Need help finding the right thyroid tests for Hashi motos

[Me1157]

I split my time between the UK and Florida USA. My US doctor is very sympathetic and has sent me to endocrinologists in the past. One was very good but has since moved out of the area. As I am currently in Florida - can anyone recommend what blood tests to take. I am usually tired, have lots of hypothyroid symptoms although the standard blood always comes back ok. I have had full thyroid panels with antibodies before sometimes they are out of line and sometimes they are ok. I have been like this for a very long time.

[SeasideSusie Remembering]

Me1157

I have had full thyroid panels with antibodies before sometimes they are out of line and sometimes they are ok

Have you got the results and reference ranges you can share with us?

For a full thyroid picture the tests needed are

TSH

FT4

FT3

Thyroid Peroxidase antibodies

Thyroglobulin antibodies

Don't bother with Total t4 or Total T3 or we sometimes see T3 Uptake with US tests, these are not relevant.

Also useful, particularly if Hashimoto's is suspected:

Vit D

B12

Folate

Ferritin

If you want to do them in the UK, which may be cheaper, you can get a full test bundle with either Medichecks or Blue Horizon:

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.)

If you take Biotin or a B Complex containing Biotin (B7), leave this off for 7 days before any blood test. This is because if Biotin is used in the testing procedure it will give false results (Medichecks definitely use Biotin, they have confirmed this and the amount of time to leave the supplement off).

When doing thyroid tests, we advise:

* Book the first appointment of the morning, or with private tests at home no later than 9am. 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 hormone replacement, leave off Levo for 24 hours before blood draw, if taking NDT or T3 then leave that off for 8-12 hours. Take your thyroid meds 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.