thyroid test

[purrpple]

my test just measured TSH and I am not happy as I clearly asked for thyroid check, be it over the phone in a 2 minute consultation

[SeasideSusie Remembering]

purrpple

It's a pretty general thing that "thyroid check" just means TSH, unless your area automatically includes FT4.

Is this your first test?

Is this a thyroid check because you have symptoms and want to know if you have thyroid disease?

Or are you already diagnosed and on thyroid meds and this is a follow up to a dose change or change in symptoms?

What is the actual result, plus reference range?

[purrpple in reply to SeasideSusie]

i have been low carb for 2 years and have not lost weight for 6 months, I wanted to rule out hypothyroidism as I feel I am still doing things the same, i have lost interest in many things do not sleep well and nod off at tea time. my feet are also very hot at night and my skin sloughs off all over the place

[purrpple in reply to SeasideSusie]

1st test i have asked for thyroid specifically result Serum TSH level 2.3 mU/L [0.27 - 4.5]

[SeasideSusie Remembering in reply to purrpple]

purrpple

So your TSH is euthyroid (normal). A normal healthy person would have a TSH of no higher than 2-ish. Here is a graph which shows TSH levels in healthy people:

healthunlocked.com/thyroidu...

You need full thyroid testing, because even when TSH is within range, it doesn't rule out hypothyroidism caused by a problem with the pituitary or the hypothalamus (which is where the TSH signal doesn't reach the thyroid to tell it to make thyroid hormone). So at the very least you need FT4 testing as well as TSH.

If your GP wont do further testing then you could do a test with one of our recommended labs.

If you are going to do a private test I would suggest you do full thyroid and vitamin testing. This is because low nutrient levels or deficiencies can have symptoms which overlap with symptoms of hypothyroidism.

I would suggest the following tests to give a complete picture:

TSH

FT4

FT3

Thyroid antibodies

Vit D

B12

Folate

Ferritin

If GP wont do them all then the following tests done by one of our recommended labs cover everything:

Medichecks Thyroid Check ULTRAVIT WITH FOLATE medichecks.com/products/thy...

You can use code THYROIDUK for a 10% discount on any test not on special offer

or

Blue Horizon Thyroid PREMIUM GOLD bluehorizonbloodtests.co.uk...

Check this page for discount code thyroiduk.org/getting-a-dia...

Both tests include the full thyroid and vitamin panel. They are basically the same test but Medichecks require a venous blood draw and Blue Horizon can be done with a fingerprick test. There are a few small differences:

Blue Horizon requires 1 x microtainer of blood (0.8ml) for the fingerprick test, or you can arrange venous blood draw at extra cost.,

Medichecks is venous blood draw only.

Blue Horizon includes Total T4 (can be useful but not essential). Medichecks doesn't include this test.

B12 - Blue Horizon does Total B12 which measures bound and unbound (active) B12 but doesn't give a separate result for each. Medichecks does Active B12.

Total B12 shows the total B12 in the blood. Active B12 shows what's available to be taken up by the cells. You can have a reasonable level of Total B12 but a poor level of Active B12.

Blue Horizon include magnesium but this is an unreliable test so don't let this sway your decision, it also tests cortisol but that's a random cortisol test and to make any sense of it you'd need to do it fasting before 9am I believe.

**

When doing thyroid tests, we advise:

* Book the first appointment of the morning, or with private tests at home no later than 9am. This is because TSH is highest early morning and lowers throughout the day. If we are looking for a diagnosis of hypothyroidism, or looking for an increase in dose or to avoid a reduction then we need TSH to be as high as possible.

* Fast overnight - have your evening meal/supper as normal the night before but delay breakfast on the day of the test and drink water only until after the blood draw. Eating may lower TSH, caffeine containing drinks affect TSH.

