Help understanding TSH - seemingly quick decline

[ttcsolomummytobe]

Hi all,

Not sure you anyone can shed light or explain a little more of what this may mean. ( I will be requesting a call with GP tomorrow but just concerned re the recent comment on my test.

I had my TSH tested on 10th Feb 23, day 21 of my cycle at 12 in afternoon, it was showing 0.73niu/L with a comment "normal - suggests patient is possibly euthyroid.

My prior test on 23rd January 23, day 3 of my cycle was 1.5miu/L

Looking back on my medical record I can see I was tested in

May 22 0.99miu/L

November 21 1.2miu/L

I understand these things can fluctuate but by so much ? Also the "possible euthyroid" , does this mean I should be testing for other health issues?

Also my 2 other concerns -

My Mum was diagnosed with thyroid cancer but completed tests and was advised it wasn't a genetically passed one.

Also since my last IUI fertility treatment failed on 21st January I have been trying to reduce my calorie intake and increased exercise to try reduce my BMI in the next 3 months before looking at starting IVF. I have lost around 5lb since then. Would this be impacting my TSH?

Thank you in advance for any ideas/explanation.

[tattybogle]

For TSH 0.73 to 1.5 is not a big fluctuation at all.. it can move that much within each day ..

Going up and down from eg 0.05 to 6 and back down to 0.05 again within a few weeks ,, that would be a significant fluctuation. and might be cause for concern .

TSH has a circadian rhythm so it is higher early am falling to lowest between 1-3pn ish .. then rising again .. and this rise and fall is not a smooth line , there are little mini spikes within it about every 45 minutes.

So your TSH variation is nothing to be concerned about , and your TSH level is not any cause for concern wither , because a level close to 1 is where TSH sits for the majority of healthy people.

" suggests patient is possibly euthyroid" don't read anything into the 'possibly ' lab comments are very general, it is not meant to be diagnostic comment .. it just means on the basis of the information we have here , this patient could be euthyroid

(Euthyroid means "thyroid function is normal" )

[ttcsolomummytobe in reply to tattybogle]

Thank you for your reply, explanation and reassurance x

[SlowDragon Administrator]

Infertility is common with thyroid issues

You need FULL thyroid and vitamin testing

ESSENTIAL to test vitamin D, folate, B12 and ferritin before TTC

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

Also both TPO and TG thyroid antibodies tested at least once 

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

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)

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...

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...