Different levels: I had a finger prick blood test... - Thyroid UK

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Different levels

I had a finger prick blood test through medichecks online in May and got tsh levels of 5.2, and free thyroxine of 11.3. I then had blood drawn at the gp and had tsh levels of 3.7. I then did another fingerprick test with a different online company and also got 5.15. Has anyone had similar varying levels? Thank you

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marginal6656

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SeasideSusieRemembering2 years ago

marginal6656

What were the FT4 levels for all three tests, and the FT3 levels with the private tests?

Did you have key nutrients tested as well or just thyroid?

Did you do all tests under the same circumstances as we advise:

Always advised here, when having thyroid tests:

* 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). See

thyroid.org/patient-thyroid...

biotin use can result in falsely high levels of T4 and T3 and falsely low levels of TSH

These are patient to patient tips which we don't discuss with phlebotomists or doctors.

marginal6656 in reply to SeasideSusie2 years ago

Thank you so much for your reply.

My gp venous blood test had tsh of 3.7. The doctor didn’t test my T4 because my TSH was ‘normal’.

Online my tsh was 5.2, T3 was 4.2 and free thyroxine was 11.3. Thyroglobulin antibodies 22, thyroid peroxidase 10.

I didn’t know anything about times of day when i got my bloods taken (but thank you for this information!). I definitely would have drank or eaten before both tests.

My gp blood test was done at 11:45am and my capillary test I did at home was 1pm.

Gp tested folate and b12 and said they were normal. Ferritin was low at 14, so I am now on iron supplement

Thanks again!

Photo

SeasideSusieRemembering in reply to marginal66562 years ago

What about the second online test where TSH was 5.15, were FT4 and FT3 also tested?

Presumably the reference ranges for the private tests were

TSH - 0-27-4.20

FT4 - 12-22

FT3 - 3.1-6.8

My gp blood test was done at 11:45am and my capillary test I did at home was 1pm.

TSH is highest between the hours of midnight and about 3am, lowers, then rises again at around 9am, then lowers throughout the day before rising again late afternoon. The lowest point of the day is about 1pm.

For diagnosis of hypothyroidism you need TSH to be as high as possible so that would mean a 9am test. By testing your pri8vate test at 1pm you have tested when TSH is at it's lowest. So from your results we can deduce that your TSH has come back lower than it would with testing at 9am, how much higher it would be is difficult to say but if your FT4 is below range then with over range TSH plus below range FT4 you should be started on Levo. However, your GP may not accept your private tests so you would need 2 x over range TSH with below range FT4 results for your GP to diagnose/treat.

marginal6656 in reply to SeasideSusie2 years ago

Thanks again for your detailed response! on my other test my t4 was 11.8 and t3 3.8.

I totally hear what you’re saying regarding time of testing and therefore realistically my levels being higher. I’m not sure what to do next.

If my gp won’t test again at 9am and won’t take these tests seriously, do you know what I could do next? I can’t seem to find a way to get bloods taken privately, the website links on thyroid Uk are all just the standard online home testing sites! I was thinking of joining simply health so I can get access to lots of different gps online and hope one treats me!!!

I’m TTC so really want to get this under control asap!

Thank you!

SeasideSusieRemembering in reply to marginal66562 years ago

marginal6656

Medichecks and Blue Horizon have the option of venous blood draw either at a clinic/hospital or can be arranged at home, this costs extra.

I would arrange to get a private test done under the correct circumstances. The results would probaby come back with a higher TSH and possibly a below range FT4. You could then show these to your GP and ask that he repeats the test himself if he wont accept your private test and that he ensures that FT4 is included as well as TSH. As for timing of test, of course it's very possible that you can't make a later appointment for blood draw due to (make up an excuse) so you need a 9am one.

Once you have new test results, post again and we can hopefully point the way forward.

Have you read through the links ThyroidUK has on their "Having a baby" page:

thyroiduk.org/having-a-baby/

marginal6656 in reply to SeasideSusie2 years ago

I have seen that link whilst lost in the rabbit hole of self diagnosis and self education! And it obviously has caused me worry as it all points towards getting my tsh level down regardless whether it’s 3.7 or 5.2 .

It’s really hard when you try and tell the gp what you’ve read online but they just brush you off and say they wouldn’t treat at that level, and you only need to get your levels below 2.5 if you have diagnosed hypothyroidism. I guess, if like you say, I can get my tsh tested at a time that gives a level above 4.2 then maybe my gp will treat me!! Although I’ve read some people say Uk gps don’t treat unless above 10…but I guess I can cross that bridge if I get to it.

I guess i am reassured that my antibodies and prolactin levels are we within range at least.

Thanks again for your help. I am going to try a different gp at my clinic who specialises in womens health in the hope she knows more! I will tell her everything you have said and If she won’t re test me then I will definitely get blood drawn and a full thyroid test so I can go armed with info!

Thank you so so much!

SeasideSusieRemembering in reply to marginal66562 years ago

marginal6656

Although I’ve read some people say Uk gps don’t treat unless above 10…but I guess I can cross that bridge if I get to it.

Yes, that's if FT4 is within range. If your FT4 is below range along with TSH above range (but below 10) then that should hopefully trigger a diagnosis/treatment, the below range FT4 will confirm that you do not make enough thyroid hormone. TSH is not a thyroid hormone, it's a pituitary hormone, a message from the pituitary to the thyroid to make thyroid hormone if it detects there is not enough. So :

High TSH suggests to little thyroid hormone (FT4)

TSH over 10 with in range FT4 = primary hypothyroidism

TSH over range but below 10 = subclinical hypothyroidism

Subclinical hypothyroidism + raised thyroid antibodies = autoimmune thyroid disease (known to patients as Hashimoto's) = diagnosis/treatment

Subclinical hypothyroidism + below range FT4 = hypothyroidism = diagnosis/treatment (hopefully)

Sparklingsunshine in reply to marginal66562 years ago

I got diagnosed just over 2 years ago, had a TSH of around 7 but my FT4 was conistently below range. Plus I had 2 sets of NHS thyroid blood tests 3 months apart which showed my TSH was climbing. So I got offered Levo as I was showing symptoms.

SeasideSusieRemembering in reply to marginal66562 years ago

Gp tested folate and b12 and said they were normal.

"Normal" just means the result is somewhere within the range, it doesn't necessarily mean they're at good levels. What are the actual results/ranges.

marginal6656 in reply to SeasideSusie2 years ago

Thats true, I could probably call and ask them for values on Tuesday.