unusual thyroid results posted as requested. Most of these make no sense to me.

[lco1]

Results form my surgery are as follows:

Clinician viewed11 Jan 2019

Result typePathology

TestsThyroid function test

ResultAbnormal

What you need to doMake an appointment to see doctor

Specimen

Specimen Type: Blood

Specimen Reference#: 1

Collected: 11 Jan 2019

Received: 11 Jan 2019

Provider Sample

Pathology Investigations

Thyroid function test Results suggest inadequate dose, non-compliance or poor efficacy

Aim for TSH towards the bottom of the reference range for T4

replacement in primary hypothyroidism, targeting to around

1.0mU/L for symptomatic patients.

Further info at: british-thyroid-association...

Serum TSH level 37.4 mU/L [0.27 - 4.2]

Above high reference limit

Result Checked

Serum free T4 level 31 pmol/L [11.0 - 22.0]

Above high reference limit

Result Checked

General Information

Service Type: New

Status: Unspecified

Provider Report

Report Date: 14 Jan 2019

Message Recipient

Position: Healthcare Professional

Message Recipient

GP Practice

Position: Healthcare Organisation

Ordering Party

Position: Healthcare Professional

Laboratory Service Provider

Position: Healthcare Organisation

Laboratory Service Provider

Position: Department

Other bloods

serum sodium level 141 mmol/L 133.0 -146.0

serum potassium level 4.1 mmol/L 35 -5.3

serum urea level 3.7 mmol/L 2,5 -7.8

serum creatinine level 51 umol/L 45.0 -85

GFR calculated abbreviated MDRD 90 mL/min/1.72m"2

Liver function tests

serum protein level 67g/L 60-80

serum albumin level 39g/L 35-50

serum alkaline phosphate level 47IU/L 30 -130

serum alanine aminotransferase level 19U/L 0-34

serum total bilrubin level 4 umol/L 21

serum cholestoral level 5.4

serum HDL cholestorol level 1.2 mmol/L 1.1

haemoglobin A1c level

Recommend no further action

FULL BLOOD COUNT

haemoglobin concentration 121g/l

platelet count observation 364x10 9/L

red blood cell count 4.28 x10 12/L

haematocrit 0.384 L/L

mean cell volume 90fl

mean cell haemoglobin level 28.3pg

total white blood count 7.5 x10 9/L

neutroohil count 4.2 x10 9/L

lymphocyte count 2.0 x10 9/L

monocyte count observation 1.1 x10 9/L

eosonophil count observation 0.2 x10 9/L

basophil count0.1 x 10 9/L

Satisfactory no further action

[SlowDragon Administrator]

As your FT4 result is ABOVE range this suggests poor conversion or Hashimoto's

TSH obviously very high

Either test was incorrect or low vitamins or thyroid antibodies are affecting result

Personally I don't think your GP should have put dose up, without repeating testing

You need FULL Thyroid and vitamin testing ASAP

For full Thyroid evaluation you need TSH, FT4 and FT3 plus both TPO and TG thyroid antibodies tested. Also extremely important to test vitamin D, folate, ferritin and B12

Low vitamin levels are extremely common, especially if Thyroid antibodies are raised

Recommended on here that all thyroid blood tests should ideally be done as early as possible in morning and fasting. Do not take Levothyroxine dose in the 24 hours prior to test, delay and take immediately after blood draw. This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip, best not mentioned to GP or phlebotomist)

Is this how you do your tests?

Private tests are available. Thousands on here forced to do this as NHS often refuses to test FT3 or antibodies or all 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 special offers, Medichecks usually have offers on Thursdays, Blue Horizon its more random

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_...

[lco1 in reply to SlowDragon]

Thank you so much for your response and so quickly. I will go back to my GP and discuss with her. She was going to write to the endocrinologist for advice so it will be interesting to see what they say. If no progress I will go ahead and have private tests done. At which point I may need more help interpreting results.

Once again thank you so much for your help.

[SlowDragon Administrator in reply to lco1]

GP should offer retesting asap.

Ridiculous not to do so

[lco1 in reply to SlowDragon]

Don’t think she will object toususl tests it’s just anything that would not be done as a matter of corse

[silverfox7]

Sadly your results illustrate the need for routine testing including FT3. I doubt that the Endo will give advice without the full results so it would be a positive if she wanted to see you so that the full testing can be done. If she doesn't do that I'd be cautious about seeing her in the future.

[lco1 in reply to silverfox7]

Thank you for your thoughts. A similar result occurred in 2010 and endocrinologist was written to by GP. Increase in thyroxine seemed to improve things. I have never actually seen a consultant perhaps if repeated test shows no change it’s time I was more forceful and ask to see one.

At least I will be more well informed with all the advice I’ve received here.

Thank you so much for taking the time to advise

[helvella Administrator]

One possibility is interference with the test. diogenes mentioned that on your previous thread.

Another is a pituitary problem which is pumping out excess TSH. The thyroid is responding by releasing more T4, but the pituitary is not reducing TSH as expected.

You definitely need repeat tests and, depending on them, to see an endocrinologist.

[lco1 in reply to helvella]

Many thanks general advice seems to be repeat tests and go back. At least I will be more well informed