Help with results print out / Update from yesterday !

[Troya18]

Got some print outs today …see photo Can you help me understand them?They won’t do a Vit D test says it’s too expensive!They said just take some supplements. Got a B12 blood draw done - see GP again next week .I saw a nurse practitioner today who said again my thyroid results are normal and I’ve probably got a virus when I mentioned temp feelings / fog head / dizziness etc - so I’m off work AGAIN and back to paracetamol etc - feeling like a 90 yr old every so often isn’t “normal” 😑

[SeasideSusie Remembering]

Troya18

There are no reference ranges, we need ranges to be able to interpret the results.

Looking at your latest TSH result - what time was the test done? It should be no later than 9am. Did you eat or drink anything but water before the test?

How much Levo are you on? A TSH of 2.8 is too high for someone taking Levo. The aim of a Hypo patient on Levo only, generally, is for TSH to be 1 or below with FT4 and FT3 in the upper part of their reference ranges, if that is where you feel well. Your TSH of 2.8 tells us that you are undermedicated and require an increase in your dose of Levo.

They won’t do a Vit D test says it’s too expensive!They said just take some supplements

You can't just "take some supplements". You need to know your level to know if you need to supplement in the first place, then if you do you base your dose on what your current level is to achieve the recommended level of 100-150nmol/L.

You can do a private fingerprick blood spot test with an NHS lab which offers this test to the general public for £29:

vitamindtest.org.uk/

[SlowDragon Administrator]

On levothyroxine TSH should ALWAYS be under 2

Make an appointment with GP and request/politely insist on 25mcg 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.

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...

Meanwhile test vitamin D yourself

NHS easy postal kit vitamin D test £29 via

vitamindtest.org.uk

Thyroid levels should be retested 6-8 weeks after each dose increase

Aiming for Ft4 at least 60-70% through range and Ft3 at least 50% through range minimum

Usually TSH will be around or under one when adequately treated

[Troya18 in reply to SlowDragon]

I’ve noticed no result for T4 - should I request this again ??

[SlowDragon Administrator in reply to Troya18]

Well you can ask…..

Just testing TSH is completely inadequate

Do you know what range on Ft4 is…typically it’s 12-22 but different labs have different ranges …some are 7-14 or 9-21

So you need to know range

Obviously if range was 12-22 last time Ft4 was tested it would have been below range

Jan 2020 - Ft4 of 11.8 ….looks low.

But need to know range

[SlowDragon Administrator]

Can’t see any antibodies results

[Troya18 in reply to SlowDragon]

Yes I need to request this also

[Troya18]

Seriously thinking of going to private doc who knows about thyroid - this is just so rubbish that they haven t picked up these things Plus they don’t like being told anything …? See how go with GP Moro, I’ll be on phone first thing

[SlowDragon Administrator in reply to Troya18]

Before considering seeing any thyroid specialist endocrinologist you need to test TSH, Ft4, Ft3, both thyroid antibodies and vitamin D

Push GP to increase dose levothyroxine up by 25mcg tomorrow

Up to 75mcg daily

(but not as 75mcg tablets as that’s Teva brand)

Stay on same brand as before

Was that Accord brand?

[Troya18]

Yes accord