Blood test results GP says thyroid normal. but taken pm and I’d had 50 levo dose

[App1]

These say TSH is 2.5 mlU/L (0.3-5.5)

Serum free T4 19.0 (10.0 - 22.0)

I’ve booked another for next week before 9 am and will not take levo beforehand.

I wasn’t feeling ‘normal’ or anywhere near it....

Comments please as due a GP telephone conversation. Many thanks in anticipation

[SeasideSusie Remembering]

App1

Comments please as due a GP telephone conversation.

I think you know what we'll all say as you have alluded to this in your post

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 doctor. Most doctors will say none of this matters, some enlightened doctors and endos agree and tell their patients to do their tests exactly as we say.

Your TSH should be higher by doing your test at 9am, but even at the current level it should tell your GP that you need a dose increase. Your FT4 should be lower if you don't take your Levo beforehand so will give a true picture of your normal circulating amount of T4. However, you are only recently diagnosed and started levo in April so it's still early days in your thyroid journey.

The aim of a thyroid 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, so this is eventually what you should be aiming for. Don't let GP stop increasing dose just because TSH is back in range, all your levels need to be optimal for you to feel well so he should look at the individual and symptoms rather than numbers.

App1 I have edited my comments as tattybogle kindly pointed out an error I made.

[tattybogle in reply to SeasideSusie]

typo alert ?

"I actually think your TSH wont reduce very much by doing your test at 9am, it should be lower to some extent but it may still be too high for a treated hypo patient. " ??

[SeasideSusie Remembering in reply to tattybogle]

Yes, I got that backwards didn't I 🙄 I obviously need my coffee (a bit late with it this morning). Thank you Tatty, I'm always very grateful when a mistake is pointed out (I'm so glad that members are happy to do this). I shall go and edit my post to avoid any confusion 👍

[tattybogle in reply to SeasideSusie]

me too , only just had a coffee, was sidetracked by men wanting to dig the pavement up at 8 am

[SeasideSusie Remembering in reply to tattybogle]

was sidetracked by men wanting to dig the pavement up at 8 am

Hunky ones?

😍😊

Oh dear, I hope the PC police aren't around 🤣

[tattybogle in reply to SeasideSusie]

No .. you have to set fire to something to get the hunky ones to turn up

[App1 in reply to SeasideSusie]

Yes I booked that appt on basis of advice from this Forum. At present have good days (yesterday) with stronger muscles and minimum fog and bad (today) when agitated beyond belief and cannot stay still or settle. About to use soupmaker for some veg soup to see if that settles me down. I’m also going to mention that my brand was changed.......Many thanks for prompt replies.

[humanbean in reply to App1]

agitated beyond belief and cannot stay still or settle

This could be caused by an issue with your cortisol levels. Having levels which are too high or too low can cause agitation and can make stress very difficult to handle. It is very unwise to guess on the basis of symptoms whether you have a cortisol problem though, it would need testing. Cortisol problems are common in people with thyroid disease.

See this link :

paulrobinsonthyroid.com/sym...

Note that patients telling doctors that they are stressed is likely to cause the patient to get a mental health diagnosis. But anti-depressants don't help. Getting thyroid hormone levels right will help more, and getting nutrient levels right will help a lot too. My almost life-long anxiety disappeared when I substantially raised my ferritin (iron stores). Which nutrients help different people depends on which ones are a problem for them.