Result Help Please

[DownAndDesperate]

My husband’s phlebotomist suggested there may be a problem with his thyroid. For now the only results we have are from TSH and T4. Can anyone help me interpret them please? Thanks!

[greygoose]

Were the blood draws for all these tests done at the same time of day? If not, you can't compare them.

But, generally speaking, a TSH over 2 suggests that the thyroid is struggling. And a result over 3 is hypo. So, yes, I would say he does have a problem with his thyroid. But no doctor is going to take any notice of those results until the TSH goes over-range on two consecutive tests. And even then, they might want to wait until it goes over 10.

Also, we would need the range for the FT4 results. Can't tell anything from just a result.

[DownAndDesperate in reply to greygoose]

Thanks. It’s usually around the same sort of time of day, yes. They have requested a full panel of thyroid tests so hopefully they will be more enlightening. Thanks for your help.

[greygoose in reply to DownAndDesperate]

And what time of day is that? Because TSH is at its highest early morning - before 9 am. Then drops towards midday. The variation in those TSH tests suggests that they are done at different