NDT & blood tests - when to take it?

[carorueil]

I've been taking ERFA Thyroid for the last 11 years: was told not to eat anything before blood test so in fact by the time blood test was done it would have been about 24 hours more or less since I had my last ERFA /NDT treatment. I've seen that some people split their dose so that their last NDT is 8 hours before the blood test- just wondering whether I should start doing this? I'm seeing my endo in 10 days time who prescribes NDT but a) doesn't seem to know about the 'life' of NDT and b)doubt she knows about this. As I'm feeling ok on current meds (THS is very low) trying to ensure that she'll actually realise that I'm not hyper like she believed before but was hypo!

Any advice welcome - I'd be tempted to do 2 blood tests - one the way I've been doing it for 11 years and the other the 'NDT' way but risk having a very bruised right arm (only arm they can manage to take blood from).

thank you!

[shaws Administrator]

If it was me who was having a blood test I would continue your method especially because you feel well. I take T3 only.

I've never spliit any dose - be it levo or NDTs and I have the earliest appointment .

I always take my dose early a.m. but when having a blood test I don't take it until afterwards .

I've never had dose ajusted by GP/endo. They seem content with results and I think it is because I don't complain of any symptoms and that's because I feel well and have no complaints.

[carorueil in reply to shaws]

Thanks Shaws - thing is endo who prescribes it seems to be obsessed with tsh, but I think you're probably right about being consistent with what I do and when I take it.

[Hidden]

My TSH is completely suppressed on NDT (<0.01) and most doctors who see this panic and think I´m hyperthyroid. The TSH is not likely to rise even if you split the dose on the day before the test so just do what is most convenient for you. I have never split my dose and the only opinion that matters to me is the one of the doctor who put me on Erfa. And he knows that the TSH is unimportant when on anything containing T3. The only lab result likely to look different depending on whether your leave 24 or 8/12 hours between last dose and going to the lab is FT3. I´ve been told that, if you leave 24 h between last dose and going to the lab, count on FT3 to be +/-20% higher on the previous day.

[carorueil in reply to Hidden]

Thanks Mirabelle70 that's my problem now! Since last year THS has gone down and endo insisted that I 'reduce' my meds - did it one day and felt terrible (don't think she realises the 'life' of ERFA). Unfortunately my endo seems to be totally focussed on TSH. As I've got scalp lupus I've been taking topical steroid gel for my scalp since last year, so not too sure if that has an impact or not on thyroid. I've been leaving 24 hours between my doses for the last 11 years so probably makes sense to stick with that 'routine'. I increased my dosage as I felt so bad after endo's recommendation to reduce and definitely feel better on current dose as well as restarted take n DHEA, just hope the blood test results convinced endo... Also did cortisol saliva test twice as that was very low and that's improved... Interesting about FT3 - just wish MY endo actually knew how all of this worked... Having first 'physical' consult with her in 3 years (since Covid), she was totally dismissive of lupus situation...unfortunately I don't have a lot of other options!! thanks again Caroline PS Sounds like you've found the perfect doctor!!

[Hidden in reply to carorueil]

Yes, I found a great doctor but it´s not an endo! I realised years ago that most endos are useless when it comes to thyroid disease...most only test the TSH and don´t care about symptoms once the TSH is in range. It´s horrible when doctors tell you to lower meds based on the TSH reading alone - it seems most endos are diabetes specialists and know nothing about hypothyrodism except that you take levo until your TSH is in range...

[carorueil in reply to Hidden]

Hi Mirabelle70 yes even though mine lived/studied in the US, I think her bread &butter money comes from dealing with diabetes! She definitely doesn't seem to know exactly how NDT works (despite prescribing it).Tried getting a 2nd opinion from another gp in Dublin - who agreed I was hypo but he prescribed even weirder stuff to take (all sounded way too dodgy for someone who has a highly sensitive body to meds). Unfortunately NDT isn't 'officially' recognised in France (even if my private healthcare provider is now covering it's cost - 10 years after I was paying for it myself, but still better than nothing), so don't have lots of options: not really keen on going back to gp in Belgium who originally prescribed NDT because of his cost & also tonnes of stuff he prescribed. So for the moment just stuck with who I've got - just hope she sees 'sense' when I see her in October 🙏