Where and what to get tested?

[h4nz05]

Please could I have recommendations on the best company to use for thyroid testing? I am planning on getting the antibodies and nutrients test too. Is it important to get reverse t3? I have heard differing views. I have all the symptoms and my dad has hypothyroidism, but am aware that the symptoms can be attributed to other things, so I want to be sure. Many thanks.

[SeasideSusie Remembering]

h4nz05

Don't bother with reverse T3 test, it's expensive and takes a long time. It can tell you if your rT3 is high but it can't tell you why, and there are lots of reasons for high rT3 and only one of them is to do with thyroid which is when there is an excess of unconverted T4.

At the moment just do a full thyroid panel plus the key nutrients

TSH

FT4

FT3

Thyroid antibodies

Vit D

B12

Folate

Ferritin

and this can be done in one test bundle with either Medichecks or Blue Horizon and can be done by fingerprick or, for extra charge, venous blood draw:

Medichecks ADVANCED THYROID FUNCTION medichecks.com/products/adv...

Check this page for details of any discounts: thyroiduk.org/getting-a-dia...

or

Blue Horizon Thyroid PREMIUM GOLD bluehorizonbloodtests.co.uk...

Check this page for discount code thyroiduk.org/getting-a-dia...

Both tests include the full thyroid and vitamin panel. They are basically the same test with just a few small differences:

Blue Horizon includes Total T4 (can be useful but not essential). Medichecks doesn't include this test.

B12 - Blue Horizon does Total B12 which measures bound and unbound (active) B12 but doesn't give a separate result for each. Medichecks does Active B12.

Total B12 shows the total B12 in the blood. Active B12 shows what's available to be taken up by the cells. You can have a reasonable level of Total B12 but a poor level of Active B12. (Personally, I would go for the Active B12 test.)

Blue Horizon include magnesium but this is an unreliable test so don't let this sway your decision, it also tests cortisol but that's a random cortisol test and to make any sense of it you'd need to do it fasting before 9am I believe.

If you want to do the fingerprick test then I have some tips I can post if you wish, please ask.

Don't bother getting their doctor's comments, it delays the receipt of your results by at least a day and you'll get a much better and more accurate interpretation of your results by posting here for members to respond.

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.

[h4nz05 in reply to SeasideSusie]

Thank you for such comprehensive advice! I have been having b12 injections for a number of years now - do you know how this would affect the b12 results, or if it is necessary? My last tests for thyroid was done in 2019 and my FT4 was at the low end of the range.

[SeasideSusie Remembering in reply to h4nz05]

h4nz05

No point in testing B12 once on injections, if you've recently had an injection it will show high anyway. But it's part of the bundle so that's cheaper than testing vitamins separately.

[h4nz05 in reply to SeasideSusie]

Thank you. I've ordered the blue horizon tests. Please could you send me the advice for finger prick testing.

Also, should I be careful taking any of my other meds before testing? My regular meds are inhalers (relvar elipta), sertriline, omeprazole. I also take naproxen, codeine and have been on a short course of diazepam for back spasms. I don't want to waste money and mess it up.

[SeasideSusie Remembering in reply to h4nz05]

TIPS FOR DOING FINGERPRICK TEST

* Be well hydrated, drink plenty of water the day before, and before you do the test.

* Some people take a shower before hand, some run up and down the stairs to get blood flowing. Personally, as I can't run up and down the stairs, I circle my arm round, windmill style.

* Have a bowl full of hot water, dip hand in and out, swish around, hand needs to go red. If blood flow stops, you can always swish round in the hot water again.

* Stand up to do the test. Make sure your arm is straight down when collecting the blood. Either use a small step stool to raise yourself well above the work surface, or put the collection tube on a lowish shelf or use an ironing board to get the perfect height.

* Prick finger on the side, not the tip. I find that half way between the nail bed and tip is about right, or maybe slightly nearer the nail bed rather than the tip. I use my ring finger, but middle finger is next best for me.

* Do not squeeze your finger to get the blood out, it can damage the blood and it may not be usable

I've recently done 2 tests. The first one there was very little blood coming out which was unusual for me so I used a second finger and between the two I gradually filled the tube. However, when I checked the prick site for the first finger the actual cut was very small and as I've had some of these lancets fail before I put it down to that. When I did the second test this is what I did

* Prick my finger as usual, at the same time try and make a very slight twist with the lancet (the blade retracts very quickly so you have like a nano second to twist the lancet). I'm not talking 90 degrees or anything, just a very slight twist to make the cut just slightly bigger, it doesn't hurt or cause a blood bath! This made a big difference, 11 generous drops of blood filled the tube in less 2 minutes.

If you supplement with Biotin, or a B complex containing it (B7), leave it off for 7 days before doing any blood tests as it can give false results when biotin is used in the testing procedure, and most labs do use it.

Sometimes the sample has haemolysed, ie the red cells rupture. This may be due to:

* bacteria (so clean area thoroughly and allow to dry)

* intense exercise (so don't go mad trying to get the blood to flow prior to the test)

* squeezing the finger to get the blood out (you can gently "milk" the finger but don't squeeze)

* shaking the tube vigourously instead of gently inverting it.

* sample collection was prolonged

* if there was a long delay between sample collection and analysis

* there is too little blood in the tube and too much coagulant for the amount of blood

Sometimes there's not enough blood in the tube to do all the tests so it's important to fill the tube to the line.

Remember to follow those tips I posted abofut timing of test, no biotin, etc, in previous reply as well.

Video showing how to do a fingerprick test:

youtube.com/watch?v=w2JzToZ...(Not working as expected?)

Also, should I be careful taking any of my other meds before testing?

I take inhalers and a couple of other medications so I do my test as soon as I get up and take my medications after the test. This is just to ensure that nothing can interfere with the results, I'm not saying they will, I just tend to err on the side of caution.