Pre test help needed re: adrenal and hypothyroid - Thyroid UK

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Pre test help needed re: adrenal and hypothyroid

Nico101 profile image
8 Replies

Could anyone please tell me what meds and/or supplements to drop pre blood and saliva testing for TSH, FT3, T4, DHEA, and cortisol? I'm also getting my B12, ferritin, folate, insulin and blood sugar, and D3 among other things tested (NHS bloods) tomorrow. I've taken no meds today but did have B12 and D3 today (but I read on here that's good, as it will show if my supplementation is working or not?).

I take Adrenavive, Metavive, and 5mgs prednisone... but I also take loads of supplements.

The bumf on the cortisol test says no biotin for 48 hours before. I didn't take that today. But I also take:

B multivitamin

B12 spray

Loads of Vitamin C

Loads of D3 and K2

L-tyrosine

Q10

Ashwaganda

Zinc

*Potassium

*Magnesium (* also being tested)

I also use progesterone cream but stopped that a week ago until the tests are over

I take full strength RSO - but doubt cannabis will mess with anything?

The GP never asks about anything that may influence tests - he only said they won't do the blood cortisol test unless I get the test done before 9am. Waited 2 1/2 weeks for an 11am appointment, so that's a no go. Since I also have a saliva cortisol test to do (private) this isn't much of an issue, as I understand from on here.

The notes with the private tests don't say much except for when to take the test and how (no eating, brushing teeth, etc. before test) and not to take steroids if poss, and no biotin.

Really appreciate any advice.

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SlowDragon profile image
SlowDragonAdministrator

B multivitamin likely contains biotin - so don't take this either if it does

Are you testing thyroid ?

Nico101 profile image
Nico101 in reply to SlowDragon

Yes. It's the Medichecks one recommended on here. M578 Thyroid Check Plus.

SlowDragon profile image
SlowDragonAdministrator in reply to Nico101

Medichecks plus ultra vitamin test is recommended as includes vitamin D

Or can test vitamin D separately via

vitamindtest.org.uk

Nico101 profile image
Nico101 in reply to SlowDragon

Having my D checked via the NHS blood test I had today. I have a very low income, so the private tests are just for essential things the NHS (disgracefully) won't do.

SlowDragon profile image
SlowDragonAdministrator in reply to Nico101

Good to hear you manage to get some tests on NHS

Nico101 profile image
Nico101 in reply to SlowDragon

Not without a fight, I can assure you.

SeasideSusie profile image
SeasideSusieRemembering

Nico101

Question/Response from other thread:

Q: May I ask, when you talk about stopping thyroid meds 24 hours before a test, would this include things like Metavive and Adrenavive? Is 24 hours enough? Does that also apply to prednisone before a cortisol test? Or would you recommend longer? Cheers.

R: Last dose of LEVO is 24 hours before a thyroid blood test.

For NDT, T3 and Metavive - because Metavive a thyroid glandular - the last dose should be 8-12 hours before a thyroid test.

As for Adrenavive, this is an adrenal supplement and you would follow instructions that come with an adrenal test for this, and there would be instructions about prednisone too, you don't need to stop Adrenavive for a thyroid test, just take any supplements after the test on the day. If you are going to do an adrenal test, use Regenerus or Genova Diagnostics who test both cortisol and DHEA and have proper reference ranges, don't use Medichecks or Blue Horizon for adrenal tests.

It's important to stop Biotin (B7) or a B Complex containing Biotin 7 days before any blood test, including thyroid tests, because if biotin is used in the assay it can give false results.

Q: Don't I want my thyroid results to show how I am without meds? I will soon be trying to get an endo to prescribe something stronger - NDT or possibly T3, as I don't think the Metavive is enough now (or I would no longer have the symptoms of hypothyroid). Will the Metavive not make my tests look more normal, so the endo can fob me off?

I was diagnosed slightly hypo about 2 years ago and refused meds, went to Dr P, and he put me on Adrenavive and Metavive, which worked very well until a period of severe and sustained stress and I upped the meds with his approval - then Dr P disappeared and I've been in limbo since.

