Further Blood Tests and TSH

[Fluffysheep]

Hi there. Still relatively new, have posted here once before with results from a medichecks blood test. My GP had also ordered a repeat blood test, and the advice on here was to do it first thing in the morning, having fasted. What I would like to know is how much of a difference does that actually make to TSH levels, does anyone know? For context, last 3 blood test results:

11/3/19 TSH 4.43 ( range 0.27 - 4.2). I believe this would have been a fasting test (not intentionally, I just rolled out of bed and went straight out to get in the queue for opening as otherwise the wait for bloods is a nightmare! I'm about 90% sure I didn't have breakfast before I went.

2/5/19 TSH 4.04 (same range as above). This was NOT a fasting test and was taken about 11am

18/6/19 TSH 6.2 (same range as above). Was definitely a fasting test and taken first thing.

I've already had advice about my previous medichecks tests (main thing that came up was Thyroglobulin Antibodies at 230 (range <115) so won't ask for any further info about that. Saw my GP who reluctantly referred me to endocrinologist (appointment is in September).

I am seeing a different GP in a couple of weeks, as the advice on here was to ask for a Vitamin D test, as that wasn't done before, and am also going to ask for a coeliac test. Is there anything else I should be asking for (vit b, ferritin and folate were done back in March)?

I'm massively symptomatic with fatigue, brain fog/memory problems being the worst issues.

Also, does anyone have any advice what I should be asking the endo for in September (am assuming they won't be that interested from everything I've read on here, but who knows, I might strike lucky!).

[SeasideSusie Remembering]

Fluffysheep

If you look at the first graph in the opening post in this thread, you will see how TSH varies over 24 hours.

healthunlocked.com/thyroidu...

Highest is at midnight to 4am, then a dip until 8am then it rises again to it's next highest point at 9am, after which it lowers until it starts to climb again at around 9pm.

In this thread

healthunlocked.com/thyroidu...

you will see a reply by Diogenes (scientist involved in thyroid research and advisor to ThyroidUK) which says

"TSH falls after eating, but FT4 not affected. Don't know about FT3 but suspect it will behave like FT4."

Taken from your previous post

Serum ferritin level 58 (range 11 - 307)

Serum vitamin B12 level 335 (range 180 - 914)

Serum folate level 9.9 (range 3 - 20)

Have you done anything about improving these, as SlowDragon mentioned?

Ferritin needs to be at least 70 for any thyroid hormone to work (our own or replacement hormone), recommended is half way through range although I have seen it said that a good level for females is 100-130.

Serum B12 should be at least 550pg/ml or ng/L according to an extract from the book, "Could it be B12?" by Sally M. Pacholok:

"We believe that the 'normal' serum B12 threshold needs to be raised from 200 pg/ml to at least 450 pg/ml because deficiencies begin to appear in the cerebrospinal fluid below 550".

"For brain and nervous system health and prevention of disease in older adults, serum B12 levels should be maintained near or above 1000 pg/ml."

Folate should be at least half way through range.

[Fluffysheep in reply to SeasideSusie]

Thanks for this, that graph is really interesting. Didn't realise quite how much of a difference there could be at different times of day. Although blood test 1 in March and blood test 3 in June were at the same time of day (around 8.15am), so quite a bit of difference in those results.

I haven't done anything about the other things yet, they are on my to do list! Can only cope with doing so many things at the moment as I'm so knackered. I suppose in my head I've not really been focusing on them because they are in range, but I know from reading through here that being in range can mean nothing, and it really depends on the individual person.

I've got a gynae appointment on Monday, as don't know if my excessive bleeding during my periods is a gynae issue, or just another symptom of my thyroid. I think probably in my head the plan is to get that out of the way, then look at those other levels and supplements that were suggested by SlowDragon.

Thanks again for your reply, really appreciate it.