Hi I have been on levothyroxine for almost ten years. I am on 175 mcgs I am due to go for a blood test tomorrow for thyroid function test should i be asking for a full vitamin check also? I have never been offered this before. I still experience negative symptoms total exhaustion,muscle and joint pains my cholesterol is also high. Can anyone please advise me. I am new to this site and any advice greatly appreciated.
THanks
Marie
Welcome to the forum Mazmilly
I still experience negative symptoms total exhaustion,muscle and joint pains my cholesterol is also high.
This all suggests you may be undermedicated and may have low vitamin levels.
When booking thyroid tests, we always 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.
* 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).
These are patient to patient tips which we don't discuss with doctors or phlebotomists.
You could ask for the following to be tested, although there is no guarantee that your doctor will agree.
Vit D
B12
Folate
Ferritin
A few days after your blood test, pop along to the surgery and ask for a print out of your results, it is our legal right here in the UK to have them. Don't accept verbal or handwritten results as mistakes can be made.
Post your results, with reference ranges, on the forum for comment, eg
TSH: 2.5 (0.2-4.2)
Thank you so much for the great advice my appointment is not till 3.40 in the afternoon and to be honest I am having great difficulty in getting appointments, if I don't take meds and fast do you think that will be ok or should I try to rearrange for an early appointment. I didn't realise that other meds are used apart from levo, although I have had this condition for many years the doctors have never been that forthcoming and supportive with their advice and care, I have also been given medication for anxiety and depression for many years and am now thinking could it all be due to the thyroid after all.
Thank you for taking b the time to reply to me😀
Mazmilly
The first post in this thread shows the daily rhythm of all thyroid hormones
healthunlocked.com/thyroidu...
You can see that TSH is highest at midnight then lowers, with the next highest level being at 9am, then it lowers throughout the day with the lowest level being at 1pm. Blood taken at 3.40pm will show a considerably lower TSH than blood taken at 9am. so if you are looking for an increase in dose of Levo, or you wish to avoid a reduction in dose because you feel that you are properly medicated, then you need the highest possible TSH, so the afternoon appointment wont do you any favours, you need an appointment at 9am.
although I have had this condition for many years the doctors have never been that forthcoming and supportive with their advice and care,
The more you read this forum, the more you will realise that doctors don't actually care much, they are now basically just there to prescribe a medication to "treat" whatever ails us, they're not there to help us find a cure or to prevent anything, the pharmaceutical companies wouldn't make any money if we got better - cynical yes, but very true.
I have also been given medication for anxiety and depression for many years and am now thinking could it all be due to the thyroid after all.
Diagnosing depression/prescribing anti-depressants is a money maker for doctors. Depression and anxiety are symptoms of underactive thyroid, it could well be that you are not optimally medicated. Doctors tend to look at the TSH result only and ignore the actual thyroid hormone results or don't even test for them. TSH is a signal from the pituitary gland that tells the thyroid to make hormone if it detects there's not enough. The aim of a treated hypo patient generally is for TSH to be 1 or below or wherever it needs to be for FT4 and FT3 to be in the upper part of their reference ranges, if that is where you feel well. The reality is that the FT4 and FT3 are not often tested and doctors tend to adjust dose of Levo by TSH only which is completely wrong.
I still experience negative symptoms total exhaustion,
This could be undermedication, it could also be low ferritin.
muscle and joint pains
This could be low Vit D.
my cholesterol is also high.
High cholesterol is a symptom of hypothyroidism so you could be undermedicated. Avoid statins like the plague if they are offered to you.
If your GP can't or wont do the vitamin tests mentioned, we can point you in the right direction to getting them done with one of our recommended labs who do home fingerprick tests or venous blood draw at extra cost.
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
Most likely the only test you will get is TSH or TSH plus FT4
Low vitamin levels are extremely common, especially if Thyroid antibodies are raised
Have you ever had thyroid antibodies tested in past?
You are legally entitled to printed copies of your blood test results and ranges.
UK GP practices are supposed to offer online access for blood test results. Ring and ask if this is available and apply to do so if possible, if it is you may need "enhanced access" to see blood results.
