New bloods test and confused what one of the doctors have put.

[Haze1975]

New test results. Could someone please explain why a doctor 👩‍⚕️ would put this.

I’ve had a total thyroid removed due to cancer. And always been thought that the TSH had to be kept low due to the cancer. Here this is lasted reported:

Test resultTHYROID STIMULATING HORM. Report, Abnormal, Need to speak to doctor

Coded entrySerum TSH level < 0.01 miu/L [0.35 - 4.94]

12 Oct 2018Test resultSerum free T4 level Report, Normal, No Further Action (Patient Informed)

Coded entrySerum free T4 level 17.8 pmol/L [9.01 - 19.05]

And t4 has come down finally. I’m now confused 🤷‍♀️ about it. I’ve been sneezing a lot and had a bad neck as well over 3 weeks and won’t be see my endo until next year to asked for advice. Any help would be greatfull.

[MaisieGray]

If that is written within the laboratory test results, then it was presumably written not by your Dr but by the lab technician who was reacting to your TSH result in isolation of any knowledge of you - if presumably the ordering Dr did not refer to your TT on the blood test request.

[Mary-intussuception]

As you can see the TSH is below the bottom of the "normal" range - hence the comment.

[SlowDragon Ambassador]

After thyroid cancer TSH should be kept suppressed

So your results are to be expected, but if FT4 is dropping you may need slight dose increase or the addition of small dose of T3 if your energy levels are low

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)

Come back with new post once you have results and ranges on all these

[jimh111]

TSH used to be kept very low after cancer. Now there is more knowledge and the degree and length of TSH supression depends upon a risk assessment.

[Nanaedake]

If your thyroid was removed due to cancer some years ago, you could ask for a reassessment on your need for TSH suppression if you wanted to. Recommendations have changed over time. You could ask for a referral to a centre of excellence for thyroid cancer care or ask your locality multidisciplinary cancer team to reveiw your case. You could contact Butterfly thyroid Cancer Trust for information or advice. If you feel well on your dose of levothyroxine and are stable, you may not want to change it.

The remark on the report is likely from the lab technician, not your GP so you could discuss the report with your GP who could get advice if needed.

[diogenes Remembering]

The current thinking no longer demands suppressed TSH after ablation of hyroid cancer. Formerly it was thought that TSH could stimulate a recurrence of cancer, but now this idea has been dropped. Unfortunately, this has led to the idea that undetectable TSH is contraindicated, whereas it still can be appropriate depending on the patient's ability to convert T4 to T3 under therapy. As a result historically more patients now complain of hypothyroid symptoms on therapy owing to the mistaken concept of normalising TSH for everyone.