Can you give me your opinions on my most recent bloods. I’ve recently had my dose reduced and have been quite run down this year and have had a lot of bugs and viruses. I’d value your opinions and knowledge.
May 2018. TSH 0.5 min/l. (0.2 - 5.5)
FT4. 23.2pmol/L. (10.0. - 24.5)
B12. 204ng/L. (180 - 1000)
July 2018. TSH 0.5miu/L (0.2 - 5.5)
FT4. 22.5pmol/L. (10.0 - 24.5)
September 2018. TSH. 1.6 min/L. (0.2 - 5.5)
When was your dose reduced (I'm assuming after the July result).
Why was your dose reduced?
When the September test was done, was there no FT4?
Were all tests done under the same conditions i.e. early morning blood draw, overnight fast (water only before blood draw), Levo left off for 24 hours before blood draw.
My dose was reduced after my July test because my TSH had gone too low. No T4 was done in September as apparently the lab only tests that if the TSH is very low. The bloods were not all done early in the morning and I didn’t know about the fasting and leaving of the thyroxine either. Sorry if I sound a bit thick but this is all relatively new to me and I’m struggling to understand all of this. The doctors don’t really explain anything either.
Your TSH was the same in May and July so it doesn't make sense that they said it was too low in July. Your FT4 was in range.
TSH is not a thyroid hormone, it's a signal from the pituitary to tell the thyroid to produce thyroid hormone if it detects there isn't enough. By taking enough Levo your pituitary is detecting there is enough hormone so it doesn't send the signal and TSH remains low. The only important results when on Levo are FT4 and FT3. If FT3 is in range then we are not overmedicated. Unfortunately doctors seem to not be able to understand this.
All thyroid tests should be done under the same conditions (as mentioned above) in order to compare results. TSH is highest at midnight and lowers throughout the day, lowest being around 1pm. Therefore, in order to avoid a reduction in dose, or to get an increase, we need the highest possible TSH so the earliest possible blood draw, no later than 9am.
Thanks. I’m going to make sure that when I next have my bloods taken I follow your advise. If doctors won’t test T3 how do you ever get treated properly and put on the right dose.
FT3 is not normally tested unless TSH is suppressed. This is why hundreds of us here do our own private tests with one of the labs recommended by ThyroidUK and why many of us are forced to take things into our own hands.
Thing is, if I have my bloods done privately and they imply that I need T3 where do I go from there.
Then you're in the same boat as hundreds of us on here. You discuss your results with your GP, if he won't accept that you need T3 then you can ask for a referral to an endocrinologist who may or may not agree to see you, and then may or may not agree to prescribe T3. If you need T3 and can't get it through the NHS then like so many of us you may want to source it yourself.
But the first thing you need to do is get a full thyroid panel plus vitamins and minerals. Vitamins and minerals need to be optimal for thyroid hormone to work properly.
B12. 204ng/L. (180 - 1000)
This is very low. Do you have any signs of B12 deficiency - check here b12deficiency.info/signs-an...
If you do then list them and discuss with your doctor, ask for testing for B12 deficiency/pernicious anaemia.
As your B12 is so low, chances are the others could be as well.
Full thyroid panel and vitamins and mineral test will include
TSH
FT4
FT3
Thyroid antibodies
Vit D
B12
Folate
Ferritin
medichecks.com/thyroid-func...
Or
bluehorizonmedicals.co.uk/t...
Come back with results (include ranges) and we can go from there.
I’ve just ordered a private blood test from blue horizon. Can I ask should I fast the night before and take the test early in the morning before I take my thyroxin as you suggested earlier.
Yes, all thyroid tests should be done that way. Last dose of Levo 24 hours before blood draw, blood draw no later than 9am, have evening meal/supper as normal the evening before then water only until after the blood draw.
Ok thanks. I’ll let you know the results when I get them back.
Hello again. I’ve just noticed a couple more results from my bloods print off from the doctor. Not sure how relevant they are but here goes.
Ferritin. 91 ug/L. (10 - 300)
Folate. 5.3 ug/L. >4.00
Ferritin is OK. It needs to be at least 70 for thyroid hormone to work properly and it's recommended that it's half way through range. However, yours isn't bad and eating iron rich foods and occasionally liver, liver pate or black pudding should either maintain your level or nudge it up.
Folate, although just over the quoted level, would be considered adequate by a doctor, but when there is no proper range it's difficult to say. Personally I'd want mine higher.
A high FT4 and not feeling on top of the world suggests that your FT3 would be low but you would need to have it tested to be sure. That is why it is stupid to not test it but they say it's down to cost.
I once had a dialogue with someone in the know and I can't remember now whether it was on here but I think more likely another group but this lady was involved with the testing in a hospital lab and had said a FT4 test cost 92p. This would be the test for the medium used not the adds on of staff wages etc but interestingly she also quoted 92p for T3 so I queried it as it wasn't supporting the fact that we hear it is so expensive to do!
Can't remember the figures now so I shall make some up just to illustrate the problem
So to run tests on the machine they use a testing solution to run each machine. So let's say it's £100 for each type of test and it does 100 tests on both run so we get a resting of £1 a test for FT4 and £1 a test for T3. The testing medium has to be fresh so presumably at thenend of the day the machines are shut down and cleaned and that most probably means some bloodsare held over to the following day.
But if someone is admitted during the night which indicates a serious thyroid issue then the technician on call would have to prime the machine and so the first test would technically cost £100 each unless the timing allowed some early morning tests to be added in but I don't know if that would be possible. So now less T3 tests are being done then the daily quota could be far lest so the cost of the actual testing should/could be far higher than the T4. So if what I've have been tol is correct why hasn't someone worked out that it could end up being a lot cheaper to always do both? To me that smacks of the other thing the NHS missed, T3 rising so quickly! I seen it said that with the money lost by not picking up the charging of T3 that the NHS could have build several more full functioning hospitals so surelyemploying a group to check on such things would have been money well spent. You would just mean a central unit calling in costs and normal practice.
So not saying all this is I've described but it's what I was told so may be more complex than I've made it sound but it does raise doubts.
That’s very interesting and also very frustrating. If I had private bloods done which showed my T3 is low, where do I go from there.
First step I would look to see if Vit D, B12, folate and ferritin ate optimal as they help the Thyroid work better, improve conversion and can help with some symptoms. If that doesn't solve , but remember it can take time to address depending how low any of them are, then it's usually an Endo who can prescribe T3 so you could ask here if anyone knows of an Endo near to ____________ who will prescribe T3 and ask for replies via Private Message or if little response ask if anyone has self treated with T3 and how do you go about it.
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