GP wants urine sample with annual blood test for thyroid…..any idea why?

[Bearo]

Has anyone ever been asked for a urine sample along with their annual NHS blood test for thyroid? I’m 69 and have been treated with Levo for hypothyroidism for a few years but don’t have any other health conditions apart from HBA1C hovering around 40-43. I’ve only been at this surgery for a year and haven’t met my GP.

If he looks at my notes from last year (surely he hasn’t bothered to do that? But if he did)he can see that my TSH was 0.02 and that I admitted having lost weight unintentionally. So he May be thinking I should have had a dose reduction.

I got away with keeping my 100mcg prescription last year and I skip one tablet a week which brought my bloods down to 62% for FT4 and 54% FT3. That was MMH so GP doesn’t know those. Nor does he know I skip a tablet. my prescription requests have been a little bit erratic as every month my Levo lasts four extra days - stupid of me not to maintain ordering as if I still took 28 tablets consecutively.

So what’s with the urine sample?

[Regenallotment Ambassador]

I wonder if it’s a diabetes check maybe? I had a surprise HBA1C recently, I decided they were being funded to test by big pharma… maybe I’m being cynical but I don’t ever remember being tested for it before and suddenly the nurse says, it’s time for your annual HBA1C… weird 🤷🏽‍♀️

I googled it, normal is under 42, pre diabetes is 42-47 according to Dr Google

Good luck xxx 🌱

[GlowCoach Administrator in reply to Regenallotment]

They get targets set for certain 'well person' checks etc that they get paid bonuses for. Likely something like that.

Bearo

[CoeliacMum1 in reply to Regenallotment]

My GP says anything over 37 need’s regular checks… our surgery do a recall for diabetes and cholesterol checks at 50yrs my husband got called in and it was added to my annual checks at 50 too, as I have 3 autoimmune disorders there’s quite a list of tests … my first diabetes one came back a tad high 39 but 5 months later 37, year later 35 this was 7 yrs or so ago and since it’s included every year but I wasn’t not quite pre diabetic (you need more than one reading over 39)… my cholesterol was low and they add that in now every 3 yrs it’s still normal so guess until I’m 60 I won’t get another cholesterol test unless a problem to investigate.

I actually think the diabetes check should be earlier and routine with any hormonal conditions tests you have, as you can avoid getting diabetes and reverse type 2 in most cases, so earlier you know something is heading towards diabetes the earlier you can address it.

I was informed by a friend a Diabetic for more than a decade that Metformin (one of the drugs used to treat diabetes) can upset stomach and deplete B12… she now has colitis and just had removal of gallbladder, last 3yrs high cholesterol and high blood pressure, that drug is not something I think many would want to be on, and if can, be avoided. I can’t say if my friends diet and lifestyle is to blame for the increasing problems but certainly hasn’t helped any other areas although we don’t know what her health would be like without it, but hasn’t stopped full metabolic syndrome deteriorating, her Diabetes is still uncontrolled.

When blood sugar is balanced it helps all other hormones too so there’s some degree of knock on effects to all hormones and metabolic processes, especially with us women.

From my experience if your Blood sugar is slightly out you can bet by healthcare professionals it will be blamed for everything going forward until proven otherwise.

Re Urine test. I have had that test since was on asthma meds (many decades) I had annual bloods/urine tests for kidneys and all been fine until noticed my annual bloods whilst on Levothyroxine and was diagnosed with hypothyroidism/Hashimoto’s, then my serum creatinine changed. All my urine tests so far been fine, but serum creatinine last decade has been high and CKD3a at its highest but it has been down CKD2 then back up, it was when my FT3 levels were better but just a one off test so not sure can take much from that one test … I have looked briefly into this a area and know hypothyroidism can cause rise in serum creatinine when hypothyroid and due to my main symptoms (musculoskeletal) I think I fall into hypothyroid myopathy area.

[Bearo in reply to Regenallotment]

yes, I did wonder if it’s that, as my glucose is a bit high. But HBa1C can be quickly checked with an instant result with a new machine in the GP surgery.

[PurpleNails Administrator]

Urine sample maybe sent off to lab for Urine Albumin to Creatinine Ratio or ACR.  It’s usually tested annually if recorded as pre / diabetic. 

About the test labtestsonline.org.uk/tests....

If in doubt ask what sample going to be tested for.

[Bearo in reply to PurpleNails]

yes, I’ll ask when/if I go for the blood test

[Simonron]

This is the first time I have heard of a Urine test for Thyroid activity under the NHS. Wow - I have been looking for this for literally decades. Here is a piece written by my mother and added to by myself which I have had online for all that time.

torty.org.uk/m-e-joy-anthon...

In short, Blood tests don't or didn't tell the full story. I am continually told they do now but I have doubted that. My Mother's blood tested 'normal' but her Urine did not. She had been wheelchair bound for years but got up and walked - shakily - on the day she got thyroid treatment.

[radd in reply to Simonron]

Simonron,

This is an amazing story of courage and determination, especially given her age.

When we get the right formula it's as if a light suddenly switches on and we can function again within the world.

[Simonron in reply to radd]

Indeed it is. Since my Father died, her drive has been lost. She now is as disabled as ever - more so now that her mind has left her, but she , the woman she was, would be delighted to know that her story is still being read and may yet help other people.

[mstp in reply to Simonron]

Is your mum still on thyroxine or does she have liothyronine (T3) added in? I found this made a huge difference to me and believe my own mum may have not had dementia until the very end but rather a lack of working thyroid meds from when her memory started facing ten years before she died. Food for thought.

