TSH test result

[amco40]

My mother's GP got back to her and said her last TSH test was on 21st June 2021 and was 1.35 which he says is perfect. She has Hashimoto's and is on 100mg Levothyroxine. She currently experiences joint pain and occasional swollen hands and feet. She also has RA. We want to make sure she is receiving the optimal treatment for her Hashimoto's and that it is not the cause of the 'RA' symptoms.

She is due for another TSH test in June this year. They only do them annually.

As for T3 and t4, the GP says the lab policy (in line with national evidence-based policy) is that if TSH is in range, they do not perform the additional T3 and T4 levels.

However, he also said he appreciated not all thyroid patients agree with the national policy and for this reason, they do ask for T3 and T4 as well as TSH if it would provide extra reassurance.

We are going to ask that T3 and T4 be added to the next test. But just wondering: can it be too low or too high even if TSH is normal? If so, what will this mean?

Thanks.

[SlowDragon Administrator]

Request GP test vitamin D, folate, ferritin and B12 now

What vitamin supplements is your Mum taking

As she has Hashimoto’s is she on strictly gluten free diet or tried it

If not, she should have Coeliac blood test via GP BEFORE considering trialing strictly gluten free diet

Does your Mum always get same brand levothyroxine at each prescription

ALWAYS test thyroid levels early morning, ideally before 9am and last dose levothyroxine 24 hours before test

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

List of private testing options and money off codes

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 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

Come back with new post once you get results

[SeasideSusie Remembering]

amco40

But just wondering: can it be too low or too high even if TSH is normal?

"Normal" isn't a particularly useful phrase when talking about hypothyroidism. There's really no such thing as normal other than it meaning "somewhere within range". Also, TSH is not an indicator of thyroid status, it is a pituitary hormone that sends a signal to the thyroid. The thyroid hormones, which tell us if we are optimally medicated, are T4 and T3, and it's the FT4 and FT3 results that we need, in particularl the FT3 is the most important test.

TSH is useful for diagnosis but once on replacement thyroid hormone it's not a lot of use.

As a general thing, most hypo patients feel best when TSH is 1 or below with FT4 and FT3 in the upper part of their reference ranges. Nothing is set in stone, we are all individual and have to find our own sweet spot.

A TSH of 1.35 may be fine for someone, it may be too high for someone else, but it's important to test FT4 and FT3 at the same time to get the full picture.

Most GP surgeries can't get the full test panel done which is why many of us resort to private testing. If your mother wants to do this the cheapest for the basic test - TSH, FT4 and FT3 - is Monitor My Health which is an NHS lab at Exeter hospital who offer a fingerprick blood test to do at home for £26.10 with code here:

thyroiduk.org/help-and-supp...

For full thyroid panel including antibodies, plus important key nutrients Vit D, B12, Folate and Ferritin, then Medichecks and Blue Horizon offer a test bundle which can be done as a fingerprick test or, for extra cost, venous blood draw. Details within the same link above.

Joint pain can be low Vit D but as she has RA it might be connected with that.