Wondering

[pet-lamb]

Hello just wondering ,I've heard from my doctors that my latest thyroid blood draw has shown up as abnormal and been traffic lighted at Amber .they plan to take another sample soon I think .

The labs have said to have a repeat blood test but it's not urgent.

I found out by ringing the receptionist for an update as I'm in shielding because of blood cancer.

I'd normally collect My results and check them myself .

My query is this, I have hashimotos disease with under active thyroid .

I usually have my bloods done early morning around 7 or 8 am .this wasn't possible as the nurse came to the house in the afternoon around 2pm .

Also I hadn't taken my levothyroxin that day until after the bloods draw but had taken it the previous day so a gap of 30 hours?

Normally I'd not take the thyroxine from the day before my bloods were due to be taken so maybe 24 hours clear.

Sorry I think I confused myself earlier saying 48hours ,I take my thyroxine when I get up every morning and would normally miss that dose the day before a blood draw 🙄not 2 days be for sorry .

I have modules and a cyst on my thyroid and they've been there for a couple of years I was assured that they would never turn cancerous.

So sorry for the long list but wondering what could have caused the abnormal reading .

thanks in advance to everyone who reads or helps .

[SeasideSusie Remembering]

pet-lamb

So sorry for the long list but wondering what could have caused the abnormal reading.

What are they classing as abnormal? We can't really comment without the results plus reference ranges.

I usually have my bloods done early morning around 7 or 8 am .this wasn't possible as the nurse came to the house in the afternoon around 2pm .

That will only affect your TSH result. It will be lower in the afternoon that it would be early morning.

Also I hadn't taken my levothyroxin that day until after the bloods draw but had taken it the previous day so a gap of 30 hours?

Normally I'd not take the thyroxine from the day before my bloods were due to be taken so maybe 48 hours clear .

Neither of those two timings is correct. There should be a gap of 24 hours between last dose of Levo and blood draw to give a measure of your normal circulating hormone. You will have had a false low FT4 with both those tests.

As you left 30 hours and your FT4 is probably low in range, I'm guessing that your TSH is low and that's why your being told your result is abnormal.

[pet-lamb in reply to SeasideSusie]

Thank you Susie I can't get the results so can't put them up ,but you're explanation really helps thanks

[SeasideSusie Remembering in reply to pet-lamb]

Can they not email results to you or give you the results/ranges over the phone (not ideal but you could read them back whilst on the phone to double check).

[pet-lamb in reply to SeasideSusie]

No sorry I asked those questions so I just have to wait .The girl in reception said she couldn't see where they showed the Tsh results .

[SeasideSusie Remembering in reply to pet-lamb]

If they do not give you your results in some form when requested, or offer to let you have them within 30 days, then they are breaking the law (assuming that you are in the UK).

[pet-lamb in reply to SeasideSusie]

Thanks Susie yes I know but I'm not pushing as I'm in shielding .Normally I don't have a problem getting them .it was the receptionist I spoke to and she didn't have a clue how to read the results.

I've asked them to email message or post my results in just waiting to see what happens.

of course if they come to my house again to repeat the blood tests they can bring them when they come .

[shaws]

First of all, I am very sorry you have blood cancer and I do hope the expert doctors can resolve this for you.

I believe it is because your bloods weren't drawn as early a.m. as possible and normally (as you would know - I think) we'd leave a gap of 24 hours between last dose and test and it is a fasting one and we take hormones afterwards. As the gap was 30 hours results would be skewed. I should also state I'm not medically qualified.

I'd ask for another test and just tell your GP that your results were skewed due to blood not being drawn early a.m. and too long a gap between last dose and test.

[pet-lamb in reply to shaws]

Thanks Shaw I told the receptionist that to pass on to the doctors x

Also yes I always fast be for a blood draw i.e no breakfast water only .

But don't tell the doctors this now as they insist that eating makes no different to the results .

[pet-lamb]

I've asked lots just waiting to find out ,the receptionist didn't know she was waiting for advice

[pet-lamb]

Will leave it a couple of days lora and try again if I haven't heard from them ,thanks

[jimh111]

I wouldn't worry about it. Levothyroxine has a half-life of about 7 days. If you were to try and get an 'average' fT4 at 12 hours after the last dose you would have about 95.2% of your initial dose left. After 30 hours there is around 88.4% left. So, as a result of leaving it 30 hours your fT4 figure will be about 7% lower (or about 2% low compared to leaving 24 hours). Nothing to worry about.

Having fT4 around 7% lower will raise your TSH a little but an afternoon blood draw will lower it more. So I guess your TSH will come out a bit lower than with your usual routine. I believe your TSH is usually around 0.5? If so, I suspect it doesn't vary much during the day as it is already lowish (compared to the population, not saying it is too low).

Doctors tend to be unaware of the inverse log normal relationship between TSH and thyroid hormones so with a lowish TSH they fail to recognise that small absolute changes are significant.

I don't think there is anything to worry about.

POST EDITED TO CORRECT STATEMENT THAT LEVOTHYROXINE HALF-LIFE IS 24 HOURS.

[pet-lamb in reply to jimh111]

Thanks Jim I'll keep everyone updated when I know what's happening

[Zebra5 in reply to jimh111]

Hi jimh111 - reference my message. Many thanks.

[pet-lamb]

Thanks Lora yes I know and as I said I don't usually have a problem getting my results ,the ref was lovely just unable to help today .But I'm a bull dog I'll get those results soon ☺

[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 Hashimoto's

What vitamin supplements are you currently taking?

Ask GP to test vitamin levels if not been done for 6 months

As blood test was pm you may find TSH is lower than not Ignore low TSH, most important result is Ft3 (nhs rarely tests)

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)

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...

[pet-lamb]

Thank you slow dragon,I'm taking vitamins D3 k2-7 something cat in my knee can't check and magnesium

my vitamin D continued to drop and it wasn't untill it got to inadequate that the doctors took notice and even then I had to push them .

I do usually do everything else you mentioned

I'm thinking of having private bloods done but can't afford it at the moment