Help please re bloods

[ClareBear1981]

I've been diagnosed hypothyroid for nearly 20 years and take levothroxine. Had bloods done in December TSH was 4.33. Just had a retest and it's now 0.17. What could be causing this? Its usually between 2 and 3.

[SlowDragon Administrator]

Were both tests done as recommended - testing early morning and last dose levothyroxine 24 hours before test

Do you always get same brand levothyroxine at each prescription

How much levothyroxine are you currently taking

Fluctuating levels suggests autoimmune thyroid disease

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.

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

 

For full Thyroid evaluation you need TSH, FT4 and FT3 tested

plus both TPO and TG thyroid antibodies tested at least once

Very important to test vitamin D, folate, ferritin and B12 at least once year minimum

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

what vitamin supplements are you currently taking

[SlowDragon Administrator]

all thyroid blood tests early morning, ideally just before 9am and last dose levothyroxine 24 hours before test 

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

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...

If you can get GP to test vitamins and thyroid antibodies then cheapest option for just TSH, FT4 and FT3

£29 (via NHS private service ) and 10% off down to £26.10 if go on thyroid uk for code

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

monitormyhealth.org.uk/

Monitor My Health also now offer thyroid and vitamin testing, plus cholesterol and HBA1C for £65 

(Doesn’t include thyroid antibodies) 

monitormyhealth.org.uk/full...

10% off code here 

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

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...

[ClareBear1981 in reply to SlowDragon]

Thank you for getting back to me.

Were both tests done as recommended - testing early morning and last dose levothyroxine 24 hours before test

NO I HAVE NEVER DONE THIS BEFORE AND RESULTS HAVE ALWAYS BEEN OKAY.

Do you always get same brand levothyroxine at each prescription

NO my pharmacy dispenses all DIFFERENT BRANDS OF LEVOTHYROXINE

How much levothyroxine are you currently taking

I TAKE 100MCG AND 125MCG ON ALTERNATIVE DAYS.

Fluctuating levels suggests autoimmune thyroid disease

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.

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

For full Thyroid evaluation you need TSH, FT4 and FT3 tested

plus both TPO and TG thyroid antibodies tested at least once

I HAD THYROGLOBULIN TESTED IT WAS 28.8

ALSO THYROID PEROXIDASE ANTIBODIES WHICH WAS 17.8. DOES THIS MEAN I HAVE HASHIMOTO’S?

Very important to test vitamin D, folate, ferritin and B12 at least once year minimum

MY B12 HAS ALWAYS BEEN OKAY . I HAD LOW FOLATE BEFORE AND TOOK A 3 MONTH COURSE OF FOLIC ACID LAST YEAR. GP SAID THERE IS NO NEED TO RETEST. I HAVE NEVER HAD MY VITAMIN D TESTED OR FERRITIN.

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

what vitamin supplements are you currently taking

I CURRENTLY TAKE VITAMIN C, VITAMIN B COMPLEX, VITAMIN D AND MAGNESIUM

MY GP IS NOT VERY FORTHCOMING WITH REGARDS TO TESTING I HAVE TO ASK FOR EVERYTHING. I HAD MY LAST TEST TAKEN THROUGH MEDICHECKS.

[SlowDragon Administrator in reply to ClareBear1981]

Remember to stop taking vitamin B complex 3-5 days before any blood test as contains biotin as biotin can falsely affect test results

endo.confex.com/endo/2016en...

endocrinenews.endocrine.org...

In week before blood test, when you stop vitamin B complex, you might want to consider taking a separate methyl folate supplement and separate B12

Get full thyroid and vitamin testing done once year privately if GP unhelpful

Always test early morning and last dose levothyroxine 24 hours before test

Work out with brand levothyroxine suits you best and always get same brand at each prescription

Antibodies appear to be negative

20% of Hashimoto's patients never have raised antibodies 

healthunlocked.com/thyroidu...

 

Paul Robson on atrophied thyroid - especially if no TPO antibodies 

 paulrobinsonthyroid.com/cou...