Results from Private Blood Test For the first t... - Thyroid UK

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Results from Private Blood Test For the first time

MurphysMama profile image
•5 Replies

Good evening 😊

I can see this gets asks quite a lot and I now find myself asking the same - I would really appreciate any advise on mine - it’s the first time I have had a T3 test also, so would be very grateful for any advice on if these seem ok. Thank you very much

Overall comment

20/09/2021

Please note, TSH is the most important parameter when considering efficacy of thyroid hormone replacement. A decision to change treatment is based upon both laboratory test and clinical considerations and should be made only in consultation with your healthcare provider.

THYROID STIMULATING HORMONE

20/09/2021

1.56 mu/L

TSH levels normal (normal range 0.27 - 4.2 mU/L)

THYROXINE

20/09/2021

16.8 pmol/L

FT4 levels normal (normal range 12 - 22 pmol/L)

TRIODOTHYRONINE

20/09/2021

3.8 pmol/L

FT3 levels normal (normal range 3.1 - 6.8 pmol/L)

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MurphysMama
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fuchsia-pink profile image
fuchsia-pink

First up - ignore the comment. TSH is the LEAST important result when you're on thyroid meds,

The actual thyroid hormone results aren't particularly great. Free T4 is only 48% through range and free T3 utterly feeble at 18.9%. So neither is high enough and you don't convert very well.

If it were me I'd be increasing levo by 25 mcg, and see how things look when free T4 is a good 3/4 through range. If free T3 is still languishing in the shallow end, I'd then start looking into an endo to give a trial of lio.

And it would be worth testing key nutrients and optimising these as necessary. Good luck x

MurphysMama profile image
MurphysMama• in reply tofuchsia-pink

Thank you so very much for taking the time to help me, I really appreciate it - looks like a trip back to the doctors again

SlowDragon profile image
SlowDragonAdministrator

Looking at previous posts and profile…you’re only on 50mcg levothyroxine?

Which brand of levothyroxine are you currently taking

Do you always get same brand levothyroxine at each prescription

Have you had thyroid antibodies tested

For full Thyroid evaluation you need TSH, FT4 and FT3 plus both TPO and TG thyroid antibodies tested.

Very 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)

Low vitamin levels common as we get older too

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...

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...

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

If TPO or TG thyroid antibodies are high this is usually due to Hashimoto’s (commonly known in UK as autoimmune thyroid disease).

About 90% of all primary hypothyroidism in Uk is due to Hashimoto’s. Low vitamin levels are particularly common with Hashimoto’s. Gluten intolerance is often a hidden issue too

Link about thyroid blood tests

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

Link about Hashimoto’s

thyroiduk.org/hypothyroid-b...

List of hypothyroid symptoms

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

SlowDragon profile image
SlowDragonAdministrator

Request GP test vitamin levels ….likely to be low

And request 25mcg dose increase in levothyroxine

Bloods should be retested 6-8 weeks after each dose change or brand change in levothyroxine

guidelines on dose levothyroxine by weight

Even if we frequently don’t start on full replacement dose, most people need to increase levothyroxine dose slowly upwards in 25mcg steps (retesting 6-8 weeks after each increase) until eventually on, or near full replacement dose

NICE guidelines on full replacement dose

nice.org.uk/guidance/ng145/...

1.3.6

Consider starting levothyroxine at a dosage of 1.6 micrograms per kilogram of body weight per day (rounded to the nearest 25 micrograms) for adults under 65 with primary hypothyroidism and no history of cardiovascular disease.

Also here

cks.nice.org.uk/topics/hypo...

gp-update.co.uk/Latest-Upda...

Traditionally we have tended to start patients on a low dose of levothyroxine and titrate it up over a period of months. RCT evidence suggests that for the majority of patients this is not necessary and may waste resources.

For patients aged >60y or with ischaemic heart disease, start levothyroxine at 25–50μg daily and titrate up every 3 to 6 weeks as tolerated.

For ALL other patients start at full replacement dose. For most this will equate to 1.6 μg/kg/day (approximately 100μg for a 60kg woman and 125μg for a 75kg man).

If you are starting treatment for subclinical hypothyroidism, this article advises starting at a dose close to the full treatment dose on the basis that it is difficult to assess symptom response unless a therapeutic dose has been trialled.

BMJ also clear on dose required

bmj.com/content/368/bmj.m41

bestpractice.bmj.com/topics...

MurphysMama profile image
MurphysMama

Thank you so much - lots for me to read and consider - I am now currently on 100 mg Levo and has always been the same brand.

This was a private blood test recommended from this forum. I did do the test first thing and 24hrs after last tablets 😊

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