Blood results : Hi this is my second post so far... - Thyroid UK

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Blood results

Btsfan profile image
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Hi this is my second post so far regarding my under active thyroid which iv suffered with for over 4 years. My initial post was regarding the weight gain & nothing seems to shift it, I received a lot of replies to which I’m grateful & I have received my results today which are as follows

Thyroid function test

Serum TSH level 0.59 mu/L [0.27 - 4.2

I did request a lot more things to be tested but the nurse basically told me that she was the nurse & knew best!! I have a Dr appointment on 12th July to see a new Dr at my surgery & was after more advice from you knowledgable people on what to ask/PUSH for as I don’t want to keep getting fobbed off. Ty in advance xx

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Btsfan
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Jaydee1507 profile image
Jaydee1507Administrator

Your TSH is looking pretty good which is why your doctor is fobbing you off. Thats really only a fraction of the story though. For a full assessment you need TSH, FT4 & FT3 done which the NHS almost never does.

Most people in this group pay for private blood tests to see exactly what is happening in all 3 levels and to assess and monitor their nutrient levels. See link for companies offering private blood tests & discount codes, some offer a blood draw service at an extra cost. thyroiduk.org/help-and-supp...

To feel well many thyroid patients have to take charge of their own care. Leaving it up to the NHS often doesn't work. They just don't have the knowledge or understanding that a patient group like this does.

You likely have low vitamin levels and may not be converting your Levo into the active hormone T3. WE won't know that for sure though unless you get it tested.

When hypo we get low stomach acid which means we cannot absorb vitamins well from our food, regardless of a great diet. For thyroid hormone to work well we need OPTIMAL levels of vitamins. Have you recently or could you ask your GP to test levels of ferritin, folate, B12 & D3?

Recommended blood test protocol: Test at 9am (or as close as possible), fasting, last levo dose 24hrs before the blood draw & no biotin containing supplements for 3-7 days (Biotin can interfere with thyroid blood results as it is used in the testing process)? Testing like this gives consistency in your results and will show stable blood levels of hormone and highest TSH which varies throughout the day. Taking Levo just prior to blood draw can show a falsely elevated result and your GP/Endo might change your dose incorrectly as a result.

Btsfan profile image
Btsfan in reply to Jaydee1507

thank you for your quick reply, I did everything you suggested b4 & asked the nurse to test all the ferritin etc, but she basically rolled her eyes at me, this is what I mean about the NHS just fobbing me off, I had a great nurse 4 years ago to start with & then she left & my GP was bloody hopeless, that’s why I’m hoping the new one will actually listen. Is it worth asking to be referred to an endocrinologist as I’ve been told they know more about thyroids?? The only issue I have with this Condition now is the weight, thanks again xx

Jaydee1507 profile image
Jaydee1507Administrator in reply to Btsfan

Its not usually the nurse that requests tests, its your GP. By all means ask your GP and they might run those tests but if they don't and you want to be able to move forward with this then you need to buy a private test.

Your thyroid hormone won't work well with less than OPTIMAL vitamin levels.

Most Endo's are diabetes specialists and you would have to pick very carefully which one you got referred to. Getting T3 prescribed on the NHS can be a post code lottery depending on what your ICB rules are and if your local Endo's believe in T3 - many don't.

Information you get here will far outstrip a 15 minute consultation with any Endocrinologist. They just don't have the skills to make us well.

All that said and you still wouldn't have tackled the low vitamin levels that you highly likely have due to years of being hypo and poor vitamin absorption.

Btsfan profile image
Btsfan in reply to Jaydee1507

ok thank you for all your help, I’m sure I will be in touch again 👍 x

SlowDragon profile image
SlowDragonAdministrator

No point requesting a referral to endocrinologist yet

First step is always to get FULL thyroid and vitamin test

You’re currently taking 150mcg levothyroxine

Do you always get same brand levothyroxine at each prescription

Have you had thyroid antibodies tested for autoimmune thyroid disease, also called Hashimoto’s

This should have been done at original diagnosis

Bloods should be retested 6-8 weeks after each dose change or brand change in levothyroxine

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 year minimum

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

Previous post you said

Vitamin B12, B6 and D deficiency. I was also anemic.

So exactly what vitamin supplements are you now taking

Vitamin D, folate, ferritin and B12 need testing at least annually

Levothyroxine can not work unless all four vitamins are at optimal levels

Many (most? ) thyroid patients need to supplement daily vitamin D, magnesium and vitamin B complex continuously

Initially a daily B12 until B12 high enough for sometimes continuing with just B complex

If ferritin low you need full iron panel test for anaemia

Many thousands of U.K. patients forced to test privately to make progress

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.

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...

Tips on how to do DIY finger prick test

healthunlocked.com/thyroidu...

Medichecks and BH also offer private blood draw at clinic near you, or private nurse to your own home…..for an extra fee

come back with new post once you get results

Btsfan profile image
Btsfan in reply to SlowDragon

hi thanks for all the help, I will be requesting everything you have suggested at my Dr appointment on 12th July, in response to what extra vitamins I take, I have B12, magnesium/ zinc, vitamin D & cod liver daily , with regards to the Levi tablets I generally get the same ones as I live in a small village so our pharmacy tends to get the same, ty again for your knowledge xx

SlowDragon profile image
SlowDragonAdministrator in reply to Btsfan

how much vitamin D

Are you also taking a daily vitamin B complex …not just B12

once your serum B12 is over 500 (or Active B12 level has reached 70), you may be able to reduce then stop the B12 and just carry on with the B Complex.

If Vegetarian or vegan likely to need ongoing separate B12 few times a week

Highly effective B12 drops

natureprovides.com/products...

supplementing a good quality daily vitamin B complex, one with folate in (not folic acid)

This can help keep all B vitamins in balance and will help improve B12 levels too

Difference between folate and folic acid

healthline.com/nutrition/fo...

B vitamins best taken after breakfast

Thorne Basic B recommended vitamin B complex that contains folate, but they are large capsules. (You can tip powder out if can’t swallow capsule)

Thorne currently difficult to find at reasonable price, should be around £20-£25. iherb.com often have in stock. Or try ebay

Other options

healthunlocked.com/thyroidu....

IMPORTANT......If you are taking vitamin B complex, or any supplements containing biotin, remember to stop these 7 days before ALL BLOOD TESTS , as biotin can falsely affect test results

endo.confex.com/endo/2016en...

endocrinenews.endocrine.org...

In week before blood test, when you stop vitamin B complex, you might want to consider taking a separate folate supplement (eg Jarrow methyl folate 400mcg) and continue separate B12

Post discussing how biotin can affect test results

healthunlocked.com/thyroidu...

Btsfan profile image
Btsfan in reply to SlowDragon

taking 1 a day Vit D 12ug & 1 a day B12 no complex 10ug (no biotin)

SlowDragon profile image
SlowDragonAdministrator in reply to Btsfan

12ug is only 480iu vitamin D

Convert ug to iu here

nafwa.org/vitamind.php

This is highly likely no where near high enough dose

More likely to need at least 2000iu daily as maintenance dose….and more if needing to improve low levels

Similarly B12 10ug (10mcg) is a tiny dose and very very unlikely high enough dose

b12-vitamin.com/dosages/

Come back with new post once you get results

SlowDragon profile image
SlowDragonAdministrator

Examples of private test results

Medichecks

healthunlocked.com/search/p...

Blue horizon

healthunlocked.com/search/p...

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