Can I eat 6 hours before thyroid test if I don't care about T4?

[The-Wasp]

Hi there! I have an NDT thyroid blood test tomorrow morning at 9:00 am. I have read as many posts as I can to understand how to have the most accurate results possible, but because I am currently on antibiotics, I don't think I'll be able to follow all the excellent recommendations. I usually go to bed at 7 am and wake up at 3 am. My question is whether it is okay for me to drink coffee and eat my breakfast as usual if I don't care about the results for my T4? My T4 results have been super low since I switched to NDT about 9 months ago and I don't think the thyroid blood test accurately gauges T4 if you're on NDT anyway? Is that correct? The instructions from my endo was that it should be a fasting test and I need a test in order for him to give me a prescription, but I don't understand why it's important to fast if we don't care about the T4 results (he said previously that T4 is the least important). The reason I'm asking is that I'm on antibiotics and cannot take a break from them. I already feel pretty terrible due to my infection and the antibiotics. The idea of fasting for 6 hours tomorrow morning is not at all appealing If I save the thyroid medication, the antibiotics and the breakfast for after the blood test, the thyroid medication and the antibiotics will not work at all well (if at all). I also would not be able to eat my usual breakfast because too many foods interact with the antibiotics. I'm feeling very overwhelmed and would love some help! Thank you 🌷

[jimh111]

I’ve never heard of fasting affecting fT4. Some people believe it will affect TSH but I don’t fast and have never seen any credible evidence that a normal (not high fat) meal affects TSH. It is important not to take your thyroid hormone tablets within a few hours before the blood draw.

Your endocrinologist may have requested fasting because they are planning other blood tests such as glucose levels so it’s important you check this out.

[The-Wasp in reply to jimh111]

Thank you so much! Great news 😃 No, there's no glucose levels. I ordered the test through Blue Horizon. I nurse is coming to draw my blood at 9.

[Lalatoot]

I think you can do whatever you want because the infection you are fighting and the effects of the antibiotics on your body will have affected your thyroid hormone levels. Testing when ill and on medication will skew your results.

[The-Wasp in reply to Lalatoot]

Yes, so true! And I just had major surgery to remove an infected kidney stone. Feels like a waste of money, but the timing of the test is mandatory. If I don't do it in time, I have to go without a prescription pay an extra 100 pounds for an "emergency prescription".

[pennyannie]

Hello Wasp :

Ideally you need to follow the same routine as previous blood tests your endo already has then he can evaluate these new results and the actions previously taken against those already on file.

The blood tests are valid for T4 as well as T3 - but when taking NDT we track on the T3 - not the T4 and the T4 reading likely be much lower than when on T4 monotherapy - and that's ok.

Maybe check with endo explaining your issues with the antibiotics and suggest even rolling over another month before follow up - if he can provide you with a prescription in the meantime.

[The-Wasp in reply to pennyannie]

Unfortunately, I can't because the test is tomorrow and I'll be on the antibiotics indefinitely for an infected kidney stone. The endo is immovable about the timing of the test. If I don't do it by the end of November, I need to go without a prescription or pay an extra 100 pounds for an emergency prescription. It's basically a fine.

[pennyannie in reply to The-Wasp]

Ok - since your appointment is tomorrow I guess you'll get charged a cancelltion fee if you don't go -

So I would do what is best for you and the endo will have to work from and adjust his thoughts and recommendations from whatever the blood tests say :

Being on antibiotics and not being well is going to skew the blood test anyway -

and it's likely a waste of time - but if you need it in order to get a new prescription I can't see another way.

[The-Wasp in reply to pennyannie]

Thank you so much🌷I've learned so much from this group. It's so kind of you to take time out of your busy day to help. Everything would've been so much more difficult without you 😃

[The-Wasp in reply to pennyannie]

Not that it matters, but I asked a month as go if I could delay the test and he said I'd have to pay the fine or take the test. It was the same when I was late with a test in the spring due to sepsis. It's just non negotiable. I'm planning to switch to a new practitioner, but with finding a surgeon to take out my stone etc, I haven't had the time or energy.

[pennyannie in reply to The-Wasp]

Oh dear - what a carry on and there's no need for him to be so obnoxious :

Yes - look for somebody else when you feel up to it -

You're dealing with a lot - so try and go just one step at a time :

Wishing you better ;

[humanbean in reply to The-Wasp]

Is this fine being imposed by the NHS? I've never heard such a thing was even possible before. Where does the money go? Into the endo's pocket?

The fact that you have an infection and are on antibiotics is not your fault. And to force you to pay a fine if you miss the test - which won't be accurate because you are ill with an infection and are taking antibiotics - is just absurd and doesn't even sound legal to me.

I think you should do whatever it takes to avoid the fine, but should then make complaints to one or more of the following : the hospital, PALS, the endo, your GP, and your MP.