Blood result

[username5]

My blood results came back as TSH 5.31is this very high?

thanks

[Lora7again]

Yes it is too high but I don't think you will get any treatment until it is at least 10 because Doctors like to see us suffer. I think they will tell you to come back in a month for a re-test just in case it is a one off. Having said that you may be lucky and your Doctor may start you on a low dose of Levothyroxine probably 25mg when it should ideally be 50mg. Your TSH should be around 1 but the ranges are in my honest opinion wrong here but the NHS have no intention of changing them. I think in Europe if your TSH is over 3 you will be treated but here in the UK they are lagging behind.

[silverfox7 in reply to Lora7again]

Its only recently though they have wanted TSH to be 10 before they start treatment so not so much as lagging behind but going backwards!

[greygoose in reply to Lora7again]

Depends where in Europe.

[username5 in reply to Lora7again]

I already am on treatment have been for over a year I’m on 100mg levo but this was my blood result as still have symptoms

[hjh88]

It could be high but it’s not possible to tell without the reference ranges, usually shown in brackets after the result.

You would also need to have at least your FT4 tested as TSH alone isn’t a very good indicator of what’s actually going on with your thyroid. Ideally you would also need results for FT3, antibodies and vitamins testing. I’m sure someone else will provide the full list. Do you know if you had any other tests done at the same time? Any results with reference ranges would be helpful.

And just a note re: diagnosis. If you get in front of the right doctor, you don’t need a TSH over 10 to start receiving treatment. I was diagnosed with in range TSH and FT4 but over range antibodies and a raft of symptoms.

[SlowDragon Administrator]

Looking at previous posts....Are you on Levothyroxine ?

How much Levothyroxine are you currently taking?

The aim of Levothyroxine is to increase the dose slowly in 25mcg steps upwards until TSH is under 2 (many need TSH significantly under one) and most important is that FT4 in top third of range and FT3 at least half way in range

NHS guidelines on Levothyroxine including that most patients eventually need somewhere between 100mcg and 200mcg Levothyroxine.

nhs.uk/medicines/levothyrox...

Also what foods to avoid (eg recommended to avoid calcium rich foods at least four hours from taking Levo)

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

Low vitamin levels are extremely common, especially if under treated and still hypothyroid

Recommended on here that all thyroid blood tests should ideally be done as early as possible in morning and before eating or drinking anything other than water . 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).

All four vitamins need to be regularly tested and frequently need supplementing to maintain optimal levels

Guidelines on dose by weight - 1.6mcg per kilo of weight approximately

healthunlocked.com/thyroidu...

Official NHS guidelines saying TSH should be between 0.2 and 2.0 when on Levothyroxine

(Many of us need TSH nearer 0.2 than 2.0 to feel well)

See box

Thyroxine replacement in primary hypothyroidism

pathology.leedsth.nhs.uk/pa...

[username5 in reply to SlowDragon]

Thank you for your reply very helpful! I’m on 100mg and have this result but when they increased me I experienced psychosis !

[SlowDragon Administrator in reply to username5]

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

Low vitamin levels are extremely common, especially if you have autoimmune thyroid disease (Hashimoto's) diagnosed by raised Thyroid antibodies

Do you have Hashimoto's?

Dose of Levothyroxine should be increased slowly in 25mcg steps upwards (or sometimes even smaller)

Bloods should be retested 6-8 weeks after each dose increase

Recommended on here that all thyroid blood tests should ideally be done as early as possible in morning and before eating or drinking anything other than water .

Last dose of Levothyroxine 24 hours prior to blood test. (taking delayed dose immediately after blood draw).

This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip, best not mentioned to GP or phlebotomist)

The aim of Levothyroxine is to increase the dose slowly in 25mcg steps upwards until TSH is under 2 (many need TSH significantly under one) and most important is that FT4 in top third of range and FT3 at least half way in range

NHS guidelines on Levothyroxine including that most patients eventually need somewhere between 100mcg and 200mcg Levothyroxine.

nhs.uk/medicines/levothyrox...

Also what foods to avoid (eg recommended to avoid calcium rich foods at least four hours from taking Levo)

All four vitamins need to be regularly tested and frequently need supplementing to maintain optimal levels

[shaws Administrator]

If you are in the UK, doctors have been told not to diagnose a person as hypothyroid until the TSH reaches 10. Other countries diagnose upon a 3+ TSH and symptoms.

Doctors used to diagnose us on our clinical symptoms alone and we were given a trial of thyroid hormones. If we improved we continued on tablets for the rest of our life.

You can be symptomatic with a TSH of 5.31 but remain undiagnosed/untreated. In other countries we are diagnosed when it reaches 10. Some doctors will prescribe if your symptoms increase.

thyroiduk.org.uk/tuk/about_...

Did you get your blood test at the very earliest possible, fasting (you can drink water). If/when you are diagnosed you must also allow a gap of 24 hours between your last dose and the test and take it afterwards.

[foxglove in reply to shaws]

I am in Wales and upper number for TSH is 5.5

[shaws Administrator in reply to foxglove]

Yes, it may be, but if someone is complaining they wont be diagnosed until TSH reaches 10 in the UK. Unless the GP is sympathetic, knowledgeable and recognises symptoms. So many people have disabling symptoms but if TSH under 10 they will not be given levo.

[foxglove in reply to shaws]

Unbelievable!

[shaws Administrator in reply to foxglove]

Who made these decisions ?- they obviously aren't hypo themselves but you wouldn't expect a doctor to have all of the clinical symptoms and not start on levo immediately.

Dr Skinner and Dr Peatfield who came under the "eye" of the medical authorities and Dr Peatfield (studying in the USA after he trained) and Dr S learning all of the symptoms as a young doctor. They didn't follow the stupid rules but took notice of what the patients complained about and given a 'trial' of levo or NDT if not improving.

We've had all options withdrawn by the 'authorities'. We wouldn't imagain we'd have to source our own replacement hormones when the majority of us may have retired or young people just beginning their lives but are unwell.

Dr Skinner couldn't understand why the rules were stupid. Re Dr Peatfield, Diana Holmes - read the book 'Tears Behind Closed Doors' available from TUK and it shows the stupidity of The Rules for Diagnosing Hypothyroidism. Diana after Dr P achieved the impossible and she went on to work for Dr Skinner and the two of them - plus Dr Skinners staff - even then all ears were closed by the medical professionals who were invited to a Conference by Dr S to discuss the 'parlous situation of hypothyroid patients who weren't diagnosed although showing clear symptoms. For that he was pursued just because he wouldn't give in to stupid rules. He was getting all of these people travelling for all over the UK to consult with him. He also spoke at the Scottish Parliament when Lorraine Cleaver had her case before them. Dr S and Dr P are sincerely missed as the seemed to be the 'last of knowledgeable doctors who treated patients and not a print-out.

[foxglove in reply to shaws]

Rules, rules...ah how even seemingly sensible docs give in to them. Is it something to do with keeping employed?

[Treepie]

Mine was 101 when diagnosed so it is not very high unless you are already on levothyroxine . However, the range is usually up to 4 so you ar3 over the range.