Hi, I'm asking on behalf of an adult female relative. She's recently getting fatigued, putting on weight and has lost motivation, she feels burnt out. She's been going through a stressful time in her life and is late 40's so this could be down to peri-menopause and stress.
Her GP didn't test ferritin, folate, vit B12, or vit D! Which seems rather odd to me when the GP was meant to be checking for causes to her symptoms. So I've suggested she ask her GP for vit/mins to be checked too.
The GP did test TSH: 0.83 (lab range 0.2 - 4.0). Is this TSH level OK? She's not on any medication of any kind.
Thanks
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HEA72
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The GP did test TSH: 0.83 (lab range 0.2 - 4.0). Is this TSH level OK? She's not on any medication of any kind.
TSH alone cannot determine our thyroid status. It needs FT4 and FT3 as well although FT3 is rarely done. Thyroid antibodies are a useful test too.
If the doctor only tests TSH it can't rule out Central Hypothyroidism which is where the problem lies with the pituitary or the hypothalamus rather than the thyroid and this is shown by a low, normal or minimally elevated TSH along with a low/below range FT4.
If she can't get full tests done with GP maybe consider one of our recommended private labs. - MonitorMy Health (an NHS lab at Exeter hospital so results should be acceptable to GP), Medichecks or Blue Horizon.
She should follow out advised testing protocol too:
* 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).
These are patient to patient tips which we don't discuss with phlebotomists or doctors.
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