Thyroid blood test

[DaisyandRosie]

I’ve just had my bloods taken privately as my doctor has refused to take any more for a year as he said the last one fine. Please could you make sense of these results and point me in the right direction; what do I need to do to feel better. I’m on my 10th migraine in 10 days...

[greygoose]

Well, you have Hashi's and are terribly under-medicated. The first thing you need is an increase in levo - assuming you are already on levo. Your TSH is too high and your Frees are at the bottom of the range. There's absolutely nothing 'fine' about those results. But, as you have Hashi's, perhaps they were fine last time they were tested. Did you get a print-out of the results?

Does your doctor know you have Hashi's? If so, he obviously doesn't know how it works.

Next, you need to get your nutrients tested: vit D, vit B12, folate and ferritin. These are bound to be low and making you feel worse.

[SeasideSusie Remembering]

greygoose must have very good eyesight. I am on my PC with a large monitor and wearing my glasses but I can't read those results, it's all too small. DaisyandRosie if you would like to edit your post and zoom in on the picture you should get more responses if you would like them.

[greygoose in reply to SeasideSusie]

Believe me, it wasn't easy to read them! I had to enlarge them enormously, and then they went a bit blurry, but I think I got them right.

[SeasideSusie Remembering in reply to greygoose]

Are you on a PC GG? If so, how do you enlarge? I've just had a new PC and still getting to grips with it (such a lot to learn), mind you I couldn't enlarge on my old one

[greygoose in reply to SeasideSusie]

Well, the way I do it might not be the best way, because I'm no expert, either. But, when I can't read them on here, I copy and paste into a word document, and then click on the + on the scale at the bottom of the page until the type gets large enough to read.

You can enlarge the page on this site by clicking on Ctrl and +, but I don't find that enlarges the photo enough. You need to isolate the photo to enlarge it.

Or, you could down-load the photo into your images file and enlarge it by clicking on the photo. But, that's too much messing around, and the results aren't any better than copying and pasting.

[Nanaedake in reply to SeasideSusie]

You might be able to enlarge print by pressing left control button and scrolling with the wheel in the middle of your mouse. I can do it on my pc. Or use the percentage enlargement on the task bar or both.

[SeasideSusie Remembering in reply to Nanaedake]

Ooooh, that's clever! Just tried it and it works. I do like "nice and easy", suits my little brain so well

Thanks Nana.

[SlowDragon Administrator]

Results read (I think)

TSH 9.67 (0.27-4.2)

FT4 12.1 (12-22)

FT3 3.7 (3.1-6.8)

TPO antibodies 163 (under 34)

So you are EXTREMELY under medicated. High antibodies confirm you have autoimmune thyroid disease also called Hashimoto's

How much Levothyroxine are you currently taking?

Take these results in and request 25mcg dose increase in Levothyroxine

Also need vitamin D, folate, B12 and ferritin tested

When under medicated, vitamin levels are frequently too low and need improving by supplementing. If very low GP should prescribe

Did you know you have Hashimoto's?

Have you had coeliac blood test?

Request this too if not been done

Thyroid levels will need retesting 6-8 weeks after 25mcg dose increase in Levothyroxine

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 is in top third of range and FT3 at least half way through 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)

Levothyroxine should always be taken empty stomach and then nothing apart from water for at least an hour after

Many people take Levothyroxine soon after waking, but it may be more effective taken at bedtime

verywellhealth.com/best-tim...

Many people find Levothyroxine brands are not interchangeable.

Once you find a brand that suits you, best to make sure to only get that one at each prescription.

Watch out for brand change when dose is increased or at repeat prescription.

Many patients do NOT get on well with Teva brand of Levothyroxine. Though it is the only one for lactose intolerant patients. Teva is the only brand that makes 75mcg tablet.

No other medication or supplements at same as Levothyroxine, leave at least 2 hour gap. Some like calcium, magnesium, HRT, omeprazole or vitamin D should be four hours away

(Time gap doesn't apply to Vitamin D mouth spray)

[DaisyandRosie in reply to SlowDragon]

Thank you! I’m currently on 100 Levo but the doctor won’t retest as the last test in October came back within range. I had no idea I had Hashimoto and know nothing about it so will find literature on thyroid uk page.

[SlowDragon Administrator in reply to DaisyandRosie]

Do you take Levothyroxine as recommended. On empty stomach and then nothing apart from water for at least an hour after

Had recent brand change in Levothyroxine?

You clearly need dose increase in Levothyroxine

See different GP. They may want to repeat tests on NHS first

Make sure to get blood test done as early as possible in morning before eating or drinking anything other than water and last dose Levothyroxine 24 hours prior to blood test

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 .

Link about thyroid blood tests

thyroiduk.org/tuk/testing/t...

