Testing for hypothyroidism

[MemmaJ]

Good afternoon - I’m experiencing a lot of symptoms of hypothyroidism but I’m embarrassed to go to my GP.

I had my thyroid function tested a few months ago by a haematologist and he said it came back normal (he didn’t tell me the figures) - so I think I’d just look silly.

My question is - can the levels fluctuate, or if you have hypothyroidism would it always show up on every blood test regardless?

Thank you.

[SeasideSusie Remembering]

MemmaJ

There's no need to be embarassed. And always, always get a copy of your results, with reference ranges. It's your body, your tests, and your legal right to have a copy of your results.

Have you checked out ThyroidUK's main website?

thyroiduk.org/tuk/about_the... - work through the purple menu on the left hand side.

Signs and symptoms of hypothyroidism - thyroiduk.org/tuk/about_the... - do you have any? If so print that list, tick them off and show your GP. Ask for full thyroid test - TSH, FT4, FT3, Thyroid antibodies.

can the levels fluctuate

Yes. TSH can fluctuate depending on the time of day - highest early morning, lowers throughout the day.

FT4 and FT3 levels also differ through the day.

See graphs here of daily rhythms of thyroid hormone - healthunlocked.com/thyroidu...

If you have raised antibodies (Thyroid Peroxidase [TPO]/Thyroglobulin [TG]) that confirms autoimmune thyroid disease. The antibodies fluctuate and that can cause fluctuations in hormone levels which can show in your test results. They wont show up on every test, just when there is antibody activity.

If you have a blood test, then book the very first appointment of the morning and fast overnight (water allowed) . This gives the highest possible TSH which is needed when looking for a diagnosis, an increase in dose or to avoid a reduction. TSH is highest early morning and lowers throughout the day. It can also lower after eating and coffee also affects TSH. If you were on thyroid replacement hormone then you would take your Levo after the blood draw because if you take it before then your FT4 will reflect this and show higher than what is normally circulating. We usually advise 24 hours between last dose of Levo and blood draw so if you take your Levo in the morning then delay until after the test, or if you take it at night then delay that dose until after the test. These are patient to patient tips which we don't discuss with doctors or phlebotomists.

And because symptoms of hypothyroidism can overlap with symptoms of low nutrient levels, ask for Vit D, B12, Folate and Ferritin to be tested as well.

[adam1850]

First of all call and ask for the results. And yes they do fluctuate