No follow up blood tests

[Rayrae]

I started on Levo 25mcg in March. I was retested this week and my TSH has come down from 4.28 (0.3 to 4.2) to 1.85.

I asked when I should come in for my next blood test and they said no further action. I’m not scheduled for any more blood tests. That’s not right, surely?

My TPO antibodies were 246 (0-34) when I got tested for those in October, not been tested since.

My free T4 was 14.2 (12-22) in July, not been tested since.

T3 not tested.

No vitamin or iron tests.

I started to feel better about 3 weeks after starting 25mcg Levo but symptoms returned after about 8 weeks.

Any ideas what should expect/be asking for? That can’t just be it?

[SeasideSusie Remembering]

Rayrae

NICE Clinical Knowledge Summary for Initiation and Titration of Levothyroxine here:

cks.nice.org.uk/hypothyroid...

When on Levo only, the aim of a treated hypo patient generally is for TSH to be 1 or lower with FT4 and FT3 in the upper part of their ranges if that is where you feel well.

It's often the case that only TSH is tested now and if that is within range then FT4 is not done, and FT3 is rarely done unless TSH is suppressed.

How do you feel? If you are still symptomatic you'll need to push your GP for further testing. 25mcg is a starter dose for children, the elderly and those with heart disease. 50mcg is the normal starting dose.

No point in retesting antibodies, they were raised, you have Hashi's, antibodies fluctuate but you'll still have Hashi's whether they're raised or not.

If you can't get all the full thyroid/vitamin tests done by your GP you may have to do what hundreds of us here do and use one of ThyroidUK's recommended labs. The full testing bundles are

Medichecks Thyroid Check ULTRAVIT medichecks.com/thyroid-func... You can use code THYROIDUK for a 10% discount on any test not on special offer.

or

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

Both tests include the full thyroid and vitamin panel. They are basically the same test but with the following small differences:

For the fingerprick test, Blue Horizon requires 1 x microtainer of blood (0.8ml), Medichecks requires 2 x microtainers (total 1.6ml)

Blue Horizon includes Total T4 (can be useful but not essential). Medichecks doesn't include this test.

B12 - Blue Horizon does Serum B12. Medichecks does Active B12.

Serum B12 shows the total B12 in the blood. Active B12 shows what's available to be taken up by the cells. You can have a reasonable level of Serum B12 but a poor level of Active B12. (Personally, I would go for the Active B12 test.)