My son has been tired a lot recently but his course is physically demanding so not worried. A blood test has come back with raised crp(12) and raised tsh (4.7 range 0.27-4.2mu/l)
He is 21 so I hadn’t really considered hypothyroidism but my niece is borderline and is being treated and my mum and sister are hypothyroid while I go in and out of range so clearly there is a familial link.
Would it be worth a full thyroid panel? The gp hasn’t commented on the results at all, if I hadn’t got the print out we wouldn’t know any of this 🙄
Thanks
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Mag999
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GP wont diagnose on the strength of one raised TSH result, test should be repeated in 2-3 months. This is because TSH can be raised due to non-thyroidal illness and this needs to be discounted first.
Full thyroid panel would be best:
TSH
FT4
FT3
Thyroid antibodies (TPO and Tg)
but GP is unlikely to be able to get all tests done. It may be worth your son doing a private test.
Always advised here, when having thyroid tests:
* Blood draw no later than 9am. This is because TSH is highest early morning and lowers throughout the day. If looking for a diagnosis of hypothyroidism, an increase in dose of Levo or to avoid a reduction then we need the highest possible TSH
* Nothing to eat or drink except water before the blood draw. This is because eating can lower TSH and coffee can affect TSH.
[* If taking thyroid hormone replacement, last dose of Levo should be 24 hours before blood draw, if taking NDT or T3 then last dose should be 8-12 hours before blood draw. Adjust timing the day before if necessary. This avoids measuring hormone levels at their peak after ingestion of hormone replacement. Take your thyroid meds after the blood draw. Taking your dose too close to the blood draw will give false high results, leaving any longer gap will give false low results. ]
* If you take Biotin or a B Complex containing Biotin (B7), leave this off for 7 days before any blood test. This is because if Biotin is used in the testing procedure it can give false results (most labs use biotin).
These are patient to patient tips which we don't discuss with phlebotomists or doctors.
CRP is a non-specific inflammation marker, range is often <5 so his result is quite high. Test can't tell where the inflammation is. If this test is repeated and comes back raised again then maybe GP should investigate cause.
Family history does look like hypothyroidism might be inevitable.
Then test folate, ferritin and B12 tested along with thyroid antibodies
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 all relevant vitamins
Thanks he rarely sees daylight so I have given him vit d spray but who knows if he takes it! His free t 4 was 17.5(12-22pmol/l) so normal but given his lack of energy I want to explore as broadly as possible. Will ask them to repeat crp and get one of the private thyroid panels you have linked.
Haha. Getting him to a dr took months! His tsh came down to normal range(2.1) and vits are ok but I will keep getting him to check yearly as my niece who is same age (21) is already on thyroxine. I can’t find other reasons why tsh would fluctuate over range and back again so will keep as close an eye as I’m allowed. Thanks for asking.
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Understanding blood tests esp raised TgAbs and TSH
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