Hi! I am 39 years old and a nurse. I have suffered from mental health issues for mostly all my life (for context: autism, bulimia nervosa, social anxiety, depression). I have been feeling awful lately, gained 35 kg over the last 18 months, a lot of anxiety, feeling really tired... I take lyrica for anxiety and nothing else. And I was getting very frustrated as I was asking for mental health support from the NHS and getting nowhere (that is a whole other topic though...) I was advised by a colleague of mine (GP) to have my thyroid and vitamin levels tested as he usually likes to rule out hormonal reasons to mental health problems before going the psychiatric route. Because all GPs are basically closed for f2f consultations now due to covid-19, I decided to do a full health screen using thriva. In my results, this things were abnormal: raised lipids, suboptimal vitamin D:28 , raised CRP: 3.2, low folate: 8.2 and most importantly very deranged thyroid function: TSH: 37.74 and FT4: 7.7. B12 levels sadly came back as unable to test due to haemolysed sample.
I was advised by thriva to contact my GP ASAP and so I did yesterday. I sent my surgery the blood results via email and my GP called me back and she said you clearly have an underactive thyroid. Her plan is to start me on levothyroxine 25 mcg for a week, then increase to 50 mcg for another week and then to 75 mcg. I guess she will do regular blood tests meanwhile but I'm not sure She has also booked me for bloods on Thursday this week to check all thyroid function again (including antibodies. I guess she wants to know the source of my derange numbers, to see whether is Hashimoto or what).
I am feeling very uneasy and I wonder how accurate are home tests really? I feel kind of like an impostor, meaning that I am somehow glad that the test gave me those results as they explain a lot of the symptoms I have been getting over the last year / two years but I am also scared I will get to my surgery on Thursday and the bloods will be normal and I will be taken off the levo... Can anyone advise me please? My bloods have always been normal otherwise, any reason as to why a home test could give false positives for hypothyroidism??
Thanks
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cheesephetamine
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We have not heard of any false positives from the home test labs. It is usual for doctors to test again simply because it wasn't an NHS check. You will be tested regularly from now on.
Make sure they do the B12 too.
Just one of your deficiencies is enough to cause fatigue and depression and anxiety so all of these together will only compound that. It's possible that you have had a thyroid condition for a lot longer than a year. It's best to keep a note of your test results (including the ranges) so that you can find out where you feel best. See if you can find out if you have been tested before for thyroid and make a not of those too.
Make sure that you take your levo on an empty stomach and don't eat for at least half an hour. Don't take your meds before the test and try to get the test done as early as possible in the morning as the TSH drops throughout the day.
I'm sure you will see an improvement in your symptoms soon.
Thank you so much this is very reassuring. I am booked at 08:15 and will take the tablet afterwards. I will ask the nurse to see if they are testing for vitamins too. Thanks
It is extremely unlikely that this is a false reading. All tests whether nhs or private have some inherent variability ( eg 2 samples taken at the same time sent to different labs will be slightly different). A TSH of over 37 is very high with a low ft4 (you need to put the ranges in for correct interpretation as they vary from lab to lab around the country). Many of your mental health problems will be exacerbated by hypothyroid and it would be sensible to treat the hypothyroidism before changing other medication.
Unfortunately it can take some months to bring thyroid levels up into range, Levothyroxine has a long half life so a dose change needs 6 weeks to stabilise before checking blood levels.
There is loads of advice on this site, so take some time to read and digest. Your gp sounds sensible in increasing your dose, this is the current best practice on how to start levothyroxine.
I don't wish to play devil's advocate, but that is no guarantee. There's always the possibility that something went wrong with the assay in the lab. If, for example, you were taking biotine at the time of the blood draw. And, this is why we should always take the three readings into consideration together: TSH, FT4 and FT3. But, you haven't given us a range for the FT4 and you haven't given the FT3 result or range. So, it's impossible to tell if they correspond.
OK, so that FT4 is very low, so presumably the FT3 will be, also.
You may not take biotin - and I'm afraid what you were aware of was false, as helvella explains - but that was just an example. There are other things that can affect TSH during testing, such as anti-TSH antibodies - and you will have no idea if you have those!
I have read both definite statements that TSH changes one way and FT4 and FT3 the other. And statements that biotin could affect some test in one direction and other tests the other way - without being definite and specific.
Biotin only affects some assays and not others.
I'd want to know exactly which test kit was used and then check for that specific platform. Even then, it is impossible to know how much of an effect it has on an individual's sample.
I will do! I find all this so confusing, my GP hasn't mentioned anything about supplementing. I guess she is waiting for the results to be back (unsure if she will test for vitamins but I will ask my nurse on Thursday) and I really need to sit down and read about what supplements I need etc ...
When I was finally tested for thyroid function after my GP insisting I had no thyroid issue, he kept saying I had depression. My TSH came back as 36 (0.55-5.50). I was put on Levothyroxine but never felt well really over a ten year period. After getting my T3 checked 2 years ago in hospital after collapsing. I found out I’m a poor converter. I did the DIO2 gene test, which came back positive. I’m now on T3, which I had to go private for. I cannot express enough on what a difference T3 has made to my life. I feel 10 years younger and my whole life has changed for the positive. Please get your T3 checked alongside TSH and T4. I also put on 2st and now have lost 3st, just by my body energised with T3 and all my cells and organs working as they should finally.
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