Worried about these results please help - Thyroid UK

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Worried about these results please help

Silverlady5 profile image
8 Replies

Had this blood test done in January and had text to say book a non urgent appointment and just put it off also getting print out from docs they’ve requested a telephone consultation which I’ve eventually booked but looking at it I know the TSH is low in their opinion and obviously cholesterol too high I don’t want to go on statins and feel quite fearful of what will be said.

What advice would you knowledgable people give?

! Serum TSH Level (MEENA18612) 0.281. mlU/L 0.35. - 4.94mlU/L

! LIPID PROFILE. (MEENA 18612)

Serum cholesterol 5.9. mmol/L

Serum HDL cholesterol level 1.3 mmol/L

Se non HDL cholesterol level 4.6 mmol/L

Serum cholesterol/HDL ratio 4.5

! Serum triglycerides 1.8 mmol/L 0.00. - 1.60mmol/L

Serum LDL cholesterol level 3.8. mmol/L

Lots of other results but unsure what else to post.

Wasn’t too happy as no vitamin levels were tested this year but any comments on the above would be very helpful.

Many thanks

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8 Replies
Jaydee1507 profile image
Jaydee1507Administrator

Well your TSH may be very slightly below range but thats not terrible at all, its just doctors think it is.

What we can't see though is your free hormone results FT4 & FT3 which would tell us if you really are over replaced. The NHS relies (completely wrongly) on just TSH.

It might be that your FT3 is on the low side.

Suggest you get some private bloods run for a full thyroid panel to include all the key vitamins including vit D.

You should refuse to change your dose if you are feeling good.

What time of day was this test taken? Highest tSH is at 9am or earlier.

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/T3 just prior to blood draw can show a falsely elevated result and your GP/Endo might change your dose incorrectly as a result.

Silverlady5 profile image
Silverlady5 in reply to Jaydee1507

Thank you so much for your reply. Blood test was at 10 am fasting and no meds previous night. I take my thyroxine at night 75 mcg two nights and 100 throughout the week. GP seems to be testing less and less! No FT4 and certainly no FT3 !

Vitamins were tested last year which I have results for which were as follows:-

B12 & Folate (SUBU) Normal - No Action

Plasma vitamin B12 level 412 ng/L 187.00 - 883.00ng/L

FOLATE LEVEL SERUM 4.3. ug/L. 3.10. - 20.50ug/L

Vitamin D Total 93. mmol/L. 50.10. - 220.00 nmol/L

Serum Ferritin - (AR) Normal no action

Serum ferritin 107 ug/L 22.00 - 204.00 ug/L

I supplement Vit D with Better You spray with K2 also B12 Better You spray also I take a daily Vit C as well.

I realise I need to get these all tested again this year and only have a yearly review with my GP.

Thank you again for your reply I really appreciate any help.

Jaydee1507 profile image
Jaydee1507Administrator in reply to Silverlady5

Vit D & ferritin are fine.

If you were taking the B spray up until the blood test then you should by now be supplementing with a B complex as well.

Your B12 was too low, also your folate was too low.

Folate - aim for a level of 20. Recommend taking an active/methyl (should say on label) B complex which contains 400mcgs folate (also B12). Slightly cheaper options with inactive B6:

amazon.co.uk/Liposomal-Soft...

Contains B6 as P5P an active form:

bigvits.co.uk/thorne-resear...

healf.com/products/basic-b-...

Explanation about the different forms of B6:

helvella.blogspot.com/p/hel...

B complex comparison spreadsheet:

healthunlocked.com/thyroidu...

Suggest you buy a private test to check levels now. Thousands of members of this group pay for private tests to get well.

Private tests are available, see link for companies offering private blood tests & discount codes, some offer a blood draw service at an extra cost.thyroiduk.org/testing/priva...

There is also a new company offering walk in& mail order blood tests in London, Kent, Sussex & Surrey areas. Check to see if there is a blood test company near you. onedaytests.com/products/ul...

Only do private tests on a Monday or Tuesday to avoid postal delays.

SlowDragon profile image
SlowDragonAdministrator

well obviously just testing TSH is useless

Higher cholesterol suggests lower Ft3

when were vitamin levels last tested

What vitamin supplements are you taking

How much levothyroxine

Always same brand?

Can you get GP to test vitamin D, folate, ferritin and B12

Is your hypothyroidism autoimmune

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

Testing options and includes money off codes for private testing

thyroiduk.org/testing/

Medichecks Thyroid plus BOTH TPO and TG antibodies and vitamins

medichecks.com/products/adv...

Blue Horizon Thyroid Premium Gold includes BOTH TPO and TG antibodies, cortisol and vitamins

bluehorizonbloodtests.co.uk...