Link about antibodies and Hashimoto's

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

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

List of hypothyroid symptoms

Migraine is common hypothyroid symptom

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

Hashimoto's frequently affects the gut and leads to low stomach acid and then low vitamin levels

Low vitamin levels affect Thyroid hormone

Poor gut function can lead leaky gut (literally holes in gut wall) this can cause food intolerances. Most common by far is gluten. Dairy is second most common.

According to Izabella Wentz the Thyroid Pharmacist approx 5% with Hashimoto's are coeliac, but over 80% find gluten free diet helps, sometimes significantly. Either due to direct gluten intolerance (no test available) or due to leaky gut and gluten causing molecular mimicry (see Amy Myers link)

Changing to a strictly gluten free diet may help reduce symptoms, help gut heal and slowly lower TPO antibodies

While still eating high gluten diet ask GP for coeliac blood test first or buy test online for under £20, just to rule it out first

Assuming test is negative you can immediately go on strictly gluten free diet




(If test is positive you will need to remain on high gluten diet until endoscopy, maximum 6 weeks wait officially)




Trying gluten free diet for 3-6 months. If no noticeable improvement then reintroduce gluten and see if symptoms get worse

chriskresser.com/the-gluten...

amymyersmd.com/2018/04/3-re...

thyroidpharmacist.com/artic...

drknews.com/changing-your-d...

restartmed.com/hashimotos-g...

[DaisyandRosie in reply to SlowDragon]

Thank you for all of your help. I take my levo at 5 am every morning and get up at 6.30 so nothing should interfere with it. I’ve been on the same brand for a few months now. I will get the advised bloods done and post results here. Thank you.

[JumpJiving]

I'm reading those figures as follows. Are these correct DaisyandRosie ?

Total T4: 108 (59 - 154)

TSH: 9.61 (0.27 - 4.2)

FT4: 12.1 (12.0 - 22.0)

FT3: 3.7 (3.1 - 6.8)

Thyroid Peroxidase Antibodies: 143.0 (0 - 34)

Thyroglobulin Antibody: 123 (0 - 115)

As has already been said, you would appear to have Hashimoto's, and are under-medicated. You want your FT3 to be close to the top of the reference range, not the bottom. Addressing that will bring your TSH down.

Also, as has already been said, get your vitamin D, vitamin B12, folate and ferritin levels checked.

In my experience, taking a magnesium supplement can help migraines, but you'll want to do that in combination with addressing other levels. If you ask your GP re. migraines, he/she will probably put you on either amitriptyline hydrochloride or propranolol. The latter should be avoided as you are hypothyroidal (propranolol makes the symptoms worse). I found that amitriptyline messed with my liver, so I avoid that too. Only after weaning myself off both GP-prescribed drugs and starting on magnesium supplements did my migraines improve.

For info, here is what I take - NDT (but levothyroxine might work fine for you), vitamin D3, folic acid 5-MTHF, vitamin B12, vitamin K2, Triple Magnesium Complex (magnesium citrate, taurate and bisglycinate). I was taking vitamin C as well, which helped get my iron levels up, but I've stopped that for the moment as I'm trying to identify what is messing with my sleep patterns.

Get those extra blood tests done and post the results here. Once you've done that, people can comment on whether you need supplements on top of the thyroid medication that your GP should be providing. Your thyroid results are not fine, so you need to go back to your GP with the results that you posted and insist on an increase in dose of levothyroxine (or NDT or T3, but realistically the GP will only offer levothyroxine).

[DaisyandRosie in reply to JumpJiving]

Thank you, yes all correct. I’m already on amitriptyline and just been put on Topiramate. I’ve been on propranolol but was taken off off them because they gave me chest pains.

[JumpJiving in reply to DaisyandRosie]

Even my (let’s dish out some drugs without thinking about it) GP advised against Topiramate because of the number of possible side effects. Having said that, I have a friend who swears by it.

[SlowDragon Administrator in reply to DaisyandRosie]

Propranolol is to treat hyperthyroid patients. It shouldn't be used when hypothyroid (but frequently is) good that you didn't get on with it

Migraine are hypothyroid symptom

[DaisyandRosie]

Thank you for all of your help and advice. I will certainly get reading

[SlowDragon Administrator in reply to DaisyandRosie]

Dr Toft, past president of the British Thyroid Association and leading endocrinologist, states in Pulse Magazine,

"The appropriate dose of levothyroxine is that which restores euthyroidism and serum TSH to the lower part of the reference range - 0.2-0.5mU/l.

In this case, free thyroxine is likely to be in the upper part of its reference range or even slightly elevated – 18-22pmol/l.

Most patients will feel well in that circumstance. But some need a higher dose of levothyroxine to suppress serum TSH and then the serum-free T4 concentration will be elevated at around 24-28pmol/l.

This 'exogenous subclinical hyperthyroidism' is not dangerous as long as serum T3 is unequivocally normal – that is, serum total around T3 1.7nmol/l (reference range 1.0-2.2nmol/l)."

You can obtain a copy of the articles from Thyroid UK email print it and highlight question 6 to show your doctor

please email Dionne at

[e-mail]

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...