Thyroid

[Janeylou69]

i need help with understanding my tsh results ,a few months ago i had my tsh tested and it was 4.06 and i had taken levythyroxine that day , but on the last tsh test i had done which was the 2nd of september it was 2.78 and i didnt take any levythyroxine that day ,shouldnt my results be about the same or should they differ like that ,i dont understand why its higher with the medication but lower witbout ,im just a bit confused thanks for any help .

[PurpleNails Administrator]

The TSH (thyroid stimulating hormone) is a pituitary hormone which signal thyroid to produce hormone.  

It fluctuates slightly through day with it being highest early morning dropping after eating & throughout day. Really it’s viewed as a overall reflection of where your thyroid levels.  

In a normally functioning person, If the HPT (Hypothalamic-Pituitary-Thyroid) axis isn’t disrupted the TSH rises when levels are low and drops when thyroid levels are high.  

Once the thyroid become abnormal the TSH can behave unexpectedly. It is often the focus of doctors but it is extremely unreliable.

What you need to look at of the FT4 & FT3.  We’re these tested?

You need to see TSH. FT4 & FT3 in same test.  If you were to take levo (LT4) a few hours before a blood draw the FT4 level would be higher than a result later in day.  

[Janeylou69 in reply to PurpleNails]

Hi purplenails my doctor said the labs dont really test ft4 or ft3 so im going to do that privately ,im hoping i can get somewhere thanks .

[PurpleNails Administrator in reply to Janeylou69]

Often private testing only way to make progress.

Were you given dose increase after TSH of 4.06?

A TSH of 2.78 is still not lower part of range most feel best with TSH of 1 or lower part of range.  

What’s you current dose?

[Janeylou69 in reply to PurpleNails]

im on 100mg of levo and no i wasnt given a dose increase on 4.06 , the only way is private testing which i will do next week .

[SeasideSusie Remembering]

Janeylou69

Taking your Levo before a blood test does not affect your TSH, it affects your FT4 level. Time of day affects TSH, as does certain foods and drink, so when doing future blood tests follow our advice and then you will be able to compare your results:

* 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:

healthunlocked.com/thyroidu...

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 doctor

[Janeylou69]

Hi seasidesusie ,the earliest appointment i could get was 11.30 am ,i didnt eat at all before that and i only drank water ,i didnt take levythyroxine before test either and i stopped taking vitamins a week before thankyou for the info . Because of my symptoms im tested quite frequently so theres a number of things it could be ,a couple of years ago they said i had megablastic anemia which was around the time they diagnosed the low b12 ,low ferritin ,which ive had for years .

[Marz in reply to Janeylou69]

You inadvertently replied to yourself so SeasideSusie would not have seen your Reply !

[Janeylou69 in reply to Marz]

sorry what a wally i am .

[Marz in reply to Janeylou69]

Easily done 🌻