Self blood test

[Rach70]

Hi all, I was just wondering if any of you have done the home Thyroid test kit. Are they easy to do and do your GP’s take any notice of them ? I’ve just ordered one after feeling like I’ve yet again been fobbed off by my GP. The only test they’ve done is the FSH (which was 0.72). When I went to see him (Nov 5th) he said he could clearly see that I had an issue with my Thyroid as it was swollen up. I’m waiting for a scan on it at the moment.

[SeasideSusie Remembering]

Rach70

Hundreds of us here do the home tests.

Some GPs accept them, some don't.

Are y ou talking about the fingerprick test or do you intend to arrange a venous blood draw?

If the fingerprick test these are my tips (I do them fairly regularly):

* 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?)

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.

The only test they’ve done is the FSH (which was 0.72).

Do you mean TSH - Thyroid Stimulating Hormone. FSH is, I believe, Follicle Stimulating Hormone which is an entirely different test.

Do you have the reference range for this test - if it's TSH? I expect your result is at the bottom of the range. However, just testing TSH is inadequate, we also need FT4 and, preferably, FT3 as well. Including thyroid antibodies completes the picture.

[Rach70 in reply to SeasideSusie]

Yes I meant TSH ( was teaching about FSH so must have had that on my brain !) and yes it is the finger prick test, when I asked him today about FT4 & FT3 he said it wasn’t needed. I don’t take any of the drugs you mentioned but do take others.Should I do the finger prick test in the morning ? Thank you for the tips x

[SeasideSusie Remembering in reply to Rach70]

Rach70

Everything you need to know about doing the blood test, including the time, is in my first reply directly below the video

Doctors are particularly ignorant about hypothyroidism. Just testing TSH alone doesn't tell them if you have Central Hypothyroidism (which is where the problem lies with the pituitary or the hypothalamus rather than the thyroid) nor whether you have autoimmune thyroid disease which thyroid antibodies can show.

You need

TSH

FT4

FT3

TPO antibodies

Tg antibodies

[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 .

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 antibodies and vitamins

medichecks.com/products/adv...

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 down to £26.10 if go on thyroid uk for code

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

monitormyhealth.org.uk/thyr...

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...

Come back with new post once you get results

[Lora7again]

My GP has never accepted my Medicheck blood tests which includes the TSH, T4, T3 and vitamin levels. He insists in using the NHS labs which usually means just the TSH and no vitamin tests. I don't involve him in my thyroid health anymore and have had to go it alone. I don't think my surgery even realises I have thyroid disease because I was recently asked for a review of my Mental Health condition!

😡

[SlowDragon Administrator in reply to Lora7again]

Does depend on GP

My GP very happy to accept my private test results

I haven’t had NHS test in 7-8 years

At each annual review I take in copy of latest full thyroid and vitamin results to be added to my medical record

[Greenwall in reply to SlowDragon]

That's interesting SlowDragaon. My GP is happy for the nurse to draw the private blood tests, but says she has also to take NHS TSH test, and can't go off the private tests, even though I let her have a copy every year. Meds don't change, as TSH is under 2, so to me the NHS test is a waste of NHS £££. I think the NHS test is a tick box exercise, as GP doesn't ask me about current symptoms, so I guess I don't really have a "review". Should I have one?

[Rach70]

I’ve ordered the test from Monitor my health, it’s for TSH, T4 & T3, my Vit D levels were fine in the November blood test, but I do take 1600 iu a day (prescribed) I have RA ( with an anti ccp of 500+) so am autoimmune, don’t know wether it’s all connected, it’s got to the point where I’m now having to eat soft food because it feels like I’m choking, I have a constant cough like I’m having to clear my throat, I’ve lost a stone in weight ( down to 8st 2lb) I have no energy and over the last few days I have developed an extremely dry mouth and a pain in the side of the neck, just feeling fed up because I know something is wrong but the blood test says otherwise x

[SlowDragon Administrator in reply to Rach70]

You will probably need TPO and TG thyroid antibodies tested

Folate, ferritin and B12 too

But come back with new post once you get MMH test results

About 90% of all primary hypothyroidism in Uk is due to Hashimoto’s.

Hashimoto’s frequently starts with transient hyperthyroid results and symptoms before becoming increasingly hypothyroid

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...

How low was vitamin D

Vitamin D needs retesting.

How long have you been on 1600iu ?

[Rach70 in reply to SlowDragon]

Been on Vit D for a couple of years now after tests showed it was sitting around 12, I was put on 3200iu and it was about 8 months before my levels started to increase , I take 1 800iu through the summer and then the Dr ups it to 2 800iu through the winter, the last time I asked (April) my levels were around 50. We were in lockdown and had been spending a lot of time in the garden as the weather was lovely. My friend suggested buying some 1000iu to top up what the Dr was prescribing.

[Rach70 in reply to Rach70]

I didn’t ask what the number was in November, the Dr just said they were fine but to carry on taking 2 800iu .

[SlowDragon Administrator in reply to Rach70]

Typically, with autoimmune thyroid disease we need high dose to increase vitamin D (often 5000-6000iu daily) and a maintenance dose of 2000-3000iu daily everyday summer and winter

GP will often only prescribe to bring levels to 50nmol.

Some areas will prescribe to bring levels to 75nmol or 80nmol

leedsformulary.nhs.uk/docs/...

GP should advise on self supplementing if over 50nmol, but under 75nmol (but they rarely do)

mm.wirral.nhs.uk/document_u...

