Any help for my sisters recent blood tests from GP

[Mistydeb01]

Hi, please can someone have a look at my sisters blood tests and advise. She has recently been feeling very tired and low energy. I advised her to get thyroid checked as she struggles to lose weight and her hair has been getting thinner and thinner, little body hair. For the last few years she has been taking some hair supplement that when she’s looks contains biotin. As biotin affects blood test, can you tell me if it makes TSH higher or lower.

Thank you, Debbie

[SeasideSusie Remembering]

As biotin affects blood test, can you tell me if it makes TSH higher or lower.

All we know is that it gives false results, there's never been any explanation of whether they can be high or low.

As they stand, those results reflect what it says in the comments re TSH - Subclinical Hypothyroidism which is where the TSH is over range with a low in range FT4, but TSH has not yet reached the magic level of 10 where Primary Hypothyroidism is diagnosed.

Her TPO antibodies are too close to the top of the range to be ignored, they suggest that she could have autoimmune thyroid disease, aka Hashimoto's, but would need to be over range for a doctor to consider that. Antibodies fluctuate and could be higher or lower with subsequent tests. Over range TSH (but lower than 10) coupled with over range thyroid antibodies, would hopefully get a diagnosis and prescription for Levo from an enlightened doctor (but not guaranteed).

Is this her first thyroid test with an elevated TSH? If so then her GP should repeat the test to see if the TSH remains high to rule out a non-thyroidal illness which may have caused the elevated TSH.

She should get the test repeated in 2 or 3 months time, and follow the advice for testing which we always give here:

* 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 (both Medichecks and Blue Horizon advise to leave Biotin/B Complex off).

These are patient to patient tips which we don't discuss with doctors or phlebotomists.

[Mistydeb01 in reply to SeasideSusie]

This was the first test she knew about and only because she requested it, this is a new GP as she moved to Yorkshire. The GP is repeating the test as she told my sis that her thyroid has been tested by her previous GP and that showed she was borderline hypothyroid as well. I have told her to make sure it’s a morning and fasting appt. I will tell her to leave the hair supplements for a week before the test. I will send her the link to this post so she can read the advice for herself (I’m sure she doesn’t believe me half the time). Although I’ve given her Thyroid uk details and she has been doing some reading and looked at the symptom list and as she doesn’t want it to be ignored and end up like me she will push it with the GP. Thank you for your response and time. Debbie