Advice Please

[Esinedharry]

I have to see an Endocrinologist in 2 weeks time. He has requested I have a blood test tomorrow in readiness for my appointment in 2 weeks. I usually have an early morning test and don’t take my Levo that morning. However the only available appointment tomorrow is at 11.40am. Should I still not take my Levo or will it not matter given the lateness of the blood test. Any advice would be welcome.

[pennyannie]

Hello Esinedharry :

I would fast overnight and just take in water and take your T4 after the blood draw then wait an hour and have an early lunch.

[SlowDragon Administrator]

Previous vitamin results from a year ago

healthunlocked.com/thyroidu...

Can’t see any ferritin results on any previous posts

Folate and B12 too low (extremely common)

What vitamin supplements are you currently taking

Presumably you are still taking a daily vitamin B complex to improve low folate and B12

Remember to stop taking any supplements that contain biotin ideally a week before all blood tests

Always test vitamin D, folate, ferritin and B12 at least once a year

If GP won’t, test via Medichecks or Blue horizon

Do you always get same brand levothyroxine at each prescription

Bloods should be retested 6-8 weeks after each dose change or brand change in levothyroxine

For full Thyroid evaluation you need TSH, FT4 and FT3 tested.

Very important to test vitamin D, folate, ferritin and B12 at least once year minimum

Recommended on here that all thyroid blood tests early morning, ideally before 9am. Just water between waking and blood test ideally…then take levothyroxine immediately after blood 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

bluehorizonbloodtests.co.uk...

[Esinedharry in reply to SlowDragon]

Thank you or your reply. The Endocrinologist saw me last June and wasn’t helpful. He tested my cortisol but I’ve never had the result. He said he would see me in 3 months but has only just given me an appointment. I take vit D 800iu every day but no other supplements.

[SlowDragon Administrator in reply to Esinedharry]

Previous post a year ago SeasideSusie recommended you start taking daily vitamin B complex

And asked you for ferritin result?

From Seasidesusie reply

Folate is very low at 4.1 (>3.00). It doesn't help when there is no proper range but in those cases it's suggested that folate level is in double figures.

B12 at 443ng/L (which is the same as pg/ml) is on the low side. According to an extract from the book, "Could it be B12?" by Sally M. Pacholok:

"We believe that the 'normal' serum B12 threshold needs to be raised from 200 pg/ml to at least 450 pg/ml because deficiencies begin to appear in the cerebrospinal fluid below 550".

"For brain and nervous system health and prevention of disease in older adults, serum B12 levels should be maintained near or above 1000 pg/ml."

To raise both B12 and Folate I'd suggest supplementing with a good quality, bioavailable B Complex containing methylcobalamin and methylfolate. Recommended here are Thorne Basic B or Igennus Super B.

No Ferritin test?

Vitamin D 800iu unlikely high enough dose

Strongly recommend getting full thyroid and vitamin results tested yourself at least annually

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

bluehorizonbloodtests.co.uk...

[Esinedharry in reply to SlowDragon]

Thank you I will look into private tests.

[SlowDragon Administrator]

Examples of private test results including ferritin

Blue horizon includes cortisol

healthunlocked.com/search/p...

Medichecks

healthunlocked.com/search/p...

[TSH110]

Can’t you get an early test the next day or when one is available? Why does it have to be two weeks beforehand? Why not a week and a bit? Your results will not be comparable to u your previous early morning tests as the TSH falls as the day goes on and ideally you want the highest value you can get, It’s a good way to justifying underdosing patients but I’m not even sure if they have the brain power to run that ruse, it’s probably just very poor practice.

[Esinedharry]

I was told that the 11.40 appointment was all they had for the next couple of weeks. I live in Wales the nhs here is practically non existent! I think the endocrinologist wanted the results in plenty of time before my appointment so that he can research all the ways to justify cutting my Levo! He is very knowledgeable on thyroid issues he’s a diabetic specialist. I don’t have much hope.