyroid antibodies - Thyroid Peroxidase (TPO) and Thyroglobulin (TG)

Vit D

B12

Folate

Ferritin

You can, if you order by the end of August, get all those done with Blue Horizon for £79.32 using code AUGUST20 as that gives 20% off the normal price of £99.15 - bluehorizonmedicals.co.uk/t...

The same test can be done with Medichecks for £99 - medichecks.com/thyroid-func...

So if there's any cost involved with the private doctor, weigh everything up carefully.

Whatever you decide to do, then the blood draw should be as early as possible in the morning, no later than 9am. Also, delay breakfast until after the blood draw and drink water only until after the test. This then gives the highest TSH which is needed when looking for a diagnosis (and when looking for an increase in dose or to avoid a reduction when on thyroid replacement hormone). TSH is highest early morning and lowers throughout the day, it can also lower after eating and coffee also affects TSH.

zepo profile image
zepo in reply to SeasideSusie

Thanks for very helpful reply! The private doc did agree with T3, T4 and anti-bodies so he may be a step up from NHS. Although he did say that Thyroglobulin is not much use! Is it? The blood draw and interpretation are included in the price he said. So I will need to compare. It's hard when the brain is in a fog tho! Cant just reach for a thinking cap! lol

I can't do a finger test for all the thyroid ones can I?

He can do more tests than NHS - although they would all be done at my NHS hospital.

Or, he said he can just draw the blood and I can send to BH or wherever. Just thought it might be easier for him send off.

Crikey before 9 a.m.! eeek! So much to learn!

SeasideSusie profile image
SeasideSusieRemembering in reply to zepo

zepo

Although he did say that Thyroglobulin is not much use! Is it?

Yes, it can be. If Thyroid Peroxidase came back negative, which would be interpreted as no autoimmune thyroid disease (aka Hashimoto's) it's possible that Thyroglobin antibodies, if tested, could be positive and that could then confirm Hashi's. With Hashi's, TPO antibodies are more common though.

I can't do a finger test for all the thyroid ones can I?

You can indeed. Not everyone can manage fingerprick tests. I've done so many I find them easy. There's a bit of a knack to get the blood flowing but with a bit of practice most people can do it. The full thyroid/vitamin panel requires 2 microtainers, each containing 0.8ml of blood for the fingerprick test.

zepo profile image
zepo in reply to SeasideSusie

WHat would 0.8ml look like - about half an inch in the phial?

zepo profile image
zepo in reply to zepo

Seaside Sue - you said earlier that the THS needs drawing before 9 a.m. I put that to the private doc and he said that THS is the same all day and that it is Cortisol which needs doing early! Hmm!?

SeasideSusie profile image
SeasideSusieRemembering in reply to zepo

zepo

you said earlier that the THS needs drawing before 9 a.m. I put that to the private doc and he said that THS is the same all day

Well, he is incorrect. There is a circadian rhythm. Have a look at the first graph in this post which shows how the TSH varies throughout the day. You'll see that it is highest between midnight and 4am and lowest around 1pm. There is a link to the study further down the post.

healthunlocked.com/thyroidu...

So if you want a diagnosis of hypothyroidism you need the highest TSH possible. That means the earliest possible blood draw. You wont be able to get it done between midnight and 4am so it needs to be done at the earliest time of the day when doctors and clinics offer it.

Your doctor will probably also say that eating and drinking doesn't affect TSH either, again it's best to fast before a thyroid blood test - by that it means delay breakfast when having an early morning blood draw until afterwards as eating can lower TSH, and coffee also affects TSH so water only is recommended.

These are all patient to patient tips that we don't discuss with doctors or phlebotomists because of the answer you got when you did.

SeasideSusie profile image
SeasideSusieRemembering in reply to zepo

Zepo

WHat would 0.8ml look like - about half an inch in the phial?

Think more of what a teaspoon holds - 5ml. So you would get 6 and 1/4 x 0.8ml amounts in a teaspoon.

