bloods recieved from doctor.

[Lolalottie]

 Just recieved bloods from doctor. I am 62 years old and the bloods were taken as a scan revealed a large growth on my Thyroid. I am on 50mg Levothyroxine and have been told this blood test is normal. I feel exhausted every day with other thyroid symptoms. Please advise what my next step should be. Many thanksI have just recieved my blood results requested from doctor..

[SlowDragon Administrator]

Just testing TSH is completely inadequate

So you have two choices

1) request GP do full thyroid and vitamin testing

2) test yourself privately

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 plus both TPO and TG thyroid antibodies tested.

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

About 90% of primary hypothyroidism is autoimmune thyroid disease, usually diagnosed by high thyroid antibodies

Autoimmune thyroid disease with goitre is Hashimoto’s

Autoimmune thyroid disease without goitre is Ord’s thyroiditis.

Both are autoimmune and generally called Hashimoto’s.

Low vitamin levels are extremely common when hypothyroid, especially with autoimmune thyroid disease (Hashimoto’s or Ord’s thyroiditis)

20% of autoimmune thyroid patients never have high thyroid antibodies and ultrasound scan of thyroid can get diagnosis

In U.K. medics hardly ever refer to autoimmune thyroid disease as Hashimoto’s (or Ord’s thyroiditis)

Recommended on here that all thyroid blood tests 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

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Medichecks Thyroid plus antibodies and vitamins

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Blue Horizon Thyroid Premium Gold includes antibodies, cortisol and vitamins

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If you can get GP to test vitamins and antibodies 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

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NHS easy postal kit vitamin D test £29 via

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Link about thyroid blood tests

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Link about Hashimoto’s

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Symptoms of hypothyroidism

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As you normally take levothyroxine at bedtime/in night ...adjust timings as follows prior to blood test

If testing Monday morning, delay Saturday evening dose levothyroxine until Sunday morning. Delay Sunday evening dose levothyroxine until after blood test on Monday morning. Take Monday evening dose levothyroxine as per normal

Only do private testing early Monday or Tuesday morning….not in a heatwave

[Lolalottie in reply to SlowDragon]

Many Thanks. I will order a private test.

[Lolalottie in reply to Lolalottie]

I see little point asking my G.P because it is a nightmare getting an appointment and the Receptionists would be unable to help.

[PurpleNails Administrator]

The TSH is a pituitary hormone which signals thyroid to produce hormone. Usually when it’s high the thyroid hormones are low the TSH is trying to get they thyroid to work more, this is how under active thyroid is diagnosed.

The TSH is in range so the doctor is assuming are thyroid hormones are too.

Unfortunately the TSH isn’t foolproof. You need FT4 & FT3 tested. If you GP / Lab won’t / can’t test you may have to arrange privately.

You have had a scan showing issue with thyroid. You may have a nodule. Benign nodule/s are very common even in people with normally functioning thyroid levels.

If you are under replaced it can cause the thyroid any connected growth to swell too. So symptoms from the thyroid and from low levels might be greatly improved if you make sure you are adequately replaced.

Obtain a copy of the scan report. The GP should have a copy or the department which carried out scan. There are often details doctors don’t pass on as they do not thinks it is relevant eg technical details confirming thyroid as expected but they down want to explain in full so say, “all ok” or “normal - nothing else to do”

Are you still taking the thyroid support supplement you mentioned. Does it contain iodine? Usual diet & levothyroxine contains all the iodine you should need - excess iodine could worsen under active thyroid.

[Lolalottie]

Many Thanks. I stopped taking the Thyroid support (Thyromax) after my last post because it did contain iodine. I am taking Vitamin B12 (1000mcg) and have just started taking Vitamin D3 (4000iu) as I was told on here it may help with headaches, I am taking it occasionally and not everyday until I have had my levels checked.I am now going to order a home test to check my levels.

The Radiographer (?) that did my scan was very forthcoming and told me the size and position of the growth on my thyroid and the fact it showed pale on the scan meant it wasn't anything to be concerned about. If it got any bigger to go back to my G.P.

[PurpleNails Administrator in reply to Lolalottie]

I've never heard it bringing described as pale, but I'm assuming they meant it wasn't a concentrated image - showing as a more solid area. The report can contain further infornation on the health of entire thyroid so always worth keeping a copy.

[Lolalottie in reply to PurpleNails]

Many thanks I will pursue that.