I have been feeling under the weather for a long time now but put it down to age and approaching the menopause years.
I am tired most of the time, memory problems, dry skin (I've had psoriasis for years but its under control), memory lapses/brain fog, weight gain (despite always being the same weight, normal gym routine and 2 miles everyday walking the dog and have tried changing diet), feeling cold most of the time and muscle/joint aches.
I had a private health assessment end of early march and thyroid tests amongst others were part of it, they contacted me as one of the results came back below range:
TSH 1.0 range 0.27-4.2
FT4 13.7 range 11-26
FT3 3.7 range 3.9-6.8
They suggested sub-clinical hypothyroidism to contact my GP and arrange repeat tests. I have been to see the GP to discuss and found her to be quite dismissive at how rubbish I feel, She said that all was fine from the private tests as my TSH and FT4 are in range and they don't need to consider the FT3 reading as it wasn't relevant, she has reluctantly agreed to repeat tests TSH and FT4 at the end of April.
I would appreciate any feedback on this as the GPs dismissive attitude may have skewed my confidence in her.
Many thanks.
Written by
Balloonbbb
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* 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 3-7 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). See
biotin use can result in falsely high levels of T4 and T3 and falsely low levels of TSH
These are patient to patient tips which we don't discuss with phlebotomists or doctors.
If you didn't do the test this way this time then I'd suggest you follow these recommendations for your next test.
For primary hypothyroidism you'd need TSH to be over range and most GPs only diagnose when it's over 10. However, if FT4 is below range that opens up a new possibility, so although nothing will be done based on your current results, hopefully your next test will show something.
Also important to test are Vit D, B12, Folate, Ferritin, as low levels or deficiencies of these can cause symptoms similar to hypothyroidism, maybe ask GP to include these next time.
I had no idea they should be taken earlier, my bloods were done at 11am and I had nothing to eat/drink after my evening meal the night before, I will make sure my next tests are as near to 9am as possible.
My B12 and Iron were all normal, not sure about vit D though so I'll request that.
"Normal" just means that the result is somewhere within the range, it's where within the range that matters, all key nutrients have recommended levels for us Hypos. Do you have the actual results and the reference ranges?
so I had my B12 checked with the GP a few months ago and they said 'normal' but I don't have the stats on that just her word, the doctor from the private appt said iron was normal but I don't see folate or ferritin on the list, would it come under another name?
It would be interesting to see if you have thyroid antibodies so perhaps ask GP to test these.
The vitamin results are very important so also try and get GP to add ferritin, folate, B12 & D3 to the April test.
Unfortunately the NHS rarely even test TSH. T3 is the active hormone and the NHS only prescribe T4 (levothyroxine) which the body needs to convert to T3. In 10-20% of people they are unable to do this naturally. As patients we know that this is wrong and why most here pay for private blood tests.
It is very common for thyroid patients to have their concerns and symptoms dismissed, ignored and blamed on psychological issues which is far from the truth. You will find yourself among good company here.
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