TSH blood testing

[Leszilla]

I have had a test that says serum TSH levels 4.06 and vitamin D levels at 23 which is deficient yet don’t have a thyroid issues according to My doctor would this be correct. I would grateful for any advice thankyou.

[SlowDragon Administrator]

Welcome to the forum

Presumably vitamin D result is in nmol?

If so 23nmol is deficient

GP should be prescribing LOADING Dose vitamin D

That’s 300,000iu vitamin D in total over 6-8 weeks

NHS Guidelines on dose vitamin D required

ouh.nhs.uk/osteoporosis/use...

GP will often only prescribe to bring vitamin D levels to 50nmol.

Some areas will prescribe to bring levels to 75nmol or even 80nmol

leedsformulary.nhs.uk/docs/...

GP should advise on self supplementing if over 50nmol, but under 75nmol (but they rarely do)

mm.wirral.nhs.uk/document_u...

Having been deficient in vitamin D, you will need ongoing daily supplements to maintain vitamin D

Test twice yearly via NHS

vitamindtest.org.uk

Vitamin D mouth spray by Better You is very effective as it avoids poor gut function. There’s a version made that also contains vitamin K2 Mk7

amazon.co.uk/BetterYou-Dlux...

It’s trial and error what dose we need

Calculator for working out dose you may need to bring level to 40ng/ml = 100nmol

grassrootshealth.net/projec...

Government recommends everyone supplement October to April

gov.uk/government/news/phe-...

Thyroid result

Just testing TSH for thyroid is completely inadequate

What’s the range on TSH result (figures in brackets after result)

Was this test done early morning?

This gives highest TSH

You need thyroid antibodies tested, plus Ft4 and ft3

Suggest you book retest after finishing vitamin D prescription

Make sure you book test for as early as possible in morning

[Leszilla in reply to SlowDragon]

Thanks the range was 0.35-5.5. and I am taking the loading dose of vitamin D but no t3 or t4 tests were done.

[SlowDragon Administrator in reply to Leszilla]

So after you finish loading dose vitamin D

Getting FULL thyroid and vitamins tested recommended

Is there any autoimmune disease in close family members?

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 B12, folate, ferritin and thyroid antibodies plus retest TSH, plus Ft4 (unlikely to get Ft3 test)

If GP won’t test use private test options

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

[SlowDragon Administrator]

You can see looking at this graph...TSH of 4 is not typical

Median TSH graph

healthunlocked.com/thyroidu...

TSH daily variation

healthunlocked.com/thyroidu...

So it’s important when in day 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”

TSH tends to drop after eating. So generally we recommend testing early morning before eating or drinking anything other than water

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.

[Leszilla in reply to SlowDragon]

Thankyou so much I do have another test in 3 months but will make sure I don’t eat before this one as I did last time, I have all the symptoms and also this runs in my family, both parents and grandparent had this too .

[shaws Administrator]

Despite a patient having clinical symptoms:-

thyroiduk.org/if-you-are-un...

We were diagnosed more easily from 1892 onwards due to our clinical symptoms alone before blood tests were invented.

Patients were then given a trial of NDTs (natural dessicated thyroid hormones - i.e. made from animals' thyroid glands).

Nowadays you have to wait until the TSH reaches 10 before you can be prescribed. Mine had to reach 100 and I had to diagnose myself.

Thanks to Thyroiduk.org.uk and Lyne Mynott who began it we are now able to converse with one another on this Healthunlocked site. It is Lyn and her staff who work in the background to try to change the medicals way of addressing the best way to diagnose and restore health.

This is the method for blood tests:-

Always make the very earliest appointment. It is a fasting test and if taking thyroid hormones allow a gap of 24 hours between last dose and test and take afterwards.

TSH is highest early a.m.

Also ask for B12, Vit D, iron, ferritin and folate to be tested. Always get a print-out for your own records and post if you have a query.

[Leszilla in reply to shaws]

Thank you so much.