Confused

[Rachel20]

Hey everyone...2 weeks ago i had a thyroid test with monitor my health my tsh level was 4.73.Which indicated subclinical underactive thyroid.This week on Monday i did another test with medi checks and my tsh levels were 2.72 and i was tols my throoid was completely normal.So confused now.Has anyone else experienced this.I do have other test but am just asking specifically about tsh levels right now

[tattybogle]

were both done at 9am ?

are both TSH lab range the same ?

[Rachel20 in reply to tattybogle]

First one done with monitor my health around 7 to 7.30am. Tsh was 4.72.Second done at 8.20am with medicheckss two weeks later Tsh was 2.72

[tattybogle in reply to Rachel20]

first one was bit 'early' .. so that probably explains most of the difference ... then once you add in the fact it was not the same day so TSH would always be a bit different anyway ...and then add on that labs are allowed a small % variation in the result of the sam e blood sample anyway .. and then add on they were probably done on different 'platform'( test machine) made by different manufacturer with slightly different ref ranges .... TSH test are fairly standardised nowadays but here is still a bit of a difference between results done using different platforms... for some platforms this difference is insignificant.. but for some it is more noticeable. ... the you can see that there is plenty of room for a smallish difference in your results.

no point doing fingerprick tests earlier in the morning that you would be able to get an NHS blood draw appointment ,, as a 8.30/9 am TSH test will nearly always be a bit lower than an 7/7.30 am test .. and for NHS diagnosis you will have to have NHS test... s basically your 7/7.30 am test doesn't count because all the ref ranges for TSH testing were calibrated to to relate to 'daytime' testing .. ie, sort of 9-5 ish

[Rachel20 in reply to tattybogle]

Does this mean i cant rely on my 1st test and my thyroid is fine do you think

[tattybogle in reply to Rachel20]

well , it well it means your 2nd set gives a truer picture than your first .

And that set shows no significant problems ......and the negative antibodies mean your GP has no evidence of thyroid disease and therefore no reason to expect a thyroid problem .

So your thyroid MIGHT be absolutely fine IF those are your usual levels of TSH and fT4 ... and IF the TSH does not show a rising trend over a few months / years and the fT4 does not show a falling trend ... the only way you can answer that question is to retest a few months apart over a year or so and see what happens to those levels .

or:

your thyroid may not be 100% 'happy' ...(but it's certainly not bad enough to get any diagnosis or treatment for it yet)...... it is more common for healthy people to have TSH closer to 1 than 3

and while some healthy people do have lowish fT4 levels like yours ~ if their body was really content with that level of T4 you would expect their TSH to have remained in it's 'happy place' (usually closer to 1 for most people) and not have gone up to nearly 3 (which suggests the body is asking the thyroid to try to make a bit more T4) .

But your results will not concern GP at all at this point .. because while most people have TSH nearer to 1 , not everybody does. .. there are a few people who's 'healthy' TSH is always around 2 or even 3 .

The graph in this link shows clearly that more people have it closer to 1 , but 3 can be healthy too. healthunlocked.com/thyroidu...

This image shows TSH/ fT4/ fT3 patterns for 10 healthy individuals so you can see the wide range of what is possible for healthy people i've converted your 2nd results to '% through range' so you can compare them to these 'healthy subjects'

TSH : 2.72 ( 0.27 - 4.2) 62 %

FT4: 14.6 (12 - 22) 26 %

FT3: 4.75 (3.1 - 6.8) 44 %

You can see that while plenty of healthy people have T4 and T3 at 25% , none of those people have TSH anywhere near 50 % let alone 62% .. so this is why i said your thyroid 'might' be struggling a bit at the moment.... but if you can improve your vitamin levels as per slowdragon's advice it may help everything work better

.

[Rachel20 in reply to tattybogle]

Thank you.Yes have taken all of slow dragons advice.Although have not had a gp test as of yet or have spoken to my gp about thyrpid as of yet.I am to have an appointment next week.

[SlowDragon Administrator]

please add all other results and ranges

Ft4 and Ft3

Plus Thyroid antibodies and vitamins too

[Rachel20 in reply to SlowDragon]

Previous results tsh.4.73

T3 4.4

T4 12.9

Medichecks results

Tsh 2.72. (0.27_4.2)

T3. 4.75(3.1_6.8

T4 14.6(12_22)

Thyroglobin antibodies 32(115)

Thyroid peroxidoen anti bodies 11(34)

CRP HS 1(0-5)

Folate. 6.64 ( 3.89)

Vitamin d. 26. (50-200)

Vitamon b12. 54.5.(37.5_150

Vitamin d and b12 i realise under but how the discrepancy between my thyroid results taken only two weeks apart

[SlowDragon Administrator in reply to Rachel20]

Take these results to GP

B12 is extremely low

You need testing for Pernicious Anaemia before starting on a separate B12 daily supplement or possibly B12 injections

Vitamin D is deficient

GP should prescribe loading dose vitamin D

NHS Guidelines on dose vitamin D required

ouh.nhs.uk/osteoporosis/use...