NHS Guidelines on dose vitamin D required

ouh.nhs.uk/osteoporosis/use...

But with Hashimoto’s, improving to around 80nmol or 100nmol by self supplementing may be better

ncbi.nlm.nih.gov/pubmed/218...

vitamindsociety.org/pdf/Vit...

Once you Improve level, very likely you will need on going maintenance dose to keep it there.

Test twice yearly via vitamindtest.org.uk

Vitamin D mouth spray by Better You is very effective as it avoids poor gut function. There’s a version made that also contains vitamin K2 Mk7

amazon.co.uk/BetterYou-Dlux...

It’s trial and error what dose we need, with hashimoto’s we frequently need higher dose than average

Calculator for working out dose you may need to bring level to 40ng/ml = 100nmol

grassrootshealth.net/projec...

Government recommends everyone supplement October to April

gov.uk/government/news/phe-...

Taking too much vitamin D is not a good idea

chriskresser.com/vitamin-d-...

With your Vit D, are you also taking it's important cofactors - magnesium and Vit K2-MK7?

Magnesium best taken in the afternoon or evening, but must be four hours away from levothyroxine

betterbones.com/bone-nutrit...

medicalnewstoday.com/articl...

livescience.com/61866-magne...

sciencedaily.com/releases/2...

Vitamin K2 mk7

betterbones.com/bone-nutrit...

healthline.com/nutrition/vi...

[Rach70 in reply to SlowDragon]

Thank you. Lots of information there for me to read through. I do use a magnesium oil body spray made by Better You, it was recommended by my Rheumatologist for my ‘achy bones’ , he said the body absorbed it better through the skin . But will look at buying a supplement. I am going to order the Vit D mouth spray as I am suffering with my gut, I had reflux earlier on this year so had to take omeprazole for a month.

[SlowDragon Administrator in reply to Rach70]

Popular magnesium supplement is Calm vitality magnesium powder, cheap and easy to use. Good if you suffer constipation. Best to start on low dose as too much can cause diarrhoea

Alternatively ReMag is good. Doesn’t upset gut at all. But expensive.

Lots of other options as tablets

[Rach70]

Ps, thank you for all your replies x

[imsotiredallthetime]

Both my husband and I did our Thriva private blood tests this morning.. Both for different things but both included vitamins. My husband struggled to fill the vile and I said to him maybe he should do the 2nd after work when he showered. When I mean he struggled he did everything the video said and could barely get a drop of blood he was really forcing it! I think the first vile may have to be redone.. However he filled the 2nd no problem after the shower while still in the bathroom.Because of his struggles this morning I bathed and did mine and I could of filled Yours mine and his twice over!

Always let them go first to perfect yours

😜

[PamBow]

Hi Rach70,

I had a test kit from a well known firm and found it easy to use with help from my daughter. My problem was the lack of blood coming out . It kept clotting and I struggled with filling the file...... I sent the kit back and was later informed they couldn’t test the sample and the company were going to send another kit out to me. Success with the second kit though.

If you follow Seaside Susies advice you will be fine.

The only fault I found was the lack of info sent with my results. They more or less thought the results were ok. I printed the results on this marvellous site and got a more detailed review of my blood tests...... I needed an increase of Levothyroxine.

I wish you every success when you test.

[JAmanda]

I do them but pay extra for the blood draw. My Endo writes down my results on my record and accepts them fine. Docs don't seem to.

[KittyAO]

I struggled with getting blood so I pay extra and go to the haemotologists at the path lab at our local NHS hospital. I have a test ready to be done and need to check if they are accepting private tests. My gp has been good and accepted my bloods and was excellent, squeezing me in for an appt on her last day before retiring. Dreading finding a new one at the practice! Wishing you start to feel well. This forum has some terrific admins and contributors.

[Roulette26]

My GP wouldn’t accept the medicheck results but to his credit organised a comprehensive check after seeing the high results for TSH and ferritin. The finger prick test is very easy, I must admit to being nervous, however it’s painless, just make sure everything is set up and follow the advice others have given you on this site.

[Rach70]

Just to let you know all my blood tests came back in range x so it’s back to the drawing board as to what is causing my swelling. My Dr booked me a scan on the 5th of November and I’m still waiting to be seen, hopefully that will give me some answers, he did say that when I had a scan 6 years ago it showed I had 3 1cm nodules so he thinks that it might be that x

[helvella Administrator]

all my blood tests came back in range

You just might find the article below (and the full paper which you can access) interesting and/or useful.

The normal range: it is not normal and it is not a range

1. Martin Brunel Whyte

2. Philip Kelly

Abstract

The NHS ‘Choose Wisely’ campaign places greater emphasis on the clinician-patient dialogue. Patients are often in receipt of their laboratory data and want to know whether they are normal. But what is meant by normal? Comparator data, to a measured value, are colloquially known as the ‘normal range’. It is often assumed that a result outside this limit signals disease and a result within health. However, this range is correctly termed the ‘reference interval’. The clinical risk from a measured value is continuous, not binary. The reference interval provides a point of reference against which to interpret an individual’s results—rather than defining normality itself. This article discusses the theory of normality—and describes that it is relative and situational. The concept of normality being not an absolute state influenced the development of the reference interval. We conclude with suggestions to optimise the use and interpretation of the reference interval, thereby facilitating greater patient understanding.

dx.doi.org/10.1136/postgrad...

pmj.bmj.com/content/94/1117...