Blood test

[Lalacop]

Hi,I’m new to this group and so confused now as you all seem very well educated in thyroid talk.Was told in feb I needed levothyroxine(50) for life due to blood test,was taken off it one month later fast forward 6 months a new blood test and put back on it but a higher doze(75)my hair is falling out frightful my joints are agony and I’m lethargic the list is endless .i don’t know what I’ve got or what I should be asking,I thot it was the menopause.help x

[shaws Administrator]

Welcome to our forum Lalacop. We've learned about hypothyroidism through no fault of our own as it is an autoimmune disease of the thyroid gland. i.e. it is not producing sufficient hormones that enable our body to function as normal. There are two main hormones i.e. T3 and T4 (also known as liothyronine and levothyronine). T4 is inactive and has to convert to T3. T3 is actually required in all of our T3 receptor cells and we have millions and our brain and heart have the most.

TSH - means thyroid stimulating hormone. It rises if our thyroid gland is beginning to fail in order to try to increase our the T4/T3.

T4 - also known as levothyroxine is an inactive hormone and has to change to

T3, which is the Active thyroid hormone needed in our millions of T3 receptor cells - i.e. heart and brain have the most.

Once we are diagnosed as hypothyroid, it is for the rest of our lifetime and we must take a hormone replacement every day with one full glass of water and wait an hour before we eat.

The aim is a gradual increase in dose until TSH is around 1 or lower but some doctors stop increasing as they wrongly believe that if TSH is very low that we've become hyPERthyroid but that isn't the case.

Always get your blood tests at the very earliest (even if you have to make your appointment weeks ahead) and also get a print-out and you can post if you have a query.

Fasting (you can drink water) and allow a gap of 24 hours between last dose and test and take afterwards.

Ask also for B12, Vit D, iron, ferritin and folate to be tested as everything has to be optimum.

[SlowDragon Administrator]

Welcome to the forum

Sounds like you have autoimmune thyroid disease, usually called Hashimoto’s on here

Technically in UK autoimmune thyroid with goitre is Hashimoto’s

Autoimmune thyroid disease without goitre is Ord’s thyroiditis

Rest of world calls both Hashimoto’s

Hashimoto’s frequently starts around hormonal upheaval....puberty, pregnancy and menopause

It also starts a bit erratically....with levels changing a lot

First thing is, do you have any actual blood test results? if not will need to get hold of copies. 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.

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

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

Ask GP to test vitamin levels

Low ferritin linked to hair loss

Painfull joints low vitamin D

Bloods should be retested 6-8 weeks after each dose increase in levothyroxine

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/getting-a-dia...

Thyroid plus vitamins including folate (private blood draw required)

medichecks.com/products/thy...

Thriva Thyroid plus vitamins

thriva.co/tests/thyroid-test

Blue Horizon Thyroid Premium Gold includes vitamins

bluehorizonbloodtests.co.uk...

If you can get GP to test vitamins and antibodies then cheapest option for just TSH, FT4 and FT3

£29 (via NHS private service ) and 10% off if go on thyroid uk for code

thyroiduk.org/getting-a-dia...

monitormyhealth.org.uk/thyr...

Medichecks - JUST vitamin testing including folate - DIY finger prick test

medichecks.com/products/nut...

Medichecks often have special offers, if order on Thursdays

healthunlocked.com/thyroidu...

If TPO or TG thyroid antibodies are high this is usually due to Hashimoto’s (commonly known in UK as autoimmune thyroid disease).

About 90% of all primary hypothyroidism in Uk is due to Hashimoto’s. Low vitamin levels are particularly common with Hashimoto’s. Gluten intolerance is often a hidden issue to.

Link about thyroid blood tests

thyroiduk.org/getting-a-dia...

Link about Hashimoto’s

thyroiduk.org/hypothyroid-b...

List of hypothyroid symptoms

thyroiduk.org/signs-symptom...

[SlowDragon Administrator]

Which brand of levothyroxine are you currently taking?

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 is the only brand that makes 75mcg tablet. So if avoiding Teva for 75mcg dose ask for 25mcg to add to 50mcg or just extra 50mcg tablets to cut in half

Teva and Aristo are the only lactose free tablets

healthunlocked.com/thyroidu...

Teva poll

healthunlocked.com/thyroidu...

academic.oup.com/jcem/artic...

Physicians should: 1) alert patients that preparations may be switched at the pharmacy; 2) encourage patients to ask to remain on the same preparation at every pharmacy refill; and 3) make sure patients understand the need to have their TSH retested and the potential for dosing readjusted every time their LT4 preparation is switched (18).

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

verywellhealth.com/best-tim...

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

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

[Lalacop in reply to SlowDragon]

Hi just got my results printed from drs

Jan my free t4 was 9.4

TSH was 5.9

August my freet4 was 10.5

TSH was 5.04

Can you tell me if this is ok

Many thanks

[SlowDragon Administrator in reply to Lalacop]

See/contact GP for 25mcg dose increase in levothyroxine ....

So if you were on 75mcg ...it needs increase up to 100mcg

Aim of levothyroxine is to increase the dose slowly upwards in 25mcg steps until on full replacement dose

Bloods should be retested 6-8 weeks after each dose increase

Ask GP to test vitamin D, folate, ferritin and B12 plus thyroid antibodies NOW

[SlowDragon Administrator in reply to Lalacop]

Get a weekly pill dispenser and always take levothyroxine at same time every day

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

verywellhealth.com/best-tim...

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

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

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

academic.oup.com/jcem/artic...

Physicians should: 1) alert patients that preparations may be switched at the pharmacy; 2) encourage patients to ask to remain on the same preparation at every pharmacy refill; and 3) make sure patients understand the need to have their TSH retested and the potential for dosing readjusted every time their LT4 preparation is switched (18).