results for my Dec 2020 test

[Raineydays]

here goes

HbA1c IFCC standardised sf12021) 38

thyroid function test

serum TSH level 5.04 miu/L 027.-4.20mlU/L

serum free T4 18 pmol/12.00 22 00pmol/L

[SeasideSusie Remembering]

Raineydays

What dose of Levo were you on when that test was done?

Was the test done as we 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.

As your TSH was over range at that time, did you have an increase in your dose of Levo, I see that you are currently taking 100mcg.

[Raineydays in reply to SeasideSusie]

Ni i just had the test as I would normally have blood test hey did not tell me to fast or have a test first thing

[SeasideSusie Remembering in reply to Raineydays]

So your results aren't a lot of use other than to say your TSH was high and your FT4 was 60% through range. Did you get an increase in dose based on your over range TSH, you didn't answer that question.

As these results are now 5 months old it would be a good idea to do a full thyroid panel - TSH, FT4 and FT3 - following our advice to give a measure of your normal circulating hormone.

I haven't read all of your previous post, too many replies for me to plough through, but it might also be a good idea to test vitamins - Vit D, B12, Folate and Ferritin. If GP wont do these then you can do a test with one of our recommended private labs

MEDICHECKS Advanced Thyroid Function test

or

BLUE HORIZON Thyroid Premium Gold

Details and discount codes can be found here:

thyroiduk.org/help-and-supp...

[Raineydays in reply to SeasideSusie]

no i have been taking the same amount for over 20 years no change at all to the amount 5th sept 2018 ferritin 16 ug/l 13.00 150.ugl

folate >20.0 390.26.80ug/l

b12 204 ng/l 390.26.80ug/l

serum c reactive protein ,1 mg/l ,5.00mg/l

serum bilirubin 6 umol/l ,21.00umol/l

serum alt 23 u/l 10.00.35.00u/l

bone profile serum alkaline 74 u/l 30.00 130.u/

calcium 2.39

serum adjusted 2.42

total protein 69 g/l 60.-80 g/l

iorganic phosphate 1.48 mmol/080=150mmol/l

albumin 45 g/l

I have more details but not sure if this is relevant

[SeasideSusie Remembering in reply to Raineydays]

Raineydays

Sorry but I'm not understanding some of your results.

Are they multiple tests done at different times?

folate >20.0 390.26.80ug/l

b12 204 ng/l 390.26.80ug/l

You have two different tests there with some numbers the same, I have no idea what the numbers are.

Perhaps you can put them like this

Date

Test - Result (Range)

Then the next lot

Date

Test - Result (Range)

5th sept 2018 ferritin 16 ug/l 13.00 150.ugl

That showed iron deficiency. What did your GP do about it? What is your current iron panel results?

Labs only do tests, they are not doctors so they can't prescribe.

Why are you taking a D3 containing calcium? Was your calcium low? Is your GP monitoring your D3 and calcium levels?

[Raineydays in reply to SeasideSusie]

Will be going to a private lab once i have had my second jab early June. Can they write a presciption for you

[Raineydays in reply to Raineydays]

I was told my the endo to take my 100mcg at night by the endo and have been taking the same amount for about 20 years now

[SlowDragon Administrator in reply to Raineydays]

What’s the range on B12

Usually it’s something like 200-680

B12 looks extremely low at 204

Ferritin is really terrible at 16

See GP and request full iron panel test for anaemia

You need vitamin D tested too

Vitamins are low BECAUSE you are under medicated and need 25mcg dose increase in levothyroxine

[Raineydays in reply to SlowDragon]

I am taking D3

[Raineydays in reply to Raineydays]

I was taking iron tablets a couple of years ago for about 6 months. I really think I should see a private clinic as I do not seem to get anywhere

[SlowDragon Administrator in reply to Raineydays]

How much vitamin D?

Important to test twice year when supplementing

(NHS only tests once every 2 years...if you’re lucky )

Test twice yearly via NHS postal kit £29

vitamindtest.org.uk

[Raineydays in reply to SlowDragon]

I take two contains 1500mg calcium carbonate equivalent to 600 mg calcium and 400 iu colecalciferol. Can I tell the GP i have spoken to you and that you have said to increase 25mcg

[SlowDragon Administrator in reply to Raineydays]

Never tell a GP you have been on an Internet forum...red rag to a bull

What date were these test results from?

[SlowDragon Administrator in reply to Raineydays]

As SeasideSusie also asked

Why are you taking calcium?

Is this on prescription ?

2 x 400iu vitamin D is low dose

Likely to need extra separate vitamin D

[SlowDragon Administrator in reply to Raineydays]

All thyroid tests should be done as early as possible in morning before eating or drinking anything other than water and last dose levothyroxine 24 hours before test

How much levothyroxine are you currently taking

When was dose last increased

Do you always get same brand of levothyroxine at each prescription

What vitamin supplements are you currently taking

Obviously TSH is far too high for someone on levothyroxine

If you took levothyroxine before blood test then Ft4 is false high result

Just testing TSH and Ft4 is completely inadequate

You need TSH, Ft4 and Ft3 tested, plus vitamin D, folate, ferritin and B12

See/contact GP for next dose increase in levothyroxine

TSH should be under 2 as an absolute maximum when on levothyroxine

gponline.com/endocrinology-...

Replacement therapy with levothyroxine should be initiated in all patients to achieve a TSH level of 0.5-2.0pmol/L.

New NHS England Liothyronine guidelines July 2019 clearly state on page 13 that TSH should be between 0.4-1.5 when OPTIMALLY treated with just Levothyroxine

Note that it says test should be in morning BEFORE taking levothyroxine

Also to test vitamin D, folate, B12 and ferritin

sps.nhs.uk/wp-content/uploa...

Aim is to bring a TSH under 2.5

UK guidance suggests aiming for a TSH of 0.5–2.5

gp-update.co.uk/SM4/Mutable...

Dr Toft, past president of the British Thyroid Association and leading endocrinologist, states in Pulse Magazine,

"The appropriate dose of levothyroxine is that which restores euthyroidism and serum TSH to the lower part of the reference range - 0.2-0.5mU/l.

In this case, free thyroxine is likely to be in the upper part of its reference range or even slightly elevated – 18-22pmol/l.

Most patients will feel well in that circumstance.

But some need a higher dose of levothyroxine to suppress serum TSH and then the serum-free T4 concentration will be elevated at around 24-28pmol/l.

This 'exogenous subclinical hyperthyroidism' is not dangerous as long as serum T3 is unequivocally normal – that is, serum total around T3 1.7nmol/l (reference range 1.0-2.2nmol/l)."

(That’s Ft3 at 58% minimum through range)

You can obtain a copy of the articles from Thyroid UK email print it and highlight question 6 to show your doctor

 please email Dionne at

[e-mail]

[Raineydays]

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