Would appreciate your thoughts on my thyroid function test results

[anma]

My Serum TSH level is 0.6 mIU/L (0.4 - 5.0 normal range) and my Serum free T4 level is 16 pmol/L (9 - 19 normal range).

I know they are within normal range but one's towards the low end and the other towards the upper. Do I have any reasons for concern? Do I have sufficient ground to ask GP to re-test and if so, what would my arguments be?

Thank you!

[fuchsia-pink]

How are you feeling? The inference is not great - despite bloods being broadly ok.

In that case, I'd suggest further blood tests might be helpful - key nutrients - ferritin, folate, vit D and B12 - and testing free T4 and free T3 together, so you can see how well you convert.

It's entirely possible to have a reasonable free T4 but rubbish free T3 and/or poor nutrients. I had some success with my GP by saying that the nutrients tests were recommended by Thyroid UK - but if s/he won't test them, can you treat yourself to private tests? There are discounts available on the Thyroid UK site

[anma in reply to fuchsia-pink]

Thank you for your thoughts on this. I have a complex medical history and multiple symptoms, I feel like I am going insane because I don't know anymore what's causing what.

I wish I knew about the discounts available through Thyroid UK a month ago when I tested myself. These are my results from Medichecks from april and the ones in my original post are from end of Jan and done through the NHS. I trust the NHS results much more as they do not spend days in transit like the Medichecks ones.

[SeasideSusie Remembering]

anma

Do you take any thyroid hormone replacement?

If so, what and the dose?

If so, when did you take your last dose before the test?

Did you do the test as we always advise:

* Blood draw no later than 9am. This is because TSH is highest early morning and lowers throughout the day. If looking for a diagnosis of hypothyroidism, an increase in dose of Levo or to avoid a reduction then we need the highest possible TSH

* Nothing to eat or drink except water before the blood draw. This is because eating can lower TSH and coffee can 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 phlebotomists or doctors.

[anma in reply to SeasideSusie]

Thank you for all the suggestions. I do not take any thyroid medication and the tests were done on an empty stomach, early in the morning. The reason why I had them done the first time was mainly due to tachicardia + a few other symptoms.

[SlowDragon Administrator]

Essential to test vitamin D, folate, ferritin and B12 too

Plus both TPO and TG antibodies if never had thyroid antibodies tested previously

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/

NHS easy postal kit vitamin D test £29 via

vitamindtest.org.uk

[anma in reply to SlowDragon]

This is priceless. Thank you so much for sharing all the info. I now have a starting point and I'll know what to ask from my GP in a first instance, or where to test myself privately in order to get to the bottom of this/to rule it out as a reason for my symptoms. Take care!