Blood results - what does it mean?

[Kip4]

Hi all! So I obtained a copy of my blood results from June 2018 which resulted in my GP prescribing 50mg of Levothyroxine. Only 1 item tested for which I know from previous responses is not enough. Please help me understand what the result tells me, thank you!

[greygoose]

Well, it doesn't tell you very much. Given that a normal (euthyroid) person has a TSH of around 1, and hypos usually need it lower than that, one assumes that your thyroid hormone levels are too low. As a general rule, the higher your TSH - a pituitary hormone - the lower your thyroid hormones will be. Although that isn't always the case. So, your TSH says that your thyroid is struggling.

It's amazing that you got diagnosed with that TSH. Are you in the UK? Did you have a lot of symptoms?

[Kip4 in reply to greygoose]

I’ve just re read my original comment and what I have typed is totally misleading, sorry!

I don’t have my original test results which prompted my doctor to put me on 50mg of Levothyroxine. The above result was after 6 weeks of taking 50mg of Levothyroxine and I still feel tired, lethargic, grumpy, brittle hair etc.

[greygoose in reply to Kip4]

Well, you would do. You're under-medicated. Someone on thyroid hormone replacement should have a TSH of 1 or under. 50 mcg is only a starter dose, and he should have raised it to 25 mcg after that test. And if your doctor is only testing the TSH, it shows he knows nothing about thyroid and is going to keep you under-medicated. You either have to educate him, change doctors or self-treat.

[Kip4 in reply to greygoose]

Thank you greygooose, really appreciate your responses! I have booked an appointment to ‘challenge’ my treatment , there are no doctors specialising in Thyroid treatment at my surgery but I feel sufficiently armed with your input to discuss my treatment, required tests and agree the correct dosage I should be taking. I will update the level of my success after next week’s appointment! Failing that, I have private health care through my job! 😬

[greygoose in reply to Kip4]

It's very rare to find a doctor that specialises in thyroid, anyway. That's why we have to learn for ourselves.

[SlowDragon Administrator]

NHS guidelines saying standard starter dose is 50mcgs

beta.nhs.uk/medicines/levot...

Dose should be increased in 25mcg steps, retested 6-8 weeks after each dose increase.

This repeats until TSH is around one and FT4 towards top of range and FT3 at least half way in range

Most patients eventually need somewhere between 100mcg and 200mcg Levothyroxine

Official NHS guidelines saying TSH should be between 0.2 and 2.0 when on Levothyroxine

(Many of us need TSH nearer 0.2 than 2.0 to feel well)

See box

Thyroxine replacement in primary hypothyroidism

pathology.leedsth.nhs.uk/pa...

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, take last dose 24 hours prior to test, and take next dose straight after test. This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip, GP will be unaware)

If antibodies are high this is Hashimoto's, (also known by medics here in UK more commonly as autoimmune thyroid disease).

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_...

List of hypothyroid symptoms

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

[Kip4 in reply to SlowDragon]

Thank you again! All of this helps me prepare for the appointment.

I really am glad I joined this group, I actually feel positive about my situation for the first time since being diagnosed!