Test results

[Billy2023]

Hi I have just got my results because but not sure what to make of it please. They are in range but only just from what I can see. I'm currently on 100 mg of levo for underactive. I have been feeling awful but feeling better over past week or so when took blood test. I've changed my hrt. Reduced and waiting a lot longer before taken anything like coffee or vitamins after levo dose. Would thus be why?

Many thanks

Thyroid Hormones

TSH 0.36 mIU/L (Range: 0.27 - 4.2)

Free T3 3.5 pmol/L (Range: 3.1 - 6.8)

Free Thyroxine 19.1 pmol/L (Range: 12 - 22)

Autoimmunity

Thyroglobulin Antibodies 88.1 kIU/L (Range: 0 - 115)

Thyroid Peroxidase Antibodies 25.2 kIU/L (Range: 0 - 34)

[SlowDragon Administrator]

FT4: 19.1 pmol/l (Range 12 - 22)

Ft4 71.00% through range

FT3: 3.5 pmol/l (Range 3.1 - 6.8)

Ft3 only 10.81% through range

Helpful calculator for working out percentage through range

thyroid.dopiaza.org/

Was test done early morning and last dose levothyroxine 24 hours before test ?

assuming it was….shows poor conversion rate of Ft4 to Ft3

Most people when adequately treated will have Ft3 at least over 50% through range

Did you also test vitamin D, folate, B12 and ferritin

What vitamin supplements are you currently taking

Next step is to get vitamins tested and maintain at OPTIMAL Levels

Which brand of levothyroxine are you currently taking

Do you always get same brand

You could try taking levothyroxine at bedtime

It may be more convenient and perhaps more effective taken at bedtime

verywellhealth.com/best-tim...

markvanderpump.co.uk/blog/p...

markvanderpump.co.uk/blog/p...

No other medication or supplements at same as Levothyroxine, leave at least 2 hour gap.

Some like iron, calcium, magnesium, HRT, omeprazole or vitamin D should be four hours away

(Time gap doesn't apply to Vitamin D mouth spray)

If you normally take levothyroxine at bedtime/in night ...adjust timings as follows prior to blood test

If testing Monday morning, delay Saturday evening dose levothyroxine until Sunday morning. Delay Sunday evening dose levothyroxine until after blood test on Monday morning. Take Monday evening dose levothyroxine as per normal

Increasing number of members find it smoother/more tolerable to split levothyroxine as two smaller doses, half dose waking, half dose at bedtime. 

It might also possibly improve conversion rate of Ft4 to Ft3

Similarly if normally splitting your levothyroxine, take whole daily dose 24 hours before test 

[Billy2023 in reply to SlowDragon]

Thank you so much. I take feroglobin liquid. All my results seem to be in range but not optimal I don't think. I do get same brand of levo

[SlowDragon Administrator in reply to Billy2023]

Never supplement iron without doing full iron panel test for anaemia first and retest 3-4 times a year if self supplementing.

It’s possible to have low ferritin but high iron 

Medichecks iron panel test 

medichecks.com/products/iro...

Any iron supplements need to be at least 4 hours away from levothyroxine

[Billy2023 in reply to SlowDragon]

I'm sorry I took test at 9 am bit I took levo in morning as well as want told not! Have I messed up results?

[SlowDragon Administrator in reply to Billy2023]

So yes…..FT4 is falsely high if took levothyroxine before test

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

Retest including vitamin D, folate, B12 and ferritin

Cheapest (as you don’t need to retest antibodies) is Monitor My Health

Recommended that 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...

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. 

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...

[SlowDragon Administrator]

Thyroid antibodies

Were these ever tested in past

Have you ever had ultrasound scan of thyroid

[Billy2023 in reply to SlowDragon]

I don't think I have. I haven't had ultrasound, why do you ask please?

[SlowDragon Administrator in reply to Billy2023]

Antibodies are currently below range. They may have been higher in past

How long since original diagnosis and have you been on levothyroxine

If antibodies have ever been high in any test, this confirms cause is autoimmune thyroid disease……even if now within range,

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.

20% of Hashimoto's patients never have raised antibodies and ultrasound can diagnose Hashimoto’s

healthunlocked.com/thyroidu...

 

Paul Robson on atrophied thyroid - especially if no TPO antibodies 

 paulrobinsonthyroid.com/cou...

Gluten intolerance is often a hidden issue with all autoimmune diseases

Only 5% of Hashimoto’s patients test positive for coeliac….but Approximately 81% more find strictly gluten free diet helps or is essential

Request coeliac blood test BEFORE considering trial on strictly gluten free diet

[SlowDragon Administrator]

Exactly what vitamin supplements are you currently taking

IMPORTANT to stop any vitamin supplements that contain biotin (eg vitamin B complex) 5-7 days before ALL blood tests as biotin can falsely affect test results

Previous post 5 days ago …..advised to test early morning and last dose levothyroxine 24 hours before test

healthunlocked.com/thyroidu...

Levothyroxine is Ft4.

Ft4 result is false high if have taken levothyroxine before test

Essential to test vitamin D, folate, B12 and ferritin at least once a year