Surprise Thyroid blood test : I attended G P... - Thyroid UK

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Surprise Thyroid blood test

Golli profile image
14 Replies

I attended G P today at 9.15 am to have specific bloods done for a haematology appointment . Seems I was overdue my thyroid blood test. I didn’t take my morning dose of Levo…(.must have had a premonition that they might do it,) but I had breakfast, … how will this affect my results , , they test T4 and TSH only.

Thank you for any response.

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Golli profile image
Golli
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14 Replies
tattybogle profile image
tattybogle

breakfast / or not is unlikely to have much if any impact .. if it does ,it might (allegedly) lower TSH result a little ,(but the evidence for this happening was always extremely dubious)Shouldn't affect fT4 as far as anyone knows.

They tested a bunch of folks TSH before breakfast,, then tested it again after they'd eaten breakfast ,, and found the TSH was a bit lower ......... but of course it would have been a bit lower any way because by then it was later in the morning ,and TSH falls naturally over the morning, They didn't do a 'control' for people who didn't eat breakfast though , so it proved nothing much at all about whether it was eating that lowered the TSH, or just the later time of day.

But just to be on the safe side , people advise it's best to have no breakfast largely because that means test results are always done under consistent conditions.

Golli profile image
Golli in reply totattybogle

Thank you for your speedy response tattybogle. I was afraid my TSH, would be lower, but my Tsh is very low ,even suppressed , anyway , and my GP panics about that , wants to lower my Levo - last time I refused. He’ll probably try the same this time 🤷🏼‍♀️

SlowDragon profile image
SlowDragonAdministrator in reply toGolli

Refuse to reduce dose unless Ft3 is over range

As NHS doesn’t test Ft3 you’ll have to test privately

Important vitamin D, folate, ferritin and B12 are tested annually and all need to be OPTIMAL

What vitamin supplements are you currently taking

Remember to stop taking any supplements that contain biotin a week before all blood tests as biotin can falsely affect test results

Golli profile image
Golli in reply toSlowDragon

Thank you Slow Dragon, , I do get my Ft3 tested privately and it is never optimal. Always in lower half of range with Medichecks. Last nhs thyroid blood test Tsh was suppressed, can’t remember now , think it was 0.008 , same ranges as Medichecks. and T4 was 23 ((12-22) . I’m on Levothyroxine 100mcg daily. I refused a reduction. , so it will probably be the same battle with the new results which I’ll have next week.

I have ceased supplements at present as I’m currently having another battle trying to investigate B12 deficiency.

SlowDragon profile image
SlowDragonAdministrator in reply toGolli

Well low vitamin levels tend to lower TSH because we need optimal vitamin levels for good conversion of Ft4 to Ft3

High Ft4 tends to lower TSH

Ideally looking for Ft4 and Ft3 at similar % through range. Ft3 at least 50-60% through range

Do you always get same brand levothyroxine at each prescription

Vitamins

How Low is your B12?

Are you vegetarian or vegan

Daily Vitamin B complex and separate B12 will improve low B12???Unless test positive for Pernicious Anaemia, then would need injections

If Ft3 remains low when all four vitamins are optimal, likely to need small doses of T3 prescribed alongside levothyroxine

Email Thyroid U.K. for list of recommended thyroid specialist endocrinologist and doctors who will prescribe T3

tukadmin@thyroiduk.org

Golli profile image
Golli in reply toSlowDragon

Read MoreFOLATE - SERUM

08 Feb 2022

6.38

ug/L

> 3.89 R

3.89

19.45

VITAMIN B12 - ACTIVE

08 Feb 2022

88.6

pmol/L

37.5 - 150 R

37.5

150

VITAMIN D

08 Feb 2022

97.1

nmol/L

50 - 200 R

I did take your good advice about supplements last year and I’m now gluten free which has improved things to an extent.

I have stopped taking supplements for last few months as I am currently trying to address my symptoms of B12 deficiency and I don’t want to skew results as per guidelines of PA forum.

I have absorption issues , low stomach acid , and now have lots of classic symptoms of deficiency, including neurological symptoms.

I know this will have an impact on my thyroid levels but really have to address this issue before it worsens and it’s too late to rectify the symptoms . If my B12 is sorted , it may mean injections and co factors.

It seems so many medics are as blinkered and ignorant about B12 issues as they are about thyroid issues! Always a battle, - im seeing a haematologist on Thursday…. Won’t hold my breath 🤷‍♀️

Thank you for all your help.

SlowDragon profile image
SlowDragonAdministrator in reply toGolli

08 Feb 2022

Folate - SERUM 6.38 ug/L (3.89-19.45)

VITAMIN B12 - ACTIVE

88.6 pmol/L (37.5 - 150 R)

B12 isn’t low, but folate is on lower side

supplementing a good quality daily vitamin B complex, one with folate in (not folic acid) may be beneficial.This can help keep all B vitamins in balance and will help improve B12 levels too

Difference between folate and folic acid

chriskresser.com/folate-vs-...

B vitamins best taken after breakfast

Thorne Basic B or Jarrow B Right are recommended options that contains folate, but both are large capsules. (You can tip powder out if can’t swallow capsule)

IMPORTANT......If you are taking vitamin B complex, or any supplements containing biotin, remember to stop these 7 days before ALL BLOOD TESTS , as biotin can falsely affect test results

endo.confex.com/endo/2016en...

endocrinenews.endocrine.org...

greygoose profile image
greygoose

Does breakfast include coffee? Because that will lower your TSH.

Golli profile image
Golli in reply togreygoose

No coffee, greygoose. , … , thank goodness. , look forward to my coffee mid morning ! Thank you for responding.

greygoose profile image
greygoose in reply toGolli

You're welcome. :)

TickTockTock profile image
TickTockTock

I've had success in raising my TSH by splitting my levo dose to half when I wake up and half right before I turn the light off to sleep.

Golli profile image
Golli in reply toTickTockTock

That’s interesting , may be worth a try.

tattybogle profile image
tattybogle in reply toTickTockTock

Me too .. i think.. can't prove it for certain as i've not done enough private testing, but it certainly looks that way. My 'usual' TSH was always about 0.05 ish for many many years on 150/ 125 /112.5mcg ..... started splitting dosing a couple of years ago , had done it occasionally before but probably not when testing.... now, when splitting my 112.5mcg dose 50mcg a.m / 62.5mcg bedtime , my TSH is over 1.

I'm pretty sure that the TSH increase is not just down to 'potentially absorbing less' as i am sensitive to even 12.5mcg reductions in levo , so if i was undermedicated on split dose i'm sure i would feel it .. and i wait 3 or 4 hours after food for bedtime dose...... I certainly don't feel any worse for it . and of course it makes life easier with GP's if your TSH looks 'nice'.. and if TSH is not so supressed , it should mean i am getting better T4 to T3 conversion, because TSH has a complex role in driving deiodinase conversion of T4 to T3

It just makes sense to me ... the thyroid doesn't dump a full days worth of T4 on you all at once, so it seems like a good idea to try and follow what it does naturally a bit closer if we can.

Somebody on here ( Hashihouseman ) splits his even further .

Golli profile image
Golli in reply totattybogle

That’s very interesting tattybogle , but it makes perfect sense.

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