GP will often only prescribe to bring vitamin D levels to 50nmol.

Some areas will prescribe to bring levels to 75nmol or even 80nmol

leedsformulary.nhs.uk/docs/...

GP should advise on self supplementing if over 50nmol, but under 75nmol (but they rarely do)

mm.wirral.nhs.uk/document_u...

But with Hashimoto’s, improving to around 80nmol or 100nmol by self supplementing may be better

pubmed.ncbi.nlm.nih.gov/218...

vitamindsociety.org/pdf/Vit...

Once you Improve level, very likely you will need on going maintenance dose to keep it there.

Test twice yearly via NHS private testing service when supplementing 

vitamindtest.org.uk

Vitamin D mouth spray by Better You is very effective as it avoids poor gut function.

There’s a version made that also contains vitamin K2 Mk7. 

One spray = 1000iu

amazon.co.uk/BetterYou-Dlux...

It’s trial and error what dose we need, with thyroid issues we frequently need higher dose than average

Vitamin D and thyroid disease 

grassrootshealth.net/blog/t...

Vitamin D may prevent Autoimmune disease 

newscientist.com/article/23...

Web links about taking important cofactors - magnesium and Vit K2-MK7

Magnesium best taken in the afternoon or evening, but must be four hours away from levothyroxine

betterbones.com/bone-nutrit...

medicalnewstoday.com/articl...

livescience.com/61866-magne...

sciencedaily.com/releases/2...

Interesting article by Dr Malcolm Kendrick on magnesium 

drmalcolmkendrick.org/categ...

Vitamin K2 mk7

betterbones.com/bone-nutrit...

healthline.com/nutrition/vi...

Rapid changes in TSH …..Strongly suggests autoimmune thyroid disease

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...

[Rachel20 in reply to SlowDragon]

Thanks slowdragon but am still extremely confused especially having my first test thay said i had subclinical underactive thyroid now on my second test its says im fine ..dont know what to think about having thyroid or not

[SlowDragon Administrator in reply to Rachel20]

Extremely low vitamin levels are either DUE to thyroid not working correctly

Or

Low vitamin levels are affecting how thyroid can work

More likely the first option

[Rachel20 in reply to SlowDragon]

Not sure where to go from here .If i have an nhs test and they come back fine .i will tell my gp the resulta but if my nhs tsh comes back normal i dont think they will ever consider thyroid

[SlowDragon Administrator in reply to Rachel20]

At this stage you need to correct terrible vitamin levels

That’s first step

What were vitamin D, B12 and folate on NHS tests

[Rachel20 in reply to SlowDragon]

I didnt have them tested.Only had tsh f3 and f4 on first test at monitor my health

[SlowDragon Administrator in reply to Rachel20]

Low B12

Are you vegetarian or vegan?

Do NOT start any B vitamins until GP has tested for Pernicious Anaemia

Low B12 symptoms 

b12deficiency.info/signs-an...

methyl-life.com/blogs/defic...

With serum B12 result below 500, (Or active B12 below 70) recommended to be taking a B12 supplement …….as well as a B Complex (starting B complex 2 weeks after B12)

Then once your serum B12 is over 500 (or Active B12 level has reached 70), you may be able to reduce then stop the B12 and just carry on with the B Complex.

If Vegetarian or vegan likely to need ongoing separate B12 few times a week 

B12 drops 

healthunlocked.com/thyroidu...

B12 sublingual lozenges 

amazon.co.uk/Jarrow-Methylc...

cytoplan.co.uk/shop-by-prod...

B12 range in U.K. is too wide

Interesting that in this research B12 below 400 is considered inadequate 

healthunlocked.com/thyroidu...

supplementing a good quality daily vitamin B complex, one with folate in (not folic acid) 

This can help keep all B vitamins in balance and will help improve B12 levels too

Difference between folate and folic acid 

chriskresser.com/folate-vs-...

Many Hashimoto’s patients have MTHFR gene variation and can have trouble processing folic acid.

thyroidpharmacist.com/artic...

B vitamins best taken after breakfast

Thorne Basic B recommended vitamin B complex that contains folate, but they are large capsules. (You can tip powder out if can’t swallow capsule) 

Thorne currently difficult to find at reasonable price, should be around £20 

If you want to try a different brand in the meantime, one with virtually identical doses of the ingredients, and bioavailable too, then take a look at Vitablossom Liposomal B Complex. Amazon sometimes has it branded Vitablossom but it's also available there branded as Yipmai, it's the same supplement

amazon.co.uk/Yipmai-Liposom...

or available as Vitablossom brand here

hempoutlet.co.uk/vitablosso... &description=true

Or 

Igennus Vitamin B complex. Nice small tablets. Full dose is 2 tablets per day. Most people are fine with just single tablet 

igennus.com/products/super-...

IMPORTANT......If you are taking vitamin B complex, or any supplements containing biotin, remember to stop these 7 days before ALL BLOOD TESTS , 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 continue separate B12