Blood test results

[jankei]

Hi lovely people out there. Just got the result of the long awaited blood test. All ok except the thyroid bit. Serum free T4 28.4 pmoi/L range 10-20. serum TSH level 0.03 miu/L 0.35 - 4.78. Didn't test T3, but last time was just under normal and Dr said no action. I take a super B complex, vitamin D caps, Magnesium Glycinate. No vitamin tests were done. Oh sorry, serum creatinine was just under normal. I am feeling quite well at the moment. Look forward to your help on the above. I am on 150 levos, but increased myself from 100 back last year and felt better after.

[jankei]

Thanks scrumbler. I will look forward to speaking to my doctor (not).

[SlowDragon Administrator]

GP won’t test Ft3

Essential to test vitamin levels once year minimum

What vitamin supplements are you currently taking

Do you always get same brand levothyroxine at each prescription

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

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

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/

NHS easy postal kit vitamin D test £29 via

vitamindtest.org.uk

[jankei]

Further to my post re FT4 and TSH levels. I was just reading that these two results combined could mean hyperthroidism. Does that mean I would have to cut down on the levothyroxine? I want to get as much information as possible before I speak to the doctor.

[tattybogle in reply to jankei]

Not 'hyperthyroidism'..... that's the term if your own thyroid is producing too much T4/3 hormone by itself.

'overmedication' means taking too much thyroid hormone replacement..

and yes.... a doctor seeing those results would almost certainly say you were overmedicated , and reduce your dose , and you'll probably have a difficult fight on your hands if you want to stay on the current dose of 150mcg.

free T4 28.4 [10-20]

TSH level 0.03 [0.35 - 4.78]

Didn't test T3, but last time was just under normal and Dr said no action.

You may be able to persuade an open minded Doctor to allow TSH at that level by arguing that fT4 is within range , but since your fT4 is now well over the top of range, they will not be happy with those results.

If you could show that fT3 is still within range at this fT4 level then you might have a chance,

So could ask them to run fT3 test , but they probably won't see the need . as they'll say the fT4 is already evidence of overmedication.

(I have managed to get a Dr to reluctantly continue to prescribe at these sort of levels without an fT3 test , but only after i reduced as requested for 6+ weeks and the result was chronic constipation , we had a couple of heated discussions and i put some evidence to him that said low TSH wasn't an increased risk unless it went below 0.04 and he's written on my records that i understand and accept the 'risks')

So prepare yourself for a 'discussion' about the risks (as they see them) of "bone loss and heart problems from low TSH" .. (i will find you a link to an old post if you need ammunition an information on the subject.)

Also , consider that it might be worth trying a very slight reduction in dose , 125mcg or 137.5mcg as you don't really want fT4 so far over range of you can help it.

And it may keep the doctor on side if you are willing to try it. And from my research it is better to keep TSH above 0.04. so that's another reason to seriously consider a slight reduction in current dose.

In an ideal world you'd have fT3 test to go along with these results and if fT3 was still in range you could say " I feel so much better on this dose , so, it seems i need over-range T4 to get enough T3 in order to make me feel well. If you want to lower my fT4 , refer me to an endocrinologist to try me on a combination of a little less Levo + a little T3 ,to keep my T3 at levels that allow me to feel well"

Sadly ...it's not an ideal world, so be prepared for a struggle.

[jankei in reply to tattybogle]

Thanks Tattybogle for your lengthy reply. The thing is I don't feel confident enough to argue the toss with my doctor. I have had a long and good relationship with him and so have my family. By the way I put myself on 150 and he only prescribed 100 and I knew he wouldn't go further. I did feel better and still feel ok. The other stumbling block is you can't get face to face at the moment and it's not so easy on the phone. Excuses I know. See what he says and go from there. Takes days to get an appointment. My family all think the doctor knows best and I am wrong to question. Thanks again for the advice.

[tattybogle in reply to jankei]

I totally understand.. i spent 17 yrs thinking the Doctor must know best, but the truth is they just don't get much education on it at med school, and (allegedly) the majority of thyroid patients seem to do OK on Levo at the levels they want to keep you too,, but we're all very individual about what precise level of thyroid hormone keeps us well ....some helpful reading matter for you , so at least you know what you're talking about.. arguing with them is not compulsory... i'm just stroppy :- When discussing the 'risks ' of Low TSH with GP you might find the following ammunition helpful :- If you look at the first reply to this:-

healthunlocked.com/thyroidu...

post, (ignore the fact it say's 'more mature')

and click on the links within it , you will find discussions , and a link to evidence that convinced me that it doesn't really present a problem until TSH is below 0.04 and even then , it's all relative.

[Miffie]

You really need to get an FT3 test along with TSH and fT4. Ideally before you speak to GP. They rely too much on TSH and many are clueless about fT3. Ideally use Monitor my Health for a finger prick test of basic thyroid. This is an NHS lab so the GP is more likely to agree with the results. The test is only £29 and there is a discount if you check the code at Thyroid UK, this saves an additional 10%. Good luck.