Major difference with medichecks and nhs tsh same day test

[ali2341]

hi everyone i got a medichecks thyroid panel done as i did one 6 months ago and wanted to see update, i also got nhs tsh test around 12 which came out as 3.5 that was at my local gp office , then about 2 hours later i had medichecks done at local hospital where i got results today and it was 1.81, both ranges are about the same, 0.2 to 4.0 for nhs and medi is 0.27 to 4.2, im shocked how can it be so different the only thing i did was take the test 2-3 hours later and i drank some juice on way to hospital ?

[helvella Administrator]

I suggest you have a look at this Thyroid Patient Canada blog:

thyroidpatients.ca/2020/07/...

It's not the perfect link because we all vary and the rate at which your TSH changes could be very different. And this is in an untreated person!

Reference intervals vary - as you have mentioned. But so too do things like the precise sensitivity across the ranges. And the susceptibility of the assay to interference.

Lack of harmonisation is a major issue. And a very real problem.

Graph showing circadian rhythms of TSH, FT4 and FT3

[Jaydee1507 Administrator]

I believe you're on treatment?

It's recommended to always get bloods done at 9am, fasting, previous dose of Levo 24hrs before and if taking T3 8-12hrs before.. This is as TSH is at it's highest then.

Looks like you need a 25mcgs dose increase.

[Jaydee1507 Administrator]

From a post of yours 6 months ago you said you have Hashi's and were on a T4/T3 combo so I'm a bit confused.

TSH is a good guide for the undiagnosed but otherwise FT4 and FT3 are important.

[tattybogle in reply to Jaydee1507]

heads up

OP is called ali2341 ..... don't know who binkster is ??

[SeasideSusie Remembering]

Binkstar

Are you the original poster who started this thread (ali2341) but with a different username? If so it's confusing to use two user names. If not then please do not piggyback on another member's thread as it takes it off track and it's not really fair on the original poster, please make a thread of your own.

[Hidden in reply to SeasideSusie]

Blinkstar has her own post! I think she's got confused between threads

[Binkstar in reply to SeasideSusie]

As far as I'm aware I have made my own thread, this is my first time on here, if I have done this incorrectly then I apologise.If you wish to delete I understand, sorry.

[ali2341]

im not binsktar, think she mixing up posts, and i think the phenylalanine in my drink actually bought down the tsh lol

[Jaydee1507 Administrator]

I think you replied to someone elses post by mistake.

[Jaydee1507 Administrator]

I have replied to you on your thread here: healthunlocked.com/thyroidu...

[SlowDragon Administrator]

i also got nhs tsh test around 12 which came out as 3.5 that was at my local gp office , then about 2 hours later i had medichecks done at local hospital where i got results today and it was 1.81

TSH has pronounced daily variation

Being highest early morning and dropping to its lowest after lunch

Had you tested at 9am TSH would have been higher …..perhaps over 4

TSH over 2 shows you are currently not on high enough dose levothyroxine

ALWAYS test thyroid levels early morning, ideally just before 9am and last dose levothyroxine 24 hours before test

How much levothyroxine are you currently taking

what were Ft4 and Ft3 results

Did you also get vitamin D, folate, ferritin and B12 levels tested

[ali2341 in reply to SlowDragon]

vitamin D, folate, ferritin and B12 , were done by doctors 6 weeks ago all fine, and over mid range, my t3 t4 are same as last time i updated results , around 50% in range and tpo has come down a bit to 291 , im still on 100mcg t4, as i was having a lot of problems these last few months i was on 125 mcg but i did not feel too good, so i been taking 100 for 2 months, think i need to increase to 125 again

[SlowDragon Administrator in reply to ali2341]

optimal vitamin levels are

Vitamin D at least over 80nmol and between 100-125nmol might be better

Serum B12 at least over 500

Active B12 at least over 70

Folate and ferritin at least half way through range

As you have Hashimoto’s are you on strictly gluten free diet and/or dairy free diet

Do you always get same brand levothyroxine at each prescription

[ali2341 in reply to SlowDragon]

ye same brand , thing vit d was around 60, not on gluten free or dairy but my tpo has come down a lot

[SlowDragon Administrator in reply to ali2341]

vitamin D is too low

Presumably you are now supplementing vitamin D

How much vitamin D are you taking daily?

Likely to need at least 2000iu, perhaps more through winter

Retest in 3-4 months

Are you also taking magnesium and vitamin K2 mk7

What were folate, B12 and ferritin results