New dr in the NE

[Smackeyes]

Hi I’m new to the group and really need some advice/ guidance.

I’ve had thyroid disease for 29 years and am on 200mg of Thyroxene.

Had blood tests recently and the dr said they were acceptable.

I feel like crap at the minute. Tired, no sex drive, no interest in anything. It’s driving me nuts.

Anyone know a dr in the NE who do proper blood tests, mine won’t.

Thanks

Paul

[Billyboy2u]

You would have to change Dr’s ?

If you post your results the guys. In here will tell you exactly what’s wrong or right with your results. There great

[Smackeyes in reply to Billyboy2u]

I asked for tests regarding reverse T3 I think it was but they basically refused

[greygoose in reply to Smackeyes]

And rightly so. The rT3 test is very expensive and doesn't give you any useful information. It will tell you if you have over-range rT3, but not why. High rT3 doesn't cause symptoms, anyway.

The tests you really need are:

TSH

FT4

FT3

TPO antibodies

Tg antibodies

vit D

vit B12

folate

ferritin

That will give a clear picture of what is going on.

[SlowDragon Administrator]

First step is to get FULL thyroid and vitamin testing

How much levothyroxine are you currently taking?

Do you always get same brand of levothyroxine?

Have you had thyroidectomy or RAI or autoimmune hypothyroidism?

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 or after Graves’ disease

Ask GP to test vitamin levels

You may need to get full Thyroid testing privately as NHS refuses to test TG antibodies if TPO antibodies are negative

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 as NHS currently rarely tests Ft3 or thyroid antibodies or all relevant vitamins

List of private testing options

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

Medichecks Thyroid plus ultra vitamin

medichecks.com/products/thy...

Medichecks often have special offers, if order on Thursdays

Thriva Thyroid plus vitamins

thriva.co/tests/thyroid-test

Blue Horizon Thyroid Premium Gold includes vitamins

bluehorizonbloodtests.co.uk...

Add most recent results from GP.....likely just TSH or TSH and Ft4 which are completely inadequate

Or come back with new post once you get results...members can advise on next steps

Frequently we need to supplement vitamins virtually continuously to improve and maintain at optimal levels

[Smackeyes in reply to SlowDragon]

Wow that’s a lot of info thank you. I don’t have recent test results and can’t really get in at the moment. May need to get an independent test done then.

[Marz in reply to Smackeyes]

Great idea - then you can start to take control. Are you taking any other pills and potions ? How do you take your Levo ?

Reading posts here will help a lot too !

[Smackeyes in reply to Marz]

No don’t take anything else at all. And take 200mg first thing on a morning.

[SlowDragon Administrator in reply to Smackeyes]

Levothyroxine is an extremely fussy hormone and should always be taken on an 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 convenient and perhaps more effective taken at bedtime

(But must still be on empty stomach)

verywellhealth.com/best-tim...

markvanderpump.co.uk/blog/p...

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. Teva contains mannitol as a filler, which seems to be possible cause of problems.

Teva and Aristo are the only lactose free tablets

healthunlocked.com/thyroidu...

Teva poll

healthunlocked.com/thyroidu...

No other medication or supplements at same as Levothyroxine, leave at least 2 hour gap.

Some like iron, calcium, magnesium, omeprazole or vitamin D should be four hours away

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

[Marz in reply to Smackeyes]

Do you wait an hour before eating or drinking anything other than water ... ?

[Smackeyes in reply to Marz]

I’ll be honest . No but never really had any issues until quite recently

[Marz in reply to Smackeyes]

Maybe now is the time to try to assist better uptake and absorption.

[shaws Administrator in reply to Smackeyes]

Allow a gap of 24 hours between last dose of hormones and the test which should also be the very earliest and take it afterwards. Always book your blood test long before you are due to get it, and you'll be able to get the earliest, fasting (you can drink water) blood test.This method helps give the highest level and may prevent doctor reducing your dose of thyroid hormones.

[SlowDragon Administrator in reply to Smackeyes]

You are legally entitled to printed copies of your blood test results and ranges.

The best way to get access to current and historic blood test results is to register for online access to your medical record and blood test results

UK GP practices are supposed to offer everyone online access for blood test results. Ring and ask if this is available and apply to do so if possible, if it is you may need "enhanced access" to see blood results.

In reality many GP surgeries do not have blood test results online yet

Alternatively ring receptionist and request printed copies of results. Allow couple of days and then go and pick up....or ask that they post results to you (in current virus situation)

Important to see exactly what has been tested and equally important what hasn’t been tested yet

Poor conversion of Ft4 (levothyroxine) into Ft3 (the active form of thyroid hormones) is often poor when vitamin levels are low

Naturally our own thyroid (when working correctly) makes 80% Ft4 and 20% Ft3.....many many people struggle on just levothyroxine.

Getting vitamin levels optimal can improve conversion...so that’s first step and to check you are on high enough dose of levothyroxine too

[shaws Administrator in reply to Smackeyes]

Remember all blood drawn has to be at the earliest possible, fasting (you can drink water) and alow a gap of 24 hours between last dose of levo and test and take afterwards. This helps keep the TSH at its highest (doctors seem to only look at the TSH result). TSH means 'thyroid stimulating hormone' and is from the pituitary gland - not thyroid gland It is highest early a.m. and drops throughout the day and may mean a reduction instead of an increase.