[* If taking thyroid hormone replacement, last dose of Levo should be 24 hours before blood draw, if taking NDT or T3 then last dose should be 8-12 hours before blood draw. Adjust timing the day before if necessary. This avoids measuring hormone levels at their peak after ingestion of hormone replacement. Take your thyroid meds after the blood draw. Taking your dose too close to the blood draw will give false high results, leaving any longer gap will give false low results.]

* 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 doctors or phlebotomists.

**

If you decide on a fingerprick test, I have some tips (some people find them easy, some struggle) so please ask if you would like me to list them.

[purrpple in reply to SeasideSusie]

thank you so much i do have these vitamin results too

Serum vitamin B12 level 328 ng/L [197.0 - 771.0]

Serum folate level 7.7 ug/L [2.0 - 18.7]

Serum ferritin level 181.0 ug/L [20.0 - 260.0]

and when i had my blood drawn i had been fasting for about 14 hours

[SeasideSusie Remembering in reply to purrpple]

purrpple

I take it these were recent? Done at the same time as the thyroid test?

Serum vitamin B12 level 328 ng/L [197.0 - 771.0]

This is low (despite being in range and your GP will say it's fine).

According to an extract from the book, "Could it be B12?" by Sally M. Pacholok:

"We believe that the 'normal' serum B12 threshold needs to be raised from 200 pg/ml to at least 450 pg/ml because deficiencies begin to appear in the cerebrospinal fluid below 550".

"For brain and nervous system health and prevention of disease in older adults, serum B12 levels should be maintained near or above 1000 pg/ml."

Some people with a B12 level in the 300s have been found to need B12 injections. Do you have any signs of B12 deficiency – check here:

b12deficiency.info/signs-an...

b12d.org/submit/document?id=46

If you do then list them to discuss with your GP and ask for testing for B12 deficiency and Pernicious Anaemia. Do not take any B12 supplements or folic acid/folate/B Complex supplements before further testing of B12 as this will mask signs of B12 deficiency and skew results.

Serum folate level 7.7 ug/L [2.0 - 18.7]

Well, you don't have folate deficiency but it could be better. Folate is recommended to be at least half way through range, so 10.5+ with that level. Eating folate rich foods will help, as can a good quality bioavailable B Complex such as Thorne Basic B or Igennus Super B. Don't start taking a B Complex if you have symptoms of B12 deficiency, testing for that must be done first.

Serum ferritin level 181.0 ug/L [20.0 - 260.0]

You're unlikely to have iron deficiency with such a good ferritin level! It is on the higher side (we mostly see low ferritin here). Do you take an iron supplement or eat lots of iron rich foods like liver, black pudding, liver pate, red meat?

Ferritin can be raised when there is infection or inflammation. Could this have been possible at the time of the test?

I don't suppose Vit D was tested? You can do this with a private fingerprick blood spot test with an NHS lab which offers this test to the general public (if you're not going for the full thyroid/vitamin panel mentioned above) and the cost is £29:

vitamindtest.org.uk/

If all you want is the full thyroid panel including antibodies then either Medichecks Thyroid Check Plus normally £69 but with an automatic 20% discount at the moment

medichecks.com/products/thy...

or Blue Horizon Thyroid Premium Silver which is normally £89 but the code linked to in my previous post gives 30% discount

bluehorizonbloodtests.co.uk...

I can't comment on what Thriva do as I can never get my head around their website.

Monitor My Health is cheapest for just TSH/FT4/FT3 but they don't offer the antibody test which I think you would be wise to include.

[purrpple in reply to SeasideSusie]

thank you again, I believe i have inflammation somewhere, these readings were all done 2 days ago this one is why i am to speak to a nurse or doctor

Serum C reactive protein level 10 mg/L [< 5.0]

Outside reference range

[SeasideSusie Remembering in reply to purrpple]

Purrpple

Oh yes, CRP is an inflammation marker so you could very well be looking at inflammation then.

Hashimoto's (autoimmune thyroid disease where the immune system attacks the thyroid and gradually destroys it) can cause inflammation markers to rises definitely get thyroid antibodies tested as well.

