Test result Query

[Haynton]

Hi all I posted my Medichecks results here last week and I was surprised

by the TSH result (5.96) which was alot higher than my GPs result (1.08) 3 months earlier. 3 days before my Medicheck bloods I think I may have taken 25mcg instead of 100mcg by mistake as I still have 25s in my pill box but I took 100mcg on the 2 days before dose 24hrs before I took blood.Would this have made my TSH result higher ?

Thanks.

[SeasideSusie Remembering]

Did you fast from evening meal the night before and drink water only before this test, or did you have breakfast, coffee, tea, etc?

It's unlikely that taking 25mcg instead of 100mcg 3 days before would have any effect, Levo is a storage hormone and doesn't work that quickly.

[Haynton in reply to SeasideSusie]

I think I had a cup of tea about 30 mins before but no food for at least 12

hours

[SeasideSusie Remembering in reply to Haynton]

Tea contains caffeine. As coffee affects TSH then I imagine that tea could do so as well. Advice here is nothing but water until after the test.

[Haynton in reply to SeasideSusie]

Ok thanks SeasideSusie,I will remember this for next time but I think I will show my doctor this and he may want bloods done again,also why do the doctors say you dont need to fast now whhen they do your Thyroid bloods ? (I do anyway)

Also do you think my Ferritin needs to higher or any other vits ?

Thanks

[SeasideSusie Remembering in reply to Haynton]

also why do the doctors say you dont need to fast now whhen they do your Thyroid bloods ? (I do anyway)

Because they're clueless, have very little knowledge of thyroid disease and don't understand that it's the hormone levels not TSH that are important. There are a few who understand, one member's endo actually has told her to do her tests exactly as we advise her. This is the advice we always give members:

When doing thyroid tests, 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 (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.

[Haynton in reply to SeasideSusie]

Thanks again,I will save this for future reference,thanks for your time.

Any advice on my Ferritin which is 140 (30-400)

[SeasideSusie Remembering in reply to Haynton]

Ferritin which is 140 (30-400)

Ferritin is recommended to be half way through range. Yours isn't dire and eating iron rich foods regularly should help raise it. If you're not vegetarian the best way is to eat liver, no more than 200g per week due to it's high Vit A content. If you don't like liver as a meal, try cutting into thin strips and do a stir-fry type meal with lots of veggies in (this is how I have it). Liver pate and black pudding are also good. Other iron rich foods here:

apjcn.nhri.org.tw/server/in...

It's not a good idea to take iron tablets unless you do an iron panel. If you already have a good amount of serum iron and a lowish TIBC you wont want to be taking iron tablets.

Your Vit D could be higher, the Vit D Council/Vit D Society/Grassroots Health all recommend between 100-150nmol/L.

Your Folate could also be a bit higher, there is no proper reference range there and with just a low limit like that I prefer mine to be in double figures. What B Complex are you using? Does it contain methyfolate rather than folic acid? Does it contain 400mcg?

[Haynton in reply to SeasideSusie]

Thanks for that,I do like liver ,black pudding so I will eat more,I take vit d3 /k2 mark 7drops and vit B-complex tablet (Folate (L-5-MTHF)

200mcg

but only take one of these

Thanks

[SeasideSusie Remembering in reply to Haynton]

I'd take 2 of your B Complex for, say, 3 months then retest to see if it has helped. Lots of Folate rich foods too - listed on the British Dietetic Association website are:

• spinach, kale, Brussels sprouts, cabbage, broccoli

• beans and legumes (e.g. peas, blackeye beans)

• yeast and beef extracts

• oranges and orange juice

• wheat bran and other whole grain foods

• poultry, pork, shellfish and liver

• fortified foods (e.g. some brands of breakfast cereals)

[Haynton in reply to SeasideSusie]

Thanks for all your help.

[HMBradley53 in reply to SeasideSusie]

I have never heard of caffeine affecting TSH results . You learn something new every day..Thank you

[SlowDragon Administrator]

New NHS England Liothyronine guidelines July 2019 clearly state on page 13 that TSH should be between 0.4-1.5 when treated with just Levothyroxine

Note that it says test should be in morning BEFORE taking Levo thyroxine

Also to test vitamin D, folate, B12 and ferritin

sps.nhs.uk/wp-content/uploa...

Here's research about TSH and affect of eating before testing

ncbi.nlm.nih.gov/pmc/articl...

Ferritin test should be done fasting too

[Haynton in reply to SlowDragon]

Thanks Slowdragon