As phials come in different sizes, and I don't know if you know how small a microtainer is, I can't say that it's half an inch.

zepo profile image
zepo in reply to SeasideSusie

Hmm I think I'll have a practice pin prick test and see how easy it is to get the blood. I don't know what a microtainer looks like, no. Thanks.

SeasideSusie profile image
SeasideSusieRemembering in reply to zepo

zepo

Don't practice with a pin, it wont do what a proper lancet will do. This is how you do fingerprick tests

youtube.com/watch?v=InHBLT-...

zepo profile image
zepo in reply to SeasideSusie

Does it take ages to get enough blood this way though?

SeasideSusie profile image
SeasideSusieRemembering in reply to zepo

Takes me a couple of minutes tops to fill 2 x microtainers, but I've done lots and find it easy.

humanbean profile image
humanbean in reply to SeasideSusie

Medichecks is offering 20% off all their tests throughout September.

SeasideSusie profile image
SeasideSusieRemembering in reply to humanbean

Yes I saw that, have made a note of the code, will get a couple of tests in stock seeing as we have 6 months to use them.

zepo profile image
zepo in reply to humanbean

Oh I thought it was August? Or is that Blue Horizon?

SeasideSusie profile image
SeasideSusieRemembering in reply to zepo

Blue Horizon had 20% off during August. Now it's Medichecks turn, from 1st - 30th September MED99 gets 20% off any test not already on offer

healthunlocked.com/thyroidu...

SlowDragon profile image
SlowDragonAdministrator

Essential to test vitamin D, folate, ferritin and B12 as well as full Thyroid and antibodies

Thousands on here forced to use private testing via Medichecks or Blue Horizon

zepo profile image
zepo in reply to SlowDragon

SlowDragon thanks. Would you say go for Serum B12 or Active B12? I have yet to look into that one. Do you know what level D I should aim for?

SeasideSusie profile image
SeasideSusieRemembering in reply to zepo

zepo

The Vit D Council, the Vit D Society and Grassroots Health all recommend a level of 100-150nmol/L.

SlowDragon profile image
SlowDragonAdministrator in reply to zepo

Medichecks use active B12.

Blue Horizon use B12 serum

You have option with both companies to pay extra £25 for blood draw at "local to you" clinic or hospital

Drink plenty of water day before and morning of test to be well hydrated

As discussed, test should be as early as possible in morning and fasting to give highest TSH

zepo profile image
zepo in reply to SlowDragon

If I had serum B12 I understand it needs to be above 500, but what level would you need with a B12 active?

SlowDragon profile image
SlowDragonAdministrator in reply to zepo

Under 70 is suggestive of B12 deficiency and recommended to get MMA and homocysteine tested

Or just start supplementing

viapath.co.uk/our-tests/act...

nutris.viapath.co.uk/pages/...

loridlee profile image
loridlee

Do you have a thermometer? Get one and take your temperature first thing in the morning. It should be 98.6, and if it is low, your thyroid is likely that low. It could be just a degree off, and your thyroid is causing you problems. The doctor can run a Free T3 and reverse T3 test to see how your thyroid is actually functioning, because you may be converting too much of your active thryoid to inactive thyroid hormone.

zepo profile image
zepo

loridlee - my temperature is always low. I use centigrade and it can often be 35.4 and usually under 36. I think 35 is considered hypothermia level, but my GP takes no notice. During the heat wave it was 24 degrees C indoors and I was cold and put a fleece on. 1st thing in the morning and at all other times it can be 35.4. What is the solution if one is converting too much active thyroid to inactive hormone?

SlowDragon profile image
SlowDragonAdministrator in reply to zepo

It doesn't work that way around. Our thyroid produces 80% T4 (inactive hormone) and 20% T3 (active hormone)

T4 must be converted in body to T3

Thyroid problems can be due to

Low thyroid hormones

Poor conversion of FT4 to FT3

Low vitamins affecting uptake

Low stomach acid

Gluten and/or dairy intolerance

drbradshook.com/understandi...

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