Do I need to fast for a full thyroid panel?

[RiaO]

So tomorrow I'm going to ask for a full thyroid panel to test for hypothyroidism. I'm wondering whether I will have to fast or not. Last time I went to test my TSH levels, I had taken norethisterone medication and breakfast that morning. My level came out at 1.88. I'm still suffering from most hypothyroidism symptoms and I will go for a full one this time. What should I ask for to guarantee accurate results? Is there any other disorder that causes symptoms similar to that of hypo's? Also, what questions should I expect from the endocrinologist so I can be prepared?

[SeasideSusie Remembering]

RiaO

When booking thyroid tests, we advise:

* Book the first appointment of the morning. This is because TSH is highest early morning and lowers throughout the day. If we are looking for a diagnosis of hypothyroidism, or looking for an increase in dose or to avoid a reduction then we need TSH to be as high as possible.

* Fast overnight - have your evening meal/supper as normal the night before but delay breakfast on the day of the test and drink water only until after the blood draw. Eating may lower TSH, caffeine containing drinks affect TSH.

*If taking thyroid replacement hormone, leave off Levo for 24 hours before blood draw, if taking NDT or T3 then leave that off for 8-12 hours. Take after the blood draw. Taking your dose too close to the blood draw will give false high results, leaving any longer gap will give false low results.

These are patient to patient tips which we don't discuss with doctors or phlebotomists.

So an early morning, fasting test is best.

Some nutrient deficiencies can cause symptoms that overlap with symptoms of hypothyroidism, so it's useful to also check

Vit D

B12

Folate

Ferritin

I can't help with the endo, my consultation is one I hope to never repeat in my lifetime, so I'm rather biased when it comes to discussing them. My experience was that you don't ask questions, they dictate to you, and bully you and dismiss your questions. Sorry.

[SlowDragon Administrator]

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

Or low vitamins can cause symptoms in their own right

Recommended on here that all thyroid blood tests should ideally be done as early as possible in morning and fasting. This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip, best not mentioned to GP or phlebotomist)

Come back with new post once you get results and ranges

[RiaO in reply to SlowDragon]

The GP took only my TSH and CBC. I couldn't get the full thyroid panel because the insurance doesn't allow it unless my TSH levels are abnormal. Is CBC helpful for Hashimoto's or something?

[SlowDragon Administrator in reply to RiaO]

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. Last Levothyroxine dose should be 24 hours prior to test, (taking delayed dose 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)

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_...

List of hypothyroid symptoms

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