Need help with my blood test results please! - Thyroid UK

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Need help with my blood test results please!

Anzay15 profile image
18 Replies

Hey everyone,

So Ive diagnosed with hashimotos and hypothyroidism since May and after having my baby.

Im currently taking 125mg levothyroxine.

I recently had a blood test after waiting forever for my GP surgery to fit me in.

I didn't fast before the bloods and I had also taken my medication.

I know optimal tsh should be close to 0..but according to my gp and the NHS, theyre saying I'm too low. Also my ft4 is above the range.

As I had eaten and taken meds before this,these results aren't accurate then are they? According to a few other groups that I've joined, they all say fasting bloods are the most accurate.

3 weeks before this blood test, I ordered a home kit and checked myself. I had fasted before taking this test and also no meds.

This was also 3 weeks after changing my dose to 125mg.. Which I know isn't long enough to test.

I'll attach those results too.

Can someone please help me interpret these results?

Do I need to redo my bloods properly?

Am I not converting efficiently?

Is my dose too high?

Thank you

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Anzay15
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Anzay15 profile image
Anzay15

These are my fasting home test results

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greygoose profile image
greygoose

Hi Anzay15, welcome to the forum.

Eating before a blood test might lower your TSH. But, it depends what you ate. Time of day also affects TSH levels. So, what time was the blood draw?

Taking your levo before will affect the FT4, you will have a false high.

There's no such thing as an 'optimal' TSH. But, a euthyroid - i.e. no thyroid problems - would be around 1. Certainly not 0. However, when on thyroid hormone replacement, most people need a lower TSH because they need higher levels of thyroid hormones.

In your home test, the FT4 is at 123% and your FT3 at 86.49%. So, your conversion isn't brilliant, but I've seen worse.

However, a) you tested too soon, so these results aren't all that reliable; b) you have Hashi's, so levels can fluctuate. So, from these result you can't really judge if you're taking too much levo.

So, the question is: how do you feel? If you feel you might be over-medicated, try dropping your dose a little - without consulting your doctor because then it gets complicated. If you feel better, then you were taking too much. If you feel worse, then put the dose back up to what it was.

But, in any case, I wouldn't redo the tests right now. Stay on a steady dose of at least six weeks first. And, if you do it early morning - before 9 am - and fast over night, 24 hour gap between last dose of levo and the blood draw, then that will give you a better idea of where you are. :)

Anzay15 profile image
Anzay15 in reply togreygoose

Hey thank you! Thank you so much for your reply.

So I take my medication at 7am and my blood test was at 11am. I had a bowl of corn flakes and a banana before the test.

Right now, I feel OK. I do get tired but nowhere near as how exhausted I was before starting levothyroxine. My hair is falling out too but then I don't know if that coincides with postpartum hairloss as I was 7 months pp when diagnosed.

I've been on 125mg for 7 weeks.

My doctor wants to adjust my dose, most likely lower it based on the high ft4. I've still to speak to a doctor... Its not easy getting appointments of any sort on the NHS!

What I was thinking was to order a home kit and test after fasting and no meds and see what the numbers are and then look into adjusting my dose and speaking to the doctor.

Would you say this is a good approach as I've been on 125mg for 7 weeks now.

greygoose profile image
greygoose in reply toAnzay15

If you've been on a steady dose for 7 weeks, then yes. But, don't be surprised if your doctor won't accept the results of a private test. They can be a bit pernickity about that!

So, the gap was only 4 hours! You would have been right in the middle of your peak. So, you do have a false high FT4, there. Don't let him reduce your dose based on that! :)

Anzay15 profile image
Anzay15 in reply togreygoose

I'll test myself to see where I am anyway, and then if it's still similar, maybe decrease my dose. I've been advised in another group that I've joined on Facebook, that I'm not converting properly and should get my reverse t3 checked and I probably need t3 meds.I thought as my ft3 is on the higher side, I'm converting fine.

So many different opinions and it gets confusing!

But your explanation makes sense 😊 thank you

Anzay15 profile image
Anzay15 in reply togreygoose

Also would you say it could be a potential conversion issue as my ft3 is in range? Do I need t3 meds?

greygoose profile image
greygoose in reply toAnzay15

Given that you have a false high FT4, it's impossible to say, because you can't judge how false it is. But your FT3 is slightly over-range so highly unlikely you need T3.

tattybogle profile image
tattybogle in reply togreygoose

just a heads up GG .... typo ? fT3 results 5.9 [4.3 -6.8] and previous 6.3 [3.1-6.8]

" but your FT3 is slightly over-range so ..."

greygoose profile image
greygoose in reply totattybogle

Must be something wrong with my eyesight! lol Thanks for picking up on that. Not a typo, no. Or, I was mixing the OP up with someone else. Still, doesn't change much in what I said. I don't think she needs T3

SlowDragon profile image
SlowDragonAdministrator

Refuse to reduce dose and get new NHS test in another 2 months

Book test early morning, ideally just before 9am, only drink water between waking and test and last dose levothyroxine 24 hours before test

Which brand of levothyroxine are you currently taking

What are most recent B12, folate and ferritin results

What vitamin supplements are you currently taking

As you have Hashimoto’s GP should do coeliac blood test…..have they?

