New results

[Sandiij]

Following advice on here i asked gp to check thyroid hormones. He said wasnt necessary so i had a medichecks home test. Unfortunately the t3 test failed. From the rest of the results does this confirm an autoimmune condition or do both have to be raised. Ive been hypothyroid for 30 years and never really felt any different on treatment. I take 100mcg thyroxin daily.

[Jaydee1507 Administrator]

You probably don't feel any different because you're not taking enough Levo. If you take your weight in kilos and times it by 1.6 you will get the approximate amount you should be taking. Your TSH is too high and should be closer to 1.

Surprised that the FT3 test failed. Can you ask them to re do it or refund?

[Sandiij in reply to Jaydee1507]

They're sending another test out free of charge. The vitd and folate failed also. I assume it perhaps clotted.

[Jaydee1507 Administrator in reply to Sandiij]

Might be an issue with the finger prick test. I think they often fail for certain tests. I pay for the blood draw which is a nuisance but I can never get enough blood from my fingers via finger prick, + they never fail.

You have Hashimoto's with those antibodies, don't need both to be positive.

The sages here will want to see your latest vitamin results as well. getting those looking good really makes a difference. B12, ferritin, folate and D3.

[SeasideSusie Remembering in reply to Sandiij]

Sandiij

Just a thought about failed tests, this might help:

Sometimes the sample has haemolysed, ie the red cells rupture. This may be due to:

* bacteria (so clean area thoroughly and allow to dry)

* intense exercise (so don't go mad trying to get the blood to flow prior to the test)

* squeezing the finger to get the blood out (you can gently "milk" the finger but don't squeeze)

* shaking the tube vigourously instead of gently inverting it.

* sample collection was prolonged

* if there was a long delay between sample collection and analysis

* there is too little blood in the tube and too much coagulant for the amount of blood

Watch out for postal strikes when sending your new sample back, at the moment information given for October strikes affect all services on the following dates:

13th, 20th, 25th October

November is virtually a write off and not much information about December yet.

I would recommend paying for Royal Mail's Special Delivery Guaranteed Next Day by 1pm, this will take priority over non-guaranteed services, and the Trackekd24 return envelope is not guaranteed. Keep the receipt with tracking number, track on RM's website and if not delivered the next day you can apply for a refund of your fee.

[SlowDragon Administrator]

Request GP test vitamin D, folate, ferritin and B12

If not already on strictly gluten free diet also request coeliac blood test

What vitamin supplements are you currently taking

was test done early morning, and last dose levothyroxine 24 hours before test

Is Medichecks sending you a new kit as Ft3 result failed

[Sandiij in reply to SlowDragon]

Test was done following regime advised on here. Already on 12 weekly b12 injections and i take vitd3 4000units with k. I take 800ug folic acid, magnesium glycinate 125mg and a b complex (didnt take this for a week before test) I have vit d insufficiency. T3 in september was 4mmol/ l range 3.1-6.8.

[SlowDragon Administrator in reply to Sandiij]

you still need to test vitamin D, folate and ferritin at least annually

You won’t need Folic acid AND vitamin B complex….. only take one or the other

FT3 is low - what was Ft4?

Inadequate dose if Ft4 low

poor conversion if Ft4 is high

Are you gluten free or dairy free

Always worth trying….. rule out coeliac BEFORE cutting gluten

[Sandiij in reply to SlowDragon]

Thank you. Ft4 at the time of the t3 result was 14.2pmol/l(12-22). Ferritin 266ug/l(30-650)

[SlowDragon Administrator in reply to Sandiij]

FT4: 14.2 pmol/l (Range 12 - 22)

Ft4 only 22.00% through range

FT3: 4 pmol/l (Range 3.1 - 6.8)

Ft4 only 24.32% through range

Helpful calculator for working out percentage through range

Was test done early morning and last dose levothyroxine 24 hours before test

most people when adequately treated will have Ft4 and Ft3 at least 50% through range

Did you get 25mcg dose increase in levothyroxine after this result

Bloods should be retested 6-8 weeks after any dose change or brand change in levothyroxine

[Sandiij in reply to SlowDragon]

I had no increase following those results. Now the ft4 is 17 i dont think GP is likely to increase it. Hopefully now my vitamin b12 deficiency and vitd insufficiency is being addressed things may pick up. Vitamin problems only diagnosed july and august. Thank you for your help.

[SlowDragon Administrator]

Ferritin looks good. Can be deceptive, as ferritin can be high due to inflammation of Hashimoto’s ….iron can be low despite high ferritin

NHS easy postal kit vitamin D test £29 via

vitamindtest.org.uk

[SlowDragon Administrator]

Approx how much do you weigh in kilo

pathlabs.rlbuht.nhs.uk/tft_...

Guiding Treatment with Thyroxine: 

In the majority of patients 50-100 μg thyroxine can be used as the starting dose. Alterations in dose are achieved by using 25-50 μg increments and adequacy of the new dose can be confirmed by repeat measurement of TSH after 2-3 months. 

The majority of patients will be clinically euthyroid with a ‘normal’ TSH and having thyroxine replacement in the range 75-150 μg/day (1.6ug/Kg on average).

The recommended approach is to titrate thyroxine therapy against the TSH concentration whilst assessing clinical well-being. The target is a serum TSH within the reference range. 

……The primary target of thyroxine replacement therapy is to make the patient feel well and to achieve a serum TSH that is within the reference range. The corresponding FT4 will be within or slightly above its reference range.

The minimum period to achieve stable concentrations after a change in dose of thyroxine is two months and thyroid function tests should not normally be requested before this period has elapsed.

[Sandiij]

Would a raised Crp be caused by the thyroid problem?

I weigh 85kg so 136mcg. Will ask gp for 25mcg increase.

[SlowDragon Administrator in reply to Sandiij]

High CRP ….could be due to Hashimoto’s ….but could be other issue

GP should do full iron panel test as CRP is high….ferritin could be falsely high with high CRP

Also GP should repeat CRP in 6-8 hours