* 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:
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, split dose and 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 doctors.
I am experiencing hair loss since July and it hasn’t improved much since starting on Levo
Your low iron/ferritin could the culprit. It's said that ferritin needs to be 70 for hair regrowth.
Do you think I may need to add T3 given it is mid-range but T4 is high in the range.
Not at this stage, in my opinion. You need to optimise your nutrient levels first, all nutrients need to be at optimal levels for thyroid hormone to work properly and good conversion to take place. Your iron/ferritin needs work.
Serum iron: 55 to 70% of the range, higher end for men - yours is 19.86%
Saturation: optimal is 35 to 45%, higher end for men - yours is ?
Total Iron Binding Capacity (TIBC) or Transferrin: Low in range indicates lack of capacityfor additional iron, High in range indicates body's need for supplemental iron - yours is ?
Ferritin: It's suggested that half way through range is required although some experts say the optimal ferritin level for thyroid function is 90-110ug/L
I would suggest getting the full iron panel if possible and a full blood count to see if you are anaemic.
You can help raise your level by eating liver regularly, maximum 200g per week due to it's high Vit A content, also liver pate, black pudding, and including lots of iron rich foods in your diet
GP said it’s in range but when I talked about symptoms agreed to prescribe me iron tablets and later liquid form. However, both caused digestive issues so I opted for Thorne supplements - they seem more gentle on me.
I can't see any FBC results, just wondering if they showed anaemia .
GP did the right thing but it's a shame they couldn't find a form of iron suitable for you. If you are happy to buy your own that's fine but do make sure that your GP monitors you by doing regular tests to check your levels .
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Advice on thyroid results
Blood results any input welcome
Blood test results help PLEASE. 
Advice on Blood Test Results
Blood test results - any advice?
