Thyroid, 1 year later check.

[LittleMiss234]

- 10th JANUARY 2018 :

Serum TSH level, 4.4. [0.3 - 4.2]

Serum Free T4 level, 12.5. [0.3 - 4.2]

- 13th FEBRUARY 2018:

Serum TSH level 5.3. [0.3 - 4.2]

Serum Free T4 level, 13.3. [0.3 - 4.2]

Serum thyroid peroxidase antibody concentration 19 ku/L. [0.0 - 34.0]

- 19th FEBRUARY 2019:

Serum TSH level 3.9.

So last year following a routine blood test I was told I had borderline hypothyroidism, fast forward to this year and a blood test which shows my TSH has come down, and I'm now 'normal' according to pathology/GP.

My lifestyle hasn't changed in the last year, so I'm confused how the results have changed.

Is this quite common? Is there any way of keeping it coming down?

I'm due to start fertility treatment late this year, and I'm aware that ideally a TSH of 2/2.5 is best when trying to conceive.

[SeasideSusie Remembering]

LittleMiss234

We always need reference ranges to be able to interpret results please, as they vary from lab to lab.

When you have thyroid tests, to be able to compare them it's essential that they are done under the same conditions every time. 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.

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

For a diagnosis of hypothyroidism, you need the highest possible TSH so an early morning blood draw, no later than 9am, after an overnight fast and drinking water only, is what you need to do. Then continue testing this way to compare results in future.

Your February 2018 TSH result of 5.3 was either very close to the top of the range, or over range. None of your TSH results are anywhere near the bottom of the range, so they all indicate you are on your way to hypothyroidism. A normal, healthy person would very likely have a TSH of no more than 2.

You have had thyroid peroxidase antibodies tested once. Raised antibodies confirm autoimmune thyroid disease aka Hashimoto's. Antibodies fluctuate so could be low with one test, and high with another. There are also thyroglobulin antibodies, and you can be negative for thyroid peroxidase but positive for thyroglobulin, so it best if both are tested, although NHS are reluctant to offer this.

You might consider doing a private thyroid panel with one of our recommended labs which gives the full tests needed

TSH

FT4

FT3

TPO antibodies

TG antibodies

and because optimal nutrient levels are important, and it's the best value way to test them, you could choose a thyroid/vitamin bundle that includes

Vit D

B12

Folate

Ferritin

Either of the following are suitable

Medichekcks Thyroid Check ULTRAVIT medichecks.com/thyroid-func... Check tomorrow (Thursday) as this is sometimes on offer for £79. If not, use code THYROIDUK for 10% discount.

Blue Horizon Thyroid Check PLUS ELEVEN bluehorizonmedicals.co.uk/t...

[LittleMiss234 in reply to SeasideSusie]

Hi SeasideSusie,

I've just edited my post to include the reference ranges.

Thank you for the tips on the best thyroid test conditions.

With my latest TSH pathology report stating 'normal', my GP hasn't contacted me to discuss it. It's only because I have online access to my records that I know my result.

I think I'll make an appointment to chat with my GP, but also going to look at the private testing you have suggested.

[SeasideSusie Remembering in reply to LittleMiss234]

So your TSH has been over range twice - January and February 2018.

You've put the TSH range for FT4

In your case, with your over range TSH, that's not borderline, that's over range. Officially that's Subclinical Hypothyroidism if FT4 is in range, but they like us to wait until TSH reaches 10 before treatment.

However, British Thyroid Foundation says to tell your doctor if you are planning a pregnancy

btf-thyroid.org/information...

An article about "Subclinical Hypothyroidism in Women Planning Conception and During Pregnancy: Who Should Be Treated and How?"

ncbi.nlm.nih.gov/pubmed/298...

Another article about TSH and pregnancy

thyroid.org/patient-thyroid...

Do plenty of research and take as much evidence in as you can. Ask to be referred to an endo who specialises in pregnancy and hypothyroidism so that you can get your TSH to where it needs to be for a successful pregnancy.

Do you have any evidence you can take from your fertility doctors? Can they back you up in this, insisting on your TSH being below 2.5?

Undiagnosed hypothyroidism can, and most likely will, result in miscarriage. I have 4 grandbabies who didn't take breath due to my daughter-in-law's undiagnosed hypothyroidism. NHS doctor wasn't interested, she had to be diagnosed/treated by a private doctor first, then after a successful birth she was tested in hospital and her notes said "TSH satisfactory for someone on thyroid hormone replacement". That was the statment that then led to her NHS GP acknowledging the diagnosis and agreeing to prescribe Levo on the NHS (she'd been getting it on private prescription before).

Good luck.

[LittleMiss234 in reply to SeasideSusie]

Thank you so much for the links and your advice.

I'm so sorry to hear of your daughter in laws experience, it's awful that the NHS GP didn't listen to her. How long was your daughter being treated for on medication before having a successful birth?

I've just made an appointment to see my GP next week so I'm going to gather info together, particularly from my fertility centre, and hopefully I'll be listened to.

[SeasideSusie Remembering in reply to LittleMiss234]

Oh gosh, how long? I'm going back a long time. I don't think it was very long, maybe a few months to get her levels stabilised. She now has children aged 23, 20 and nearly 16.

What I do remember is that she used to just pass out, often at the dinner table (how did she miss the plate of food!?!). No mention of checking thyroid but she was sent to hospital who diagnosed epilepsy!!! They wanted her to go on a blind trial, one of 5 drugs/placebos would be used. Reading the side effects of the drugs she decided she wasn't going to risk it due to wanting children and the effects they could have, so she declined the trial. That's when she went to the private doctor and got diagnosed.

I totally and utterly despair at the treatment - or non-treatment - of what should actually be quite easy for a doctor to spot. I told my d-i-l that she was hypothyroid at the start!