Is it normal for TSH to change this much so quickly?

[Scottishsally]

Hey everyone,

I’ve posted here before and received some great help. I’m currently receiving loaded doses of B12 after having to really push my doctor to acknowledge my low b12 levels (don’t get me started on that!)

I asked my doctor about my thyroid results and he said not to worry about them but I just wondered if this was normal. The first blood test I had at the doctor produced the following results.

TSH 0.87 (0.35 - 5.0)

FT4 12.1 (9.0 - 21.0)

3 weeks later I took a Thriva full thyroid panel finger prick test and received these results

TSH 2.07 (0.27 - 4.2)

FT3 6.2 (3.2 - 6.8)

FT4 16.5 (12 - 22)

Thyroglobulin antibodies 15.9 (0 - 115)

TPO antibodies 12.6 (0 - 34)

T4 162 (59 - 154)

I also have low ferritin (prescribed ferrous fumarate 3 times a day) and just in range folate which I’m supplementing via OTC folic acid.

I know that the results were processed in different labs but is it normal for my TSH to be so different? And should I worry about my high T4 level?

Thanks!

[SeasideSusie Remembering]

Scottishsally

I know that the results were processed in different labs but is it normal for my TSH to be so different?

TSH varies throughout the day, it is highest at midnight and gradually lowers throughout the day. We always advise testing at the same time so that results can be accurately compared. 9am is a good time, after that TSH continues to fall then starts to rise again around 9pm- see first graph here:

healthunlocked.com/thyroidu...

T4 162 (59 - 154)

And should I worry about my high T4 level?

No. This test is Total T4 and it measures the total amount of T4 which is bound to proteins and unbound (free). It is the Free T4 test which shows the normal circulating level of unbound T4 and that is the test that is important.

Your FT4 is 26% through range with your GP test and 45% through range with the Thriva test. Again time of day can make a difference - see second graph in that link.

[Scottishsally in reply to SeasideSusie]

Thanks for your reply

My GP test was at 11am and I took the thriva test at 9:30am just after it arrived in the post so would that time be enough to explain the change?

[SeasideSusie Remembering in reply to Scottishsally]

Yes.

Have you looked at the graphs? TSH is quite a bit higher at 9.30am than 11am.

[SlowDragon Administrator]

Have you had vitamin D tested yet

If not you need to

NHS easy postal kit vitamin D test £29 via

vitamindtest.org.uk

Aiming for vitamin D at least around 80nmol and around 100nmol maybe better

Suggest you work on getting all four vitamins optimal then retest thyroid levels

20% of Hashimoto's patients never have raised antibodies

healthunlocked.com/thyroidu...

Paul Robson on atrophied thyroid - especially if no TPO antibodies

paulrobinsonthyroid.com/cou...

[Scottishsally in reply to SlowDragon]

Hey, thanks for your reply.

Yes my vitamin D was 76 (75 - 175) so just in range but I’ve started supplementing that now. I’ll get another thriva test in august and see how it’s looking