New here. Any initial advice please?

[Rabbitm22]

Hi,

I’ve had recent blood tests as below

TSH 4.35 mIU/L (.27 - 4.2) 103.8%

Free T4 (fT4) 18.9 pmol/L (11.2 - 20.2) 85.6%

and these have been similar at previous tests over the last year. GP booked a phone consultation for a few weeks time. Feel like I have some symptoms of sub clinical hypothyroidism now eg weight gain, anxiety, feeling cold but could also be menopause. My Mum has taken levo for years.

Any suggestions on what to ask or expect?

Thank you.

[SlowDragon Administrator]

First test TSH is higher than typical population so bloods should be retested 2-3 months after this test

Does your Mum have autoimmune thyroid disease

Ask GP they test thyroid antibodies and vitamin D, folate, B12 iron and ferritin at next thyroid test

For full Thyroid evaluation you need TSH, FT4 and FT3

plus both TPO and TG thyroid antibodies tested for autoimmune thyroid disease

Very important to test vitamin D, folate, ferritin and B12

About 90% of primary hypothyroidism is autoimmune thyroid disease, usually diagnosed by high thyroid antibodies 

Autoimmune thyroid disease with goitre is Hashimoto’s

Autoimmune thyroid disease without goitre is Ord’s thyroiditis. 

Both are autoimmune and generally called Hashimoto’s.

Low vitamin levels are extremely common when hypothyroid, especially with autoimmune thyroid disease (Hashimoto’s or Ord’s thyroiditis)

20% of autoimmune thyroid patients never have high thyroid antibodies and ultrasound scan of thyroid can get diagnosis 

In U.K. medics hardly ever refer to autoimmune thyroid disease as Hashimoto’s (or Ord’s thyroiditis)

Recommended on here that all thyroid blood tests early morning, ideally just before 9am

This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip)

what time was previous test

Private tests are available as NHS currently rarely tests Ft3 or all relevant vitamins

List of private testing options and money off codes

thyroiduk.org/getting-a-dia...

Medichecks Thyroid plus antibodies and vitamins

medichecks.com/products/adv...

Blue Horizon Thyroid Premium Gold includes antibodies, cortisol and vitamins

bluehorizonbloodtests.co.uk...

NHS easy postal kit vitamin D test £29 via

vitamindtest.org.uk

Only do private testing early Monday or Tuesday morning. 

Watch out for postal strikes, probably want to pay for guaranteed 24 hours delivery 

Link about thyroid blood tests

thyroiduk.org/getting-a-dia...

Link about Hashimoto’s

thyroiduk.org/hypothyroid-b...

Symptoms of hypothyroidism 

thyroiduk.org/wp-content/up...

[Rabbitm22 in reply to SlowDragon]

Thank you so much. That’s really useful.

[SlowDragon Administrator in reply to Rabbitm22]

Starting levothyroxine - flow chart 

If TSH is over 5 on two separate blood tests (at least 4-6 apart) and symptoms then a trial of levothyroxine could be offered

gps.northcentrallondonccg.n...

[Buddy195 Administrator]

You’ve had great advice from SlowDragon , so can only add that It may be useful to have a look at Dr Louise Newson’s free Balance App, regarding peri menopause symptoms. I find it really useful for highlighting symptoms, medications & up to date research articles. There is also an ability to post questions.

healthunlocked.com/redirect... 

Many members here feel so much better for optimising thyroid medication and key thyroid vitamins. High anxiety was the worst thyroid symptom for me, but following advice here massively helped reduce this.

Keep posting if you require further information or support Rabbitm22; we are here to help! 🦋

[Rabbitm22 in reply to Buddy195]

Thank you very much. Appreciate the advice.