So...I had a blood test last week, heard nothing so called doctors today and to be told by the receptionist ‘normal, no action’. I had no call from the doctor to say what my results actually are and what happens now if I am considered normal ( which I I find it really hard to believe when I still feel exhausted and my last results seemed I was a long way away! )
Has anyone else had this experience, I have requested a call and for my results to be posted in the hope to have some more information.
I mean I’m happy that they are normal but just confused as I still feel like crap tbh!
Any advice? What would be normal levels?
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Bubble214
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If results come back within range then the surgery has no reason to contact you. This is why it's important to always ask for a print out of your results a couple of days after you know they're back at the surgery, keep them for your records and if you feel unwell even if they're "normal" you will have a record of where you do feel well and why you may need a change in your dose.
Can see from previous posts you had levothyroxine increased to 75mcg daily 3 months ago
Likely to be ready for next 25mcg dose increase
Do you always get same brand of levothyroxine
Which brand
When were vitamin levels last tested
What vitamin supplements are you currently taking
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
Far to often only TSH is tested and this is completely inadequate
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 and thyroid antibodies if not been tested yet
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)
Is this how you do your tests?
Private tests are available as NHS currently rarely tests Ft3 or thyroid antibodies or all relevant vitamins
Even if we don’t start on full replacement dose, most people need to increase levothyroxine dose slowly upwards in 25mcg steps (retesting 6-8 weeks after each increase) until on, or near full replacement dose
Consider starting levothyroxine at a dosage of 1.6 micrograms per kilogram of body weight per day (rounded to the nearest 25 micrograms) for adults under 65 with primary hypothyroidism and no history of cardiovascular disease.
Traditionally we have tended to start patients on a low dose of levothyroxine and titrate it up over a period of months.
RCT evidence suggests that for the majority of patients this is not necessary and may waste resources.
For patients aged >60y or with ischaemic heart disease, start levothyroxine at 25–50μg daily and titrate up every 3 to 6 weeks as tolerated.
For ALL other patients start at full replacement dose. For most this will equate to 1.6 μg/kg/day (approximately 100μg for a 60kg woman and 125μg for a 75kg man).
If you are starting treatment for subclinical hypothyroidism, this article advises starting at a dose close to the full treatment dose on the basis that it is difficult to assess symptom response unless a therapeutic dose has been trialled.
A small Dutch double-blind cross-over study (ArchIntMed 2010;170:1996) demonstrated that night time rather than morning dosing improved TSH suppression and free T4 measurements, but made no difference to subjective wellbeing. It is reasonable to take levothyroxine at night rather than in the morning, especially for individuals who do not eat late at night.
The aim of levothyroxine is to increase dose upwards until TSH is under 2, and many people will have TSH well under one when adequately treated. Most important Ft4 is in top third of range and Ft3 at least half way through range (regardless of how low TSH is) ...
Extremely important to have optimal vitamin levels too as this helps reduce symptoms and improve how levothyroxine works
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