[Simonron in reply to mstp]

She is in a nursing home and not getting any thyroid meds at all. I am deeply saddened by this as she hated the idea of living in a home. Her dementia is protecting her from that reality. I have no control over her meds. I have tried.

[mstp in reply to Simonron]

Oh dear. That is really sad. I would have thought care homes would be bound by law to make sure people had the meds they need. Obviously not. Doesnt bode well for me then as I medicate myself not through the GP!

[nightingale-56 in reply to Simonron]

Simonron I was at that Thyroid UK Conference and heard your Mother speak. At the time it was all very new to me, but her speech and enlightenment gave me much hope. When I began to think that I had dementia in 2018, I eventually found that I needed B12 injections. I do hope your Mother can rally round from this current problem.

[Simonron in reply to nightingale-56]

Incredible ! I shall do my best to tell her today ! Many thanks for your comment. It means a lot to me. 😃

[Simonron in reply to nightingale-56]

I have Long Covid and I too am having B12 injection which are helping to some extent.I have not had the Urine test ! If anyone has details on how I could have such a test under the NHS, please tell me.

My Dr wants to know!

[nightingale-56 in reply to Simonron]

Simonron I am afraid I do not know anything about the urine test. I am self-injecting every other day for B12 as GP would only give one injection (Hydroxocobalamin) every 8 weeks and this was not enough. You will get a lot more advice over on the Pernicious Anaemia forum on HealthUnlocked. You will also get a lot of help on this site if you have any Thyroid blood test results to share. So many knowledgeable people on this site. It has taken 5 years so far and I am still improving on the B12 injections.

[Bearo in reply to Simonron]

we’ll, it might not be a urine test for thyroid at all. The receptionist didn’t know what it was for. I’ll find out when I go for the blood test.

[McPammy]

is it a urine collection over a 24hr period or just a small sample? If 24hr it could be to test your adrenals.

[Bearo in reply to McPammy]

no, it’s just a single pee test. Would love to have my adrenals tested, but I doubt that will happen.

[McPammy in reply to Bearo]

Adrenal/cortisol testing is very easy with a 9am blood draw. I get mine tested every 3 months by my gp. It’s a simple test, the range is normally155-650. Or you can do a private saliva test promoted on this forum. I had a synacthen test 3 days ago ordered by my NHS endocrinologist, why I have no idea as my cortisol is always adequate. Waiting for the results of that now. But boy did I feel fantastic after the test. They inject false ACTH into you and see if your adrenals respond with enough cortisol. Mine definitely did I feel. I felt I could have flown to the moon no problem. Or taken up park hall no problem 😂

[Hedgeree]

Hi Bearo,

If your GP surgery is easily contactable by phone the easiest thing to do is just to ring and ask your surgery 😊

If it's a routine test that's often requested the reception will likely know. Otherwise they'll probably say you'll need to speak with who ever ordered it.

[Bearo in reply to Hedgeree]

I did ask the receptionist but she said it wasn’t in my notes.

[crystalcat10]

i had this request to bring a urine sample in on my anual reveiw . The explanation was that hypothyoid pateints are at an increased risk of kidney disease . i refused , why would i want to be diagnosed with another aliment to be misstreated .

[Simonron in reply to crystalcat10]

Read my Mother's story...

I fully support your doubts though !

[WiscGuy in reply to crystalcat10]

A couple of years ago I wouldn't have understood this outlook. (I have been having problems such that, even though I am typically a slave to inertia, I am changing doctors, because my current doctor has consistently been both wrong and insistent.)

That said, I reluctantly suggest that you agree to the urine test. Maybe they will understand the results and actually help you.

[Bearo in reply to crystalcat10]

ok, that’s interesting

[Gingernut44]

It’s to check your kidney function as hypos are prone to kidney problems. I have been having to do this for my annual check up since having RAI.

[Sususulio]

it’s standard procedure at the group of gp practices where I live - annual review bring a urine sample. I have thyroid issues and other conditions but my husband doesn’t and was the same for him!

Interestingly I don’t get the blood test before the visit 🤷‍♀️ I get my own done anyway but think it’s everything to do with targets and not directed at you individually

[serenfach]

I had a letter yesterday from the GP practice for a blood test appointment at the end of July. I phoned them up and asked what it was for. Oh, she said, its for your diabetes.

I dont have diabetes. Some 9 months ago the blood pressure meds altered my potassium levels, which in turn altered my blood sugar levels. The GP wanted to start treating me until I pointed out the BP meds and their effect. He arranged another blood test, and my levels were fine,

I have never been called for a thyroid test, even after a dose change. But then they dont get paid for thyroids...

[CoeliacMum1 in reply to serenfach]

Yes Blood pressure/water tablets can lower your potassium levels, that can cause your body to produce less insulin so can cause higher blood sugar .

My mum is in this yo-yo problem with heart/water tablets getting her potassium right then blood sugar regulation. 🙄

[Bearo in reply to serenfach]

Yes, on that note my partner thought the invitation to a blood test was just computer generated and that if I don’t book one, no one will notice or chase me up. I’d be tempted to skip it because my TSH is too low for their liking…….but I’d like a repeat HbA1c.

[CoeliacMum1]

I would have thought a diabetes check, unless your kidney tests flagged something at some point … or even just routine after a period of time to keep a record… are you on medication that may require thus investigation?

[Bearo in reply to CoeliacMum1]

no other meds, just Levo.