Only do private testing early Monday or Tuesday morning.

Link about thyroid blood tests

thyroiduk.org/testing/thyro...

Link about Hashimoto’s

thyroiduk.org/hypothyroid-b...

Symptoms of hypothyroidism

thyroiduk.org/signs-and-sym...

Tips on how to do DIY finger prick test

support.medichecks.com/hc/e...

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

Just TSH, Ft4 and Ft3 test - £32

monitormyhealth.org.uk/thyr...

10% off code here

thyroiduk.org/testing/priva...

Monitor My Health also now offer thyroid and vitamin testing, plus cholesterol and HBA1C for £65

(Doesn’t include thyroid antibodies)

monitormyhealth.org.uk/full...

10% off code here

thyroiduk.org/testing/priva...

Silverlady5 profile image
Silverlady5 in reply to SlowDragon

So sorry SlowDragon I haven’t replied to you before this as you can see my other test results are above in my reply to Jaydee1507.

I did miss off in my reply that I always have the same brand thyroxine which is Mercury Pharma and it looks as if I would benefit from a B complex as well as other vitamins I’m taking.

Feeling a little stressed as the telephone consultation draws near with the GP as I don’t feel I want to reduce my T4 medication or take statins.

Your help and previous reply is very much appreciated .

Thank you.

SlowDragon profile image
SlowDragonAdministrator in reply to Silverlady5

Yes definitely need to improve B12 and folate

Low B12 symptoms

b12deficiency.info/signs-an...

methyl-life.com/blogs/defic...

With serum B12 result below 500, (Or active B12 below 70) recommended to be taking a separate B12 supplement

A week later add a separate vitamin B Complex 

Then 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...

Or

B12 sublingual lozenges

uk.iherb.com/pr/jarrow-form...

cytoplan.co.uk/shop-by-prod...

B12 range in U.K. is too wide

Interesting that in this research B12 below 400 is considered inadequate

healthunlocked.com/thyroidu...

Low folate

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...

Many Hashimoto’s patients have MTHFR gene variation and can have trouble processing folic acid.

thyroidpharmacist.com/artic...

B vitamins best taken after breakfast

Igennus B complex popular option too. Nice small tablets. Most people only find they need one per day. But a few people find it’s not high enough dose

Post discussing different B complex

healthunlocked.com/thyroidu...

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

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...

helvella.blogspot.com/p/hel...

How other member saw how effective improving low B vitamins has been

healthunlocked.com/thyroidu...

SlowDragon profile image
SlowDragonAdministrator in reply to Silverlady5

Obviously just testing TSH is unacceptable

You can explain to GP you would need TSH, Ft4 and Ft3 tested before you would consider reducing your dose

SlowDragon profile image
SlowDragonAdministrator

Politely refuse to reduce your levothyroxine

If GP says " I have to reduce your dose because the guidelines say i can't let you have a below range TSH" .....

The first paragraph in the NICE (NHS) Thyroid Disease, Assessment and Management guidelines says :

nice.org.uk/guidance/ng145

"Your responsibility

The recommendations in this guideline represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, professionals and practitioners are expected to take this guideline fully into account, alongside the individual needs, preferences and values of their patients or the people using their service. It is not mandatory to apply the recommendations, and the guideline does not override the responsibility to make decisions appropriate to the circumstances of the individual, in consultation with them and their families and carers or guardian. "

healthunlocked.com/thyroidu...

See Diogenes reply here

“the best paper on this that I have seen indicates that a TSH of 0.03-0.5 is best on therapy. Above that is insufficient and below MAY or MAY NOT indicate slight overdosing”

ncbi.nlm.nih.gov/labs/pmc/a...

Conclusions: The serum biochemical markers of thyroid function in patients on LT4 following total thyroidectomy suggest that the patients with mildly suppressed TSH levels were closest to euthyroid, whereas those with normal TSH levels were mildly hypothyroid and those with strongly suppressed TSH levels were mildly hyperthyroid.

academic.oup.com/jcem/artic...

Interestingly, patients with a serum TSH below the reference range, but not suppressed (0.04–0.4 mU/liter), had no increased risk of cardiovascular disease, dysrhythmias, or fractures. It is unfortunate that we did not have access to serum free T4 concentrations in these patients to ascertain whether they were above or within the laboratory reference range. However, our data indicate that it may be safe for patients to be on a dose of T4 that results in a low serum TSH concentration, as long as it is not suppressed at less than 0.03 mU/liter. Many patients report that they prefer such T4 doses (9, 10). Figure 2 indicates that the best outcomes appear to be associated with having a TSH within the lower end of the reference range.

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