Advice on results

[cahod6103]

Hi,I’ve not posted for a while, bu I got my latest results back on Wednesday, my TSH had risen from 3.6 to 5 in a month, (ref range 0.3-5.0), bu my t4 was normal, can anyone tell me why that would be please ? Thank you.

[SeasideSusie Remembering]

cahod6103

Did you do the test under exactly the same conditions? To compare TSH the blood draw should be done at the same time and water only to drink beforehand (no tea or coffee as this affects TSH result) and fasting from evening meal/supper the night before as eating can also affect TSH.

bu my t4 was normal

What are the numbers? Normal just means within range. Was your FT4 result the same both times, or were they different? With a higher TSH one would expect a lower FT4 providing the same time gap had been left since last dose of Levo, which is recommended to be 24 hours before blood draw.

[cahod6103 in reply to SeasideSusie]

Thanks, test was done at roughly the same time as previous test one month before hand, and I had already had breakfast before hand on both tests, the bloods were done about 11. 45 am both times. My t4 level was 18 (ref range is 11 - 27 ).

[SeasideSusie Remembering in reply to cahod6103]

my t4 level was 18 (ref range is (11 - 27).

And what was it last time?

With a TSH of 5 (0.3-5.0) and FT4 of 18 (11-27) which is 44% through it's range, then you are undermedicated.

For some reason you are more hypothyroid now that previously. Can you pinpoint anything different - change of brand of Levo maybe? What are your current nutrient levels, if ferritin level has dropped then thyroid hormone probably wont work as well.

For future reference, for more accurate results of normal circulating hormone, 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, last dose of Levo should be 24 hours before blood draw, if taking NDT or T3 then last dose should be 8-12 hours before blood draw. Adjust timing the day before if necessary. This avoids measuring hormone levels at their peak after ingestion of hormone replacement. 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 can 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.

[Lalatoot]

As Seaside susie says we need numbers. Normal on my lab tests can be FT4 of 12 or FT4 of 22. There is a big difference!

[cahod6103 in reply to Lalatoot]

Thanks, my t4 level was 18 (ref range is (11 - 27).

[SlowDragon Administrator in reply to cahod6103]

So your FT4 is only 43.75% through range

Useful calculator for working out % through range

chorobytarczycy.eu/kalkulator

[cahod6103 in reply to SlowDragon]

Thank you.

[SlowDragon Administrator]

Previous post ....perhaps set up to fail on T3 trial

healthunlocked.com/thyroidu...

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 ....especially after T3 is stopped

Low vitamin levels are extremely common, especially if Thyroid antibodies are raised

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).

If/when also on T3, make sure to take last dose 8-12 hours prior to test, even if this means adjusting time or splitting of dose day before test

Is this how you do your tests?

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 primary 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 .

[cahod6103 in reply to SlowDragon]

Thanks, I have done the Medichecks thyroid test, the one with b12, ferritin, and antibodies. I’m already on b12 injections, also take vitamin d3 .