This is the best way to get access to loads of historic test results
In reality many GP surgeries do not have blood test results online yet
Alternatively ring receptionist and request printed copies of results. Allow couple of days and then go and pick up.
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)
Last Levothyroxine dose should be 24 hours prior to test, (taking delayed dose immediately after blood draw).
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 .
High cholesterol is linked to possibly being under treated and still hypothyroid
nhs.uk/conditions/statins/c...
Come back with new post once you get results and ranges
I have never had thyroid antibodies test but I will definitely be asking more questions then I normally do. As soon as I get my results will post. Thank you again for sound advice
Hi I have had my blood test results
TSH 9.2 [0.40-4.90mu/L] increased thyroxine from 175 to 200 mcgs
T4 10.9 [9.00-19.00pmol/L] no action required
CRP 9 [0.00-5.00mg/L]
Vit D 15.7 [49-90nmol/L] given 50.000 unit tabs
Ferritin 105 [15.00-204.00ng/ml] no action required
B12 322 [187.00-883.00ng/L] no action required
Folate 10.7 [3.10-20.50ug/L] no action required
Iron 17.1 [9.00-30.40umol/L] no action required
Cholesterol 19.4 [5.00mmol/L]
Triglycerides 14.5 [0.00-1.70mmol/L]
Doctor also said my test shows pre diabetic HBA1c level.
Thank you for your last post and just wanted to know if all treatment seems reasonable at this stage.
Thank you😀
Cholesterol is high because you are hypothyroid and need dose increase in Levothyroxine
So ignore that for moment
nhs.uk/conditions/statins/c...
If you have an underactive thyroid (hypothyroidism), treatment may be delayed until this problem is treated. This is because having an underactive thyroid can lead to an increased cholesterol level, and treating hypothyroidism may cause your cholesterol level to decrease, without the need for statins. Statins are also more likely to cause muscle damage in people with an underactive thyroid.
Your TSH is far too high - indicates you need 25mcg dose increase In Levothyroxine
Bloods should be retested 6-8 weeks after each dose increase
Always stick to same brand of Levothyroxine at each prescription
You need to test thyroid antibodies privately
Can do so via Medichecks now, or wait until 6-8 weeks on new dose and include testing of a TSH, FT3 and FT4
Your vitamin D was dire
B12 and folate could be better
Low B vitamins often linked to low vitamin D
See why here
drgominak.com/sleep/vitamin...
It appears that vitamin D deficiency causes B12 deficiency, which also affects sleep. There are Vitamin D receptors in the salivary glands that make haptocorrin which binds the B12 in food and accompanies it through the stomach. There are also D receptors in the stomach cells that make “intrinsic factor”, another chemical that binds to B12 and helps us absorb it. When the D is so low that haptocorrin and intrinsic factor are also low we are not able to absorb B12 from our food.
B12 and folate on the low side. Supplementing a good quality daily vitamin B complex, one with folate in not folic acid may be beneficial.
chriskresser.com/folate-vs-...
B vitamins best taken in the morning after breakfast
Recommended brands on here are Igennus Super B complex. (Often only need one tablet per day, not two. Certainly only start with one tablet per day after breakfast. Retesting levels in 6-8 weeks ).
Or Jarrow B-right is popular choice, but is large capsule
If you are taking vitamin B complex, or any supplements containing biotin, remember to stop these 7 days before any blood tests, as biotin can falsely affect test results
endo.confex.com/endo/2016en...
endocrinenews.endocrine.org...
Suggest you don't start on vitamin B complex until been on vitamin D a couple of weeks
Come back with new post once you get thyroid antibodies tested
Many thyroid patients find changing to low carb diet is helpful
Michael Moseley low sugar diet books are very helpful and great recipes
Great BBC prog
m.youtube.com/watch?v=Xw9FL...
Astonishing thing is if you eat low carb, you are much less likely to feel hungry
You can significantly lower Hba1c levels
Thank you so much for all the great advice I really appreciate it😊
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