What is it you want from your blood test results?

Do you want the endo to diagnose hypothyroidism and prescribe thyroid treatment? If so then you will most likely need to be off Metavive to bring your TSH/FT4/FT3 to levels where hypothyroidism would be diagnosed, i.e. TSH over 10 with low FT4.

If you got a diagnosis, first line treatment would be Levothyroxine. You would need to be on this for some time before T3 would be considered, and only then by an enlightened endo who actually understands/believes about T4:T3 poor conversion and you would only be prescribed it if your results actually showed poor conversion.

NDT is unlikely to be prescribed as this is unlicensed.

So to get to that point, you will need to be off your Metavive for a few weeks and you'll very likely feel very unwell.

If you continue to take your Metavive then you are going to get results akin to someone taking some kind of thyroid medication and they will reflect whether or not that medication is giving you good results in the endo's eyes. You would have to let the endo know what you are taking and how you reached that point.

You are between a rock and a hard place.

I had NHS blood tests for vitamins/minerals and a few other things last Thurday,

It will be interesting and enlightening to see your vitamin/mineral and other test results, if you post them (with ranges) when you have them we can comment further.

but am also getting privately tested now for cortisol and dhea (saliva), and the Thyroid Plus test (blood). I'm just getting confused now about stopping certain supplements, and my Adrenavive and Metavive and prednisone, before the tests, as there seems to be a lot of conflicting info out there.

Supplements to stop for 7 days for thyroid test -

Biotin (B7) - in a B Complex or as a stand alone supplement

We should actually leave off Biotin for any blood test, not just thyroid.

Any other supplements can continue but on the day of the test take them after the blood draw.

Thyroid treatment:

Metavive - treat as NDT and the time gap between last dose and blood draw is 8-12 hours.

For adrenal test, this is what Regenerus say:

"Do not take any supplements on the day of collecting the saliva samples" - so you can take all your normal vitamin/mineral supplements up to the day before the test.

Topical hormones (you mentioned progesterone cream before) - last dose between 12-24 hours before collecting first saliva sample. Do not use topical hormones on the day of collection.

Cortisol/Glucocorticoid supplements

Cortisol containing supplements (which would include Adrenavive) - I asked them about continuing with my adrenal supplement and was told "Your samples will record your current levels of Cortisol and DHEA as they stand with any supplementation you are taking". I take my adrenal supplement up to the day before but not on the day of collection because I want to know if the dose I am taking is giving me the results I need.

Glucocorticoid supplements (this will be your prednisolone) - you are supposed to ask your practioner about whether or not to continue this but in your case it appears you can't. However, if you can't do without your prednisolone, then you should carry on.

They suggest leaving cortisol/glucocorticoid supplements off for 5 days prior to collecting the samples as this would then evaluate your natural cortisol production. But as mentioned above, if you want to know how the Adrenavive is affecting your results then you continue right up to the day before.

BUT it's important to fill in the form and in the appropriate section mention everything that you take - tablets/creams/etc (and your RSO) and the full dosing information.

I rang Medichecks about when to stop the Metavive, etc., but they didn't know. The chap I spoke to says he'll ask and get back to me. I'm a bit desperate to get it sorted, as I keep stopping and starting the meds and feel awful when I do. Hopefully, I'll get my head around it all and get the tests out of the way this week and get back to some normality... unless I need NDT and/or T3 - but that's a fight for another day. I just want to get through these tests, first.

To be honest, I wouldn't expect Medichecks to know anything about Metavive, the doctors may never have heard of it or NDT, they are just the same as NHS doctors and unless they are doctors of a certain age who were around when NDT was prescribed, they probably know nothing about it.

Nico101 profile image
Nico101 in reply to SeasideSusie

Cheers for that. Sorry to be a pain, but I'm panicking now, as I just want the tests done - properly - so I can try and get treated while I still have some hair left! It's just so much to take in. Some of it is finally starting to stick in the old noodle, though, so there's hope for me yet.

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