If not get tested BEFORE considering trial on gluten free diet

Anzay15 profile image
Anzay15 in reply toSlowDragon

Hey thank you, I'll try to get another appointment booked.. Its mad as they say they're booked up to 2 months in advance and the only appointments they give me are cancellations.. So they can be at any time of the day. That's when I get confused as to how to fast and take my dose accordingly as it probably will be more than 24 hours.

I still need to speak to the doctor and tell her I don't want to reduce my dose... I dont know how to convince her that it needs to be fasting bloods as they don't believe in that and say its not required.

I'm currently on 100mg Accord and 25mg Teva.

I'm not very consistent yet with my supplements but I have zinc, iron, vitamin d, vitamin b12, selenium and I'm taking black seed oil.

Ive heard a lot about probiotics I haven't started taking any yet.. I feel so overwhelmed with all the different recommendations.

I need to emphasise to my gp that I have hashimoto as this isn't something the gp tested for.

How shall I ask for celiac testing? I have a feeling they're going to say I don't need to be tested if I don't have symptoms.

Also I've been told that I should go gluten free regardless as it helps lower antibodies and helps with symptoms.

Shall I get tested for it or just trial gluten free?

Also im lactose intolerant... So would it be wise to go dairy free too? I currently use lactose free products and I feel fine.. But when I have normal cows milk, it causes stomach issues.

I really appreciate everyone's advice

SlowDragon profile image
SlowDragonAdministrator in reply toAnzay15

How shall I ask for celiac testing? I have a feeling they're going to say I don't need to be tested if I don't have symptoms.

Explain to GP you are thinking of trialling gluten free diet as you have autoimmune thyroid disease and that you understand NICE recommends that all autoimmune thyroid patients should be tested for coeliac disease

Most GP’s only ever call Hashimoto’s autoimmune thyroid disease. They frequently completely ignore the autoimmune aspect and simply treat the subsequent hypothyroidism

coeliac test and autoimmune thyroid disease

nice.org.uk/guidance/ng20/c...

1.1 Recognition of coeliac disease

1.1.1 Offer serological testing for coeliac disease to:

people with any of the following:

persistent unexplained abdominal or gastrointestinal symptoms

faltering growth

prolonged fatigue

unexpected weight loss

severe or persistent mouth ulcers

unexplained iron, vitamin B12 or folate deficiency

type 1 diabetes, at diagnosis

autoimmune thyroid disease, at diagnosis

irritable bowel syndrome (in adults)

first‑degree relatives of people with coeliac disease.

I dont know how to convince her that it needs to be fasting bloods as they don't believe in that and say its not required.

Just say you need early morning appointment because of work/caring or other commitments

NHS England Liothyronine guidelines July 2019 state quite clearly

sps.nhs.uk/wp-content/uploa...

See page 13 last box ….test should be Early morning BEFORE taking levothyroxine

Vitamin testing, if not had folate, B12 and ferritin tested these need testing now - same document

sps.nhs.uk/wp-content/uploa...

Page 9

Test for Deficiency of any of the following: Vitamin B12, Folate, Vitamin D, Iron

HealthStarDust profile image
HealthStarDust

The results suggest your dose is too high. But, as you’ve explained taking the medication on the day before the test would have influenced results. Suggest you speak to GP, explaining you want to repeat test if you think the dose is right and you feel well.

I’m just a newbie, and the admins will be able to advise much more and better.

Anzay15 profile image
Anzay15 in reply toHealthStarDust

Thank you, yes I panicked thinking its going to be more than 24 hours since my last dose so I took my medicine. Not sure if I can adjust the timings of my medication the day before my blood test so I'm within the 24 hour window.

HealthStarDust profile image
HealthStarDust in reply toAnzay15

Try the pinned posts on blood test protocol for tips.

tattybogle profile image
tattybogle in reply toHealthStarDust

it's here Anzay : healthunlocked.com/thyroidu... suggested-thyroid-hormone-test-timing-protocols

Anzay15 profile image
Anzay15

Hey everyone,

So I ordered a kit and tested again.

It was 22 hours between dose and blood test.

These are my results.

Can you please have a look and see how it compares to the above?

In the doctors comment under these medicheck results, he says I'm slightly hyper and should reduce the dose. My GP is also saying to reduce to 100mg based on the previous results (posted above)

What does everyone suggest? Thank you

greygoose SlowDragon

Anzay15 profile image
Anzay15

Current fasting results

New results

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