Hi
Collected my thyroid results today, please can you help me understand them, I have learnt such a lot being on this forum and really appreciate your advice
Serum Free T4 level -12.6 pmol/L (12.0 -22.0)
Serum TSH Level - 12.2 mu/L (0.3 - 4.2)
What does the brackets mean exactly ?
I’m feeling spaced out today, and emotional can cry easily but not feeling depressed
Thank you
The (brackets) are the normal range.
TSH above & FT4 very low in range.
Have you considered private testing to include FT3, nutrient & antibodies.
Did your GP give you a dose increase?
Thank you
Was prescribed 25MCG back in August but had side effects and came of them, therefore had another blood test in October then GP wrote to the Endocrinologist who recommended 25MCG again but in a split dose am/pmI
I have been on them nearly a month and seem to have tolerated it so far have appointment with Endocrinologist on Tuesday but I’m aware the dose is probably not high enough
Looking at previous posts you are not currently taking any replacement thyroid hormones
Standard starter dose of levothyroxine is 50mcg
Bloods should be retested 6-8 weeks after each dose increase
Aim of levothyroxine is to increase the dose slowly upwards in 25mcg steps until TSH is under 2 as absolute maximum
Most people on levothyroxine will have TSH well under one when adequately treated
Ft4 will be in top third of range - on your ranges eg around 18-20
Ft3 at least 50-60% through range as minimum
Essential to regularly retest vitamin D, folate, ferritin and B12
Low vitamin levels extremely common when hypothyroid as you currently are
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
About 90% of primary hypothyroidism is autoimmune thyroid disease
Ask GP to test vitamin levels and 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 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...
Also vitamin D available as separate test via MMH
Or alternative Vitamin D NHS postal kit
Many people find Levothyroxine brands are not interchangeable.
Many patients do NOT get on well with Teva brand of Levothyroxine. Teva contains mannitol as a filler, which seems to be possible cause of problems. Teva is the only brand that makes 75mcg tablet. So if avoiding Teva for 75mcg dose ask for 25mcg to add to 50mcg or just extra 50mcg tablets to cut in half
Teva, Aristo and Glenmark are the only lactose free tablets
Most easily available (and often most easily tolerated) are Mercury Pharma or Accord
Note Accord is also boxed as Almus via Boots, and Northstar 50mcg and 100mcg via Lloyds ....but beware 25mcg Northstar is Teva
List of different brands available in U.K.
thyroiduk.org/medications-f...
Teva poll
healthunlocked.com/thyroidu...
Once you find a brand that suits you, best to make sure to only get that one at each prescription.
Watch out for brand change when dose is increased or at repeat prescription.
academic.oup.com/jcem/artic...
Physicians should: 1) alert patients that preparations may be switched at the pharmacy; 2) encourage patients to ask to remain on the same preparation at every pharmacy refill; and 3) make sure patients understand the need to have their TSH retested and the potential for dosing readjusted every time their LT4 preparation is switched (18).
Levothyroxine is an extremely fussy hormone and should always be taken on an empty stomach and then nothing apart from water for at least an hour after
Many people take Levothyroxine soon after waking, but it may be more convenient and perhaps more effective taken at bedtime
verywellhealth.com/best-tim...
No other medication or supplements at same as Levothyroxine, leave at least 2 hour gap.
Some like iron, calcium, magnesium, HRT, omeprazole or vitamin D should be four hours away
(Time gap doesn't apply to Vitamin D mouth spray)
If you decide to normally take levothyroxine at bedtime/in night ...adjust timings as follows prior to blood test
If testing Monday morning, delay Saturday evening dose levothyroxine until Sunday morning. Delay Sunday evening dose levothyroxine until after blood test on Monday morning. Take Monday evening dose levothyroxine as per normal
Thank you so much for the information its so informative, I have decided to have the advanced thyroid test, I have been taking Vitamin D for the last 4 years due to being deficient
Vits results
Thyroid Blood Results
Test results
Beginners post: Thyroid antibody test results in plain English please 
Thyroid results
