Latest results

[Bubble214]

Hi

Following on from my last message, here are my latest results. Symptoms: mainly tiredness.

Please can someone advise if this is considered normal? I am going to get a private test done too as previously recommended on here.

Thank you!

[SeasideSusie Remembering]

Bubble214

TSH far too high for someone on thyroid hormone replacement. The aim of a thyroid patient on Levo, generally, is for TSH to be 1 or below with FT4/FT3 in the upper part of their reference ranges, if that is where you feel well.

How much Levo are you on?

When did you take your last dose before the test?

What time did you do the test?

Did you eat before the test, or drink anything other than water? These can affect TSH.

Do you take Biotin or a B Complex? If this is not stopped for 7 days before a test it can give false results.

[Bubble214 in reply to SeasideSusie]

Hi!

My initial reaction was the same, especially as I still feel very tired. I’m on 75mcg daily.

I had my test late in afternoon 5ish so last dose would have been the morning ( I know supposed to in morning)

No, would have been around lunchtime.

Do not take anything else.

I’m going to pay for a test privately.

[SeasideSusie Remembering in reply to Bubble214]

Bubble214

In that case your results aren't the most accurate.

When you have results of your new test, post them on the forum for comment.

To get the most accurate results best to follow our advice

* 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.

[SlowDragon Administrator]

TSH would be likely higher testing in morning

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

Median TSH graph

healthunlocked.com/thyroidu...

TSH daily variation

healthunlocked.com/thyroidu...

Plus important when you test TSH ....

researchgate.net/publicatio...

“According to the current TSH reference interval, hypothyroidism was not diagnosed in about 50% of the cases in the afternoon.”

“Further analysis demonstrated inadequate compensation of hypothyroidism, which was defined in 45.5% of the morning samples and in 9% of the afternoon samples”

ncbi.nlm.nih.gov/pubmed/252...

TSH levels showed a statistically significant decline postprandially in comparison to fasting values. This may have clinical implications in the diagnosis and management of hypothyroidism, especially SCH.

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

Try to always get same brand of levothyroxine

Extremely important to regularly retest vitamin D, folate, ferritin and B12

When were they last tested

[Bubble214 in reply to SlowDragon]

Thanks. Can only get a telephone appointment on 12th January what a joke! Feel like they are trying to par me off now.

I’ve requested so many times for this but nothing so I am going to get a private test.

The serum free t4 level what should that be reading as? What does this result mean?

[SlowDragon Administrator in reply to Bubble214]

Suggest you get FULL thyroid and vitamin testing done privately BEFORE that phone consultation

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

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)

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/

Also vitamin D available as separate test via MMH

Or alternative Vitamin D NHS postal kit

vitamindtest.org.uk

[McPammy]

My private only Endocrinologist informed me that any TSH over 2.5 is hypothyroidism. You need to be below 2.5 preferably at 1.00. Most healthy peoples thyroids are around 1.00. The NHS ranges are set too wide I have been informed. Even if you go over the range they leave it mostly until you get to a TSH of 10 before treatment. They left me until my TSH was 36. You could do with a retest and next time get TSH, T4 and T3 all done at same time. It could be that you are a poor converter of Levothyroxine T4 to active T3. You could get the DIO2 gene test through Regenerus Laboratories promoted on here. I did this and mine came back positive. This then made me and my GP realise then reason I’m a poor converter. You may need to add T3 to your thyroxine medications. I have added T3 and it’s been a huge success.

If you need to go private please message me and I will pass on my private only Endocrinologists details.