Blood Tests prior to Endo’ appointment

[Lassithi]

Hello,

I am in the process of applying for access to my records/results on line as (with the invaluable help of this site) I have realised I need to become the expert on my diagnosis (hashi/hypo) and understand my own results/levels.

I continue to have much the same symptoms on 100 much Levo thyroxine as I did prior to commencing treatment. I have first appointment with endocrinologist in 3 weeks time -had to be very assertive with GP to be referred to Endo as GP believes my TSH bloods are fine although also stated that T3 and T4 are not required.

I haven’t had a recent blood test as was trying to get it as close to endo appt as possible.

Can I please ask what blood tests shall I request (strongly assert) prior to the endo appointment as I want to go in as prepared as possible as have waited 8 months for this appt.

I am hoping to go next week so I can post my results here for advice.

Thanks 🙏

[shaws Administrator]

The Endo may not do all of the tests so I'd get my own and take results with me.

Make sure you are well-hydrated and follow the usual routine, i.e. fasting, the earliest blood draw and allow a gap of 24 hours between last dose of levo and the test and take it afterwards.

Private labs do home finger pin-prick blood draw and many members have done so.

You need TSH, T4, T3, Free T4, Free T3 and thyroid antibodies.

thyroiduk.org.uk/tuk/testin...

GP should test B12, Vit D, iron, ferritin and folate.

[Lassithi in reply to shaws]

Thank you-advice greatly appreciated and will follow up with link 🙏

[fuchsia-pink in reply to Lassithi]

I was lucky - young, female GP and when I said that all the tests mentioned by shaws were recommended by Thyroid UK - she put that on the bloods form and got the lot done for me

[shaws Administrator in reply to fuchsia-pink]

Wow! - a doctor who listened as most will usually only do TSH and T4.

[fuchsia-pink in reply to shaws]

I've been getting T3 testing for a while (I'm on NHS lio) but was the first time I'd seen her: I think the things that really helped were (a) I took my husband along* and (b) I have learned a LOT from this forum - and that as she is young (and not a partner at the practice) she wasn't embarrassed to admit she doesn't know much about thyroid.

* because , obviously, as a professional person who has successfully run my own business, I'm liable to be hysterical and/or foolish unless I provide some Y chromosomes to stablise me

Next step - to get the NHS endo to treat me as an adult who isn't totally stupid ...

[SlowDragon Administrator]

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 as you have autoimmune thyroid disease (Hashimoto's) diagnosed by raised Thyroid antibodies

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)

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

thyroiduk.org.uk/tuk/testin...

For thyroid including antibodies and vitamins

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 taking any supplements that have biotin in stop these a week before any blood tests

If taking iron supplements and wanting to know iron level stop iron a week before blood test too

Do you always get same brand of levothyroxine?

[Lassithi in reply to SlowDragon]

Thank you, I haven’t had bloods done this way before, usually done after morning levo dose so this will be the first time I will have followed this advice so interested to compare with previous tests.

Thank you about the information re: private lab tests. It will be worth it to get accurate testing.

With regard to brand of levo, supplier is Northstar /Actavis.

[SlowDragon Administrator in reply to Lassithi]

Watch out ....if/when levothyroxine dose is increased....Northstar 25mcg is actually Teva

healthunlocked.com/thyroidu...

[Lassithi in reply to SlowDragon]

Thank you-excellent point if increased by 25 at any point I will remember to ask for same brand in 50 and score that down to 25.

[Lassithi in reply to Lassithi]

Hello-just wanted to check two things please;

I requested all tests recommended on here prior to my endo appt and the lab request form states:

B12, FER, FT3, PTH, SF, TFT, TPO, TVD

1). Is this everything I need testing prior to endo' appt'?

I have finally accessed my health records and although the 2+ yrs of tests it took to diagnose Hashimotos/Hypothyroid in June 2019 there are no blood tests results included in my health record from that time. The ones below are sadly the only recorded results so I don't have any comparisons.

The blood test results I can access from Dec 2019 have me puzzled

2). Can anyone please help me to interpret the results below:

Serum TSH: 0.86mu/L (range 0.35-5.00) (Allegedly) Normal

Serum Free T4 level 24.7pmol/L (range 11.00-23.0) Abnormal

Serum Gamma GT level 48 u/L (range 0-42) Abnormal

Was also told that phosphate was high with normal range Vit D and had further Parathyroid and Bone density tests which both came back normal .

Advice/Comments greatly appreciated,

Thank you