Concerned after blood test: Annual thyroid blood... - Thyroid UK

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Concerned after blood test

suzieh profile image
10 Replies

Annual thyroid blood tests done last week

Results sound concerning as tsh 0.08, T4 20.3. Both out of normal range?

Dr phone appt not for 3 weeks unless I request an urgent appt . Do you think I ought to or am I ok to wait?

I have been taking 100mcg a day for a few yrs

Feeling very well at mo, energetic and fit Decided to lose weight last jan as near the top of BMI for my height- now 1.5 stone lighter. Lowest weight for 25yrs! Middle age spread -gone. Done by low carb diet

Any advice gratefully received or comments on results

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suzieh
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humanbean profile image
humanbean

You can't just assume that a result is out of range. Your T4 at 20.3 could be in range for some reference ranges but over the top for some others.

You could phone up your surgery and ask for the reference ranges for the two results you've been given.

humanbean profile image
humanbean in reply to humanbean

P.S Congrats on the weight loss. I wish I could do the same!

suzieh profile image
suzieh in reply to humanbean

I did it really slowly jan -July 1lb a week! Nhs calorie counting app- daily, 1200 cals per day. Only hungry for first 2 weeks. Had a cup a soup to fill me up when needed, an apple or rice cake as snacks. Basically - very low carb but not low fat!

suzieh profile image
suzieh in reply to humanbean

Thanks

SlowDragon profile image
SlowDragonAdministrator

Was this test done as early as possible in morning before eating or drinking anything other than water and last dose levothyroxine 24 hours before test

Recommend you get FULL thyroid and vitamin testing done yourself privately BEFORE considering any dose reduction

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 with autoimmune thyroid disease (Hashimoto’s or Ord’s thyroiditis)

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 all relevant vitamins

List of private testing options

thyroiduk.org/getting-a-dia...

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

Medichecks Thyroid plus antibodies and vitamins

medichecks.com/products/adv...

Blue Horizon Thyroid Premium Gold includes antibodies, cortisol and vitamins by DIY fingerprick test

bluehorizonbloodtests.co.uk...

Thriva Thyroid plus antibodies and vitamins By DIY fingerpick test

thriva.co/tests/thyroid-test

Thriva also offer just vitamin testing

If you are now slightly over medicated, due to weight loss, you might only need TINY dose reduction…..perhaps 25mcg per week

Come back with new post once you get results

suzieh profile image
suzieh in reply to SlowDragon

Thank you

McPammy profile image
McPammy

Great you’ve lost the weight. But please be careful you don’t lose the vitamins you need to help in converting T4 to active T3. I did what you have done some years ago losing 1lb a week for ages. I didn’t realise I was also losing vital vitamins due to my eating habits. Have you had your vitamins checked recently. B12, ferritin, folate and vit D.

suzieh profile image
suzieh in reply to McPammy

Thank you- just considering a private blood test, to check, if Dr won’t agree to this. I do take a multi vit every day and some vit d supplements 2 x a week

tattybogle profile image
tattybogle

If you feel well on this dose , then even if TSH is slightly under range (and fT4 ? slightly over range, might not be until you know the range some are [12-22]) .. then i wouldn't worry about your current results ... GP may disagree and tell you they worry about heart and bone risks.

I was concerned about my long term low TSH (0.05 ish with fT4 slightly over range sometimes) and so i did a lot of reading of research papers.

I found a large long term study showing the risks associated with low TSH were not a problem until TSH goes below 0.04

The risks for TSH 0.04 to 0.4 were in fact no greater than risks for TSH 0.4 to 4 (ie. normal range), and even then, the risks for 0.04 - 0.4 were still less than than risks of TSH over 4.... and we don't hear any doctors trying to frighten people about the risks of TSH over 4.

GP's are unlikely to have looked at it in this much detail .. they just see the bullet points that "low TSH =risk"

These threads contain a link to that evidence , and also contain other useful discussions on the subject of risks of low TSH vs quality of life.

healthunlocked.com/thyroidu... risks-of-suppressed-tsh-analysis?

healthunlocked.com/thyroidu... /tsh-and-the-more-mature

healthunlocked.com/thyroidu... dangers-of-suppressed-tsh?

IF you/GP do wish to reduce dose i would try to negotiate a very small reduction in dose rather than accept a 25mcg reduction just because that's what size the tablets come in. You could reduce by 12.5mcg/day or less.. for example by taking alternate doses or halving a 25mcg tablet.

I once reduced dose due to blood results when i was feeling relatively well ... it left me on the sofa again and even though we later put the dose back up, to be honest it was very difficult if not impossible to regain my former sense of well being and fitness.

So since you feel well on this dose, think carefully before you agree to a reduction.

I have once been overmedicated and with hindsight it was obvious .. i had over frequent bowel movements and a fine tremor in my fingers.... classic signs of overmedication, and in that case a reduction of 12.5mcg meant i gradually felt improved But then based on my bloods still being out of range they wanted to reduce it by a further 12.5mcg.. which i did and it led to chronic constipation and loss of wellbeing.. so GP put dose back up , even though TSH /fT4 were still out of range. saying he didn't want to make me ill.,, but that little adventure messed me up for months .

suzieh profile image
suzieh in reply to tattybogle

Thank you. Will read the links. Yes I’m feeling well so will discuss this with my Dr

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