I have decided to get a private test done as since the other week when my prescription went awol, I went 2 weeks without medication (100mcg Levo) and then started taking a tablet only every other day and I feel better for it - more alert, more energetic and not so tired.
Drs have never explained the different aspects of the thyroid test (fts, tsh, etc), have never discussed test results and I very much doubt they would hand a copy over. Tablet brand is whichever one the chemist has at a time (so changes month to month). I know they are busy, but I really think their attitude is appointments and medication are free, be happy with what you get!
My question is - which test should I get done. I had a look on Medicare and they have 3 different tests under the thyroid section.
I have looked at Medicare as I saw they carried out tests via my local hospital.As the levo is the only medication I'm on, and I seem to feel better when not taking it, I think I just wanted the thyroid function checked.
They have to, by law. In the UK we are legally entitled to a copy of our results. Ask the receptionist for a print out who will probably have to get permission from a GP and they may, if they want to be awkward, make you wait 30 days, but they must provide them if requested. Or check to see if your surgery offers online access, some do.
My question is - which test should I get done
If you want full thyroid panel plus key nutrients (Vit D, B12, Folate, Ferritin) then either of the following:
Both tests include the full thyroid and vitamin panel. They are basically the same test with just a few small differences:
Blue Horizon includes Total T4 (can be useful but not essential). Medichecks doesn't include this test.
B12 - Blue Horizon does Total B12 which measures bound and unbound (active) B12 but doesn't give a separate result for each. Medichecks does Active B12.
Total B12 shows the total B12 in the blood. Active B12 shows what's available to be taken up by the cells. You can have a reasonable level of Total B12 but a poor level of Active B12. (Personally, I would go for the Active B12 test.)
Blue Horizon include magnesium but this is an unreliable test so don't let this sway your decision, it also tests cortisol but that's a random cortisol test and to make any sense of it you'd need to do it fasting before 9am I believe.
If all you want is the basic test consisting of TSH, FT4 and FT3 then Monitor My Health is cheapest. This is an NHS lab at Exeter hospital which provides this as a fingerprick test to the general public for £26.10 with code here:
* Book the first appointment of the morning, or with private tests at home no later than 9am. This is because TSH is highest early morning and lowers throughout the day.
In fact, 9am is the perfect time, see first graph here, it shows TSH is highest around midnight - 4am (when we can't get a blood draw), then lowers, next high is at 9am then lowers before it starts it's climb again about 9pm:
If we are looking for a diagnosis of hypothyroidism, or looking for an increase in dose or to avoid a reduction then we need TSH to be as high as possible.
* Nothing to eat or drink except water before the test - have your evening meal/supper as normal the night before but delay breakfast on the day of the test and drink water only until after the blood draw. Certain foods may lower TSH, caffeine containing drinks 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 doctors.
If you're going to do a fingerprick test and not done one before, I have some tips which I'm happy to post if you would like me to, just ask.
Levo22 It is usual to feel great when you cut back or stop levo. We don't know why but that's the way it is for folks.I reduced my dose from 100mcg per day to 25mcg per day and I felt fantastic!
IT LASTED 3 MONTHS before I became very unwell and very very hypo. I made myself very ill. My TSH was in the 30s, my ft4 and ft3 were below range.
It would be good for you to get the tests done as you intend so you can monitor your levels and avoid become so hypo like me.
Other drugs have ‘bounce back’ too. I am not entirely sure why this is but I think it’s when the body temporarily is released and reminded of what it is supposed to be doing and can temporarily return it to its norms. In the case of hypothyroidism, maybe enough T4 has built up through medication that can last the patient a certain amount of ‘time’. That is, until the body realises again that it just can’t do ‘this’ normality stuff itself. It’s what patients report for example when they come off painkillers that are no longer ‘working’ and suddenly the pain disappears - this is can be permanent. Similarity with anti-acid drugs. When stopped there can be a rush of acid making symptoms worse but then they settle again and with care they can be stopped altogether (probably people who do not have enough stomach acid in the first place). I know there other examples but I can’t think of them at the moment.
I would also be interested in this info, as my doctor has decided not to give me a blood test this year.They wouldn't allow me my Thyroxine early as I was going on holiday, so I had to return early or I would've run out of tablets. Doctor hasn't seen me in 2 years.
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