Blood Test Advice Please

[SilverSavvy]

Hello All

Having recently started on a trial for T3 (as well as my normal T4 dose) I am due some blood tests next Monday. Do I have to stop ALL B supplements from today or just B6? I have a simple Folate/B12 supplement which I can use instead of my normal B Complex. Would that be okay to take this week?

[TiggerMe]

I think it's just Biotin that you need to avoid for 3-5 days before testing if you take it in large doses... separate B12 and folate shouldn't be an issue, not aware that B6 causes any issue either?

Let's see if someone puts me straight there 🙃

[Jaydee1507 Administrator]

You only need to stop any supplement containing Biotin 3-5 days before your blood test. other B vitamins are fine to continue taking right up until the day before your test.

So just take the stand alone supplements this week then after the blood test switch back to the B complex.

[SilverSavvy in reply to Jaydee1507]

Thanks very much guys...will stick to the B12/folate for this week then. Relieved tbh: everything seems to slow down and cause probs without the B12.

[SlowDragon Administrator]

Recommended that all thyroid blood tests early morning, ideally just before 9am, only drink water between waking and test and last dose levothyroxine 24 hours before test

This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip)

On T3 - day before test split T3 as 2 or 3 smaller doses spread through the day with last dose 8-12 hours before test

[SilverSavvy in reply to SlowDragon]

Thanks SlowDragon, I didn't know about the splitting of the T3 either, so that's useful info. Following your earlier advice, I always get my bloods done first thing using your recommended protocol on all else.

At the moment, I'm still slightly titrating up on the T3. Endo suggested I'd need 15mg but after advice from the forum I started on 2.5, then 5 and now I'm on 10. Because I've had to fight to get the T3 and they'll only give me 20mcg tablets (cost-related I'm sure but at least they are Mercury Pharma same as T4) it is very difficult to split the tiny pill but 10mcg is making a good difference and I only take it once per day. I guess we'll know from the blood tests next week if all is well on this dose.

I am feeling quite improved on 100mcg T4 and 10mcg of T3 - more energy, better concentration, sleeping pretty well. I'm slightly concerned I might not sleep if I have another 5mcg in the afternoon. Is it vital to have it twice per day or is it okay just to have the 10mcg in the morning do you think?

[SlowDragon Administrator in reply to SilverSavvy]

I would recommend splitting as 2 x 5mcg everyday, especially initially

Can cut with sharp scalpel into 1/4’s

[SilverSavvy in reply to SlowDragon]

I have a pillcutter (with a scalpel edge) but it's not even easy to cut into half cleanly, never mind quarters...and I don't want to waste any. Which has sometimes happened.

Why is it important to split it and not have it all at once pls?

[SlowDragon Administrator in reply to SilverSavvy]

Day before test you need to split T3 as it’s only measurable in blood for 12 hours after taking (lasts longer in cells)

TSH more likely to become suppressed with one larger dose T3

But mainly many people find it better/smoother

Though some people prefer single dose

It’s all trial and error what suits you

I don’t get on with pill cutter

I use scalpel and take as 4 x 1/4 tablet per day

amazon.co.uk/Scalpel-Suitab...

[SlowDragon Administrator in reply to SilverSavvy]

I'm slightly concerned I might not sleep if I have another 5mcg in the afternoon.

Many members find T3 improves sleep

Lots of us take last dose at bedtime when on 3 doses per day

[SilverSavvy in reply to SlowDragon]

Thanks again Slow Dragon. I didn't know single dose T3 could suppress TSH so that's really useful experience...maybe I will try the scalpel if smaller doses are not going to stop me sleeping. Presumably then it doesn't matter about taking T3 on an empty stomach then, unlike T4?

[SlowDragon Administrator in reply to SilverSavvy]

Ideally nothing apart from water for an hour before

And about 45 minutes after taking

[SilverSavvy in reply to SlowDragon]

Thanks, will give it a go

[SilverSavvy in reply to SilverSavvy]

Btw SD, I am curious to know why it's necessary to titrate up very slowly on T3...I guess it's to do with the TSH suppression you mentioned. But what would that look like in terms of symptoms? My T4 was 80% through the range when I started on it but my T3 only about 25% through the range which is why the endo/doc agreed a trial. And whilst I've been on it many things have improved but I'm also quite swollen up with water retention which I thought was due to the heat but that's gone now and yet the fat legs have not! Would that be overmedication with the T4 kicking in do you think? Also, although my heart rate is still fairly low and no palpitations, I do sometimes feel a bit anxious again.