[Alma1960 in reply to purrpple]

Why should anyone have yo to lsyfor a test that a GP in Britain should fo gor free!!!!

[giselajames in reply to SeasideSusie]

Dear Seaside Susie, I have ordered a Medicheck blood test for hypothyroidism and they definitely sent me a finger prick test kit. Just for your info.

[SeasideSusie Remembering in reply to giselajames]

giselajames

Which test did you order?

[giselajames in reply to SeasideSusie]

The full test for thyroid and vitamin levels, I think.

[SeasideSusie Remembering in reply to giselajames]

Thyroid ULTRAVIT can be done with a fingerprick test but doesn't include Folate.

If the test including Folate is required, it is the ULTRAVIT WITH FOLATE and has to be a venous blood draw. They no longer include Folate in a fingerprick test.

[giselajames in reply to SeasideSusie]

Thank you so much, Seaside Susie. I can’t do the test for a while because I am deficient in vitamin B 12 and have to stop taking it a week before test. I have to build up my reserves or else I fear the symptoms will return, am I correct in thinking that?

[SeasideSusie Remembering in reply to giselajames]

giselajames

I am deficient in vitamin B 12

Do you mean you have been diagnosed with B12 deficiency?

A year ago you posted this result for Active B12

Vitamin B 12 active 162 pmol/L 37.5-188

and that is an exceptionally good result. Considering our B12 store is good for about 4 years, I doubt very much whether you are B12 deficient.

To get a baseline B12 level to see what you are holding on to, you'd have to be off any B12 supplement for 4-5 months. With the B12 level you posted you wouldn't be needing a B12 supplement.

[giselajames in reply to SeasideSusie]

Dear Seaside Susie, about 2 months ago I began to experience a lot of unpleasant symptoms like pins and needles in my feet and hand, mouth ulcers (my mouth was so sore, I could hardly eat), felt unsteady on my legs and had blurred vision. I rang my doctor 3 times to ask what might be going on, but did not get any sense out of her, so googled my symptoms and up came Vitamin B 12 deficiency. I supplement with iherb Vitamin B 12 and began to feel slightly better, but still had palpitations, tinnitus, really lacking in energy and went into meltdown at least 2 to 3 times a day. Again I googled my symptoms ( doctor suggested an apple and some cheese at 11am) and up came anaemia. I now supplement with Spatone iron and am beginning to feel human again.

If you think my vitamin B 12 levels are good enough to make me withstand a week without supplements, then I can do the Medicheck blood test to see what is going on.

Kind regards, Gisela

[giselajames in reply to giselajames]

I have just remembered that as my vitamin B 12 levels were so good, it was suggested that I do not supplement any more and so I did not take any supplements until I got those symptoms.

Would you be kind enough to comment on my last post, as I am thrashing around in the dark and rely entirely on what you and other contributors post in the forum.

Many thanks in advance, Gisela

[SlowDragon Administrator]

Looking at your profile have you had radiotherapy for head or neck cancer

This can result in thyroid problems

jamanetwork.com/journals/ja...

For full Thyroid evaluation you need TSH, FT4 and FT3 plus both TPO and TG thyroid antibodies tested. Also important to test vitamin D, folate, ferritin and B12

Recommended on here that all thyroid blood tests should ideally be done as early morning and before eating or drinking anything other than water .

This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip)

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...

[purrpple in reply to SlowDragon]

thank you for the information I will check out private tests if i get no further with dr. i actually have these results

Serum vitamin B12 level 328 ng/L [197.0 - 771.0]

Serum folate level 7.7 ug/L [2.0 - 18.7]

Serum ferritin level 181.0 ug/L [20.0 - 260.0]

[SlowDragon Administrator in reply to purrpple]

As SeasideSusie has said B12 and folate are on low side...B12 especially

Important to regularly retest vitamin D

Low vitamin D and low B vitamins can often go together