Thyroid blood test, how to go about it?

[Puddleperson]

I have decided to have my first comprehensive thyroid blood test. I have been taking adrenal and thyroid supplements plus T3 for the past 15 or so years which has resolved most of my problems, but not all. In order to get the most accurate analysis of my condition would it be wise to discontinue my meds to clear my system before taking the blood sample? If so for how many days prior to taking the sample should I stop taking anything?

[fuchsia-pink]

If your supplements contain biotin, it's usually recommended to come off them a week before the tests, so that the biotin doesn't distort the results. And have a gap of 24 hours from your previous dose of levo and 8 - 12 hours from lio.

In terms of having a home fingerprick test, SeasideSusie gives great advice about how best to do it - so click on her icon and check out recent replies to people x

[Puddleperson in reply to fuchsia-pink]

Thanks for this. Not taking biotin but having just looked up what it does maybe I should given my major problem now is hair loss! Hopefully proper blood tests will reveal all. Thanks again for your help.

[SeasideSusie Remembering]

Puddleperson

In order to get the most accurate analysis of my condition would it be wise to discontinue my meds to clear my system before taking the blood sample?

Crickey no! You'll make yourself hypothyroid.

What you need to know is if the current dose of thyroid meds you are taking is giving you optimal results - and of course it's important to take into account how you feel. So you continue with your meds but there is an important time gap between last dose and the blood draw, as fuchsia-pink has mentioned.

Always advised here, when having thyroid tests:

* Blood draw no later than 9am. This is because TSH is highest early morning and lowers throughout the day. If looking for a diagnosis of hypothyroidism, an increase in dose of Levo or to avoid a reduction then we need the highest possible TSH

* Nothing to eat or drink except water before the blood draw. This is because eating can lower TSH and coffee can affect TSH.

* Last dose of Levo 24 hours before the test, take that day's dose after the blood draw. This is because if you take your Levo before the blood draw the test will measure the dose just taken and show a false high. If you leave longer than 24 hours the result will show a false low.

* If you take Biotin or a B Complex containing Biotin (B7), leave this off for 7 days before any blood test. This is because if Biotin is used in the testing procedure it can give false results (most labs use biotin).

These are patient to patient tips which we don't discuss with phlebotomists or doctors.

Which comprehensive test are you considering? The one that tests vitamins as well? If so then choose carefully.

To get the full set of vitamins in a fingeprick test you will need the Blue Horizon Thyroid PREMIUM GOLD. Generous discount available:

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

This test also includes cortisol but it's a random serum cortisol test which, I believe, tests total cortisol and it's free cortisol that is the more useful test and a saliva test covers this.

It also tests magnesium but because about 99% of magnesium is stored in bone, muscles and soft tissues, leaving about 1% in the blood then testing what's in the blood isn't giving an accurate picture of our magnesium status.

If you're considering the more or less equivalent test from Medichecks then their ULTRAVIT test can be done by fingerprick but doesn't include Folate. Folate and B12 work together so it's a good idea to have folate included in which case you'd need the ULTRAVIT WITH FOLATE test which can only be done by venous blood draw (at extra cost).

TIPS FOR DOING FINGERPRICK TEST

* Be well hydrated, drink plenty of water the day before, and before you do the test.

* Some people take a shower before hand, some run up and down the stairs to get blood flowing. Personally, as I can't run up and down the stairs, I circle my arm round, windmill style.

* Have a bowl full of hot water, dip hand in and out, swish around, hand needs to go red. If blood flow stops, you can always swish round in the hot water again.

* Stand up to do the test. Make sure your arm is straight down when collecting the blood. Either use a small step stool to raise yourself well above the work surface, or put the collection tube on a lowish shelf. One member uses an ironing board so she can get the perfect height.

* Prick finger on the side, not the tip. I find that half way between the nail bed and tip is about right, or maybe slightly nearer the nail bed rather than the tip. I use my ring finger, but middle finger is next best for me.

* Do not squeeze your finger to get the blood out, it can damage the blood and it may not be usable

I've recently done 2 tests. The first one there was very little blood coming out which was unusual for me so I used a second finger and between the two I gradually filled the tube. However, when I checked the prick site for the first finger the actual cut was very small and as I've had some of these lancets fail before I put it down to that. When I did the second test this is what I did

* Prick my finger as usual, at the same time try and make a very slight twist with the lancet (the blade retracts very quickly so you have like a nano second to twist the lancet). I'm not talking 90 degrees or anything, just a very slight twist to make the cut just slightly bigger, it doesn't hurt or cause a blood bath! This made a big difference, 11 generous drops of blood filled the tube in less 2 minutes.

If you supplement with Biotin, or a B complex containing it (B7), leave it off for 7 days before doing any blood tests as it can give false results when biotin is used in the testing procedure, and most labs do use it.

Video showing how to do a fingerprick test:

youtube.com/watch?v=w2JzToZ...(Not working as expected?)

**

As you have been taking adrenal supplements for 15 years, surely you've been testing regularly to check your levels and make sure you still need the dose you're taking, whether it needs adjustment or whether you still need to take it?

If you want an accurate assessment of your adrenal status then the 24 hour adrenal saliva test which includes cortisol plus DHEA is the one to go for, don't test just cortisol on it's own. You can get this test from either Regenerus or Genova Diagnostics:

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

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

[Puddleperson in reply to SeasideSusie]

Many thanks for your reply, it is really helpful as I have never done this before. I went away for five days a few years ago and forgot to take my meds with me and learned the hard way what can happen! So I certainly don't want to stop again if I don't have to but also don't want any measurements skewed.

My symptoms started almost 30 years ago. My GP diagnosed Hashis 14 years ago but of course wouldn't treat it. I found Dr P who told me to take Nutri thyroid and adrenal extra along with T3, CoQ10 30, 1000mg Vitamin C. No Levo and no Biotin. He said if I felt right then I was right. I guess I was so happy that my energy levels came back and I felt generally better that I was just grateful for that and accepted that the remaining symptoms (night sweats, balance, brain fog, hair thinning etc) had to be put up with. So I have never had any blood tests other than the one the GP did 14 years ago.

It feels the right time to start from scratch. I'm older and wiser now and realise that there is a lot that should have been checked much earlier. The most urgent thing I want to discover is the reason for thinning hair just on one side of my head. Hashis might even be a red herring, who knows, but I feel now is the time to review everything and change or adjust my meds if needed. My GP is also doing more blood tests for me which will no doubt be 'normal'. Last time I fought them off over taking statins but if cholesterol is still higher than they like I'll be doing the same again, but this time I want to be sure it isn't raised simply because my thyroid dosage isn't right.

I will definitely go for Blue Horizon Premium Gold. I think I might also go for the adrenal saliva test. I think this may be relevant as when I reduced my adrenal plus (a stupid attempt to save money!) I felt the difference significantly.

I will be in touch again when I have my results as I hope somebody will be able to interpret it all for me.

Thanks again for your help

[SeasideSusie Remembering in reply to Puddleperson]

Puddleperson

Does your GP know that you are taking T3?

How much do you take?

Do you take your dose all at once or split the dose?

When doing the test the last dose of T3 should be 8-12 hours before the blood draw so you may need to adjust the timing and split your dose if necessary. I take T3 in 2 doses so when I do a private test it's usually at 8.30am and I take my second dose of T3 between 9pm and midnight on the evening before my test.

When taking T3 only you can expect your results to show a suppressed TSH and a below range FT4.

Blue Horizon kit will include a Tracked24 return envelope which can be put in a normal post box. Do your test and post the same day so it gets to the lab as quickly as possible (hopefully next day). Only do the test and post Monday to Wednesday so that there's no chance of delivery being delayed over a weekend.

There will be a tracking number on the label on the return envelope, make a note of this number it will be 2 letters about 8 numbers then GB. You can put this into Royal Mail's Tracking website and this will show when the sample has been delivered. It doesn't guarantee next day delivery, it can take 48 hours, but it's better than normal first class post. I've recently done this test and I posted it on the 1st September and had my results on the 7th.

Make a new post when you have the results, either add a photo of your results (making sure it doesn't show your personal details, name, date of birth, etc) or type the results with reference ranges into your post. We'll be be happy to comment

[Puddleperson in reply to SeasideSusie]

You can’t see GP’s at the moment so I was very pleased when my telephone consultation was with the ‘nice’ one who every woman in my town wants to see. She was so helpful and sympathetic that I broke the golden rule and told her I took T3. She was still sympathetic and helpful after that, her biggest concern being the quality of on line purchases. (Aren’t we all !!)She has arranged the blood test, don’t know what’s included but I have to see another GP when the results are back. I’m not confident that that will go as well hence my plan to get as much information as I can to try and protect myself and argue my corner as well as my brain fogged mind can.

I take Tiromel 2x25mg most in the morning the last half tab at night. I need to be ordering more soon and am filled with horror at the prospect. Current batch seems fine with no evidence of the issues you warned about so hopefully both it and the supplier will be good.

I

[SeasideSusie Remembering in reply to Puddleperson]

Puddleperson

There has only been complaints about one batch of Tiromel from just one supplier so just look out for that batch number and it being different on the blister pack than on the box.

[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 if 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)

If/when also on T3, make sure to take last third or quarter of daily dose 8-12 hours prior to test, even if this means adjusting time or splitting of dose day before test

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...

Medichecks Thyroid plus vitamins including folate (private blood draw required)

medichecks.com/products/thy...

Thriva Thyroid plus antibodies and vitamins By DIY fingerpick test

thriva.co/tests/thyroid-test

Thriva also offer just vitamin testing

Blue Horizon Thyroid Premium Gold includes antibodies, cortisol and vitamins by DIY fingerprick test

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...

Biotin is in lots of supplements..double check any vitamins you are taking and stop taking biotin a week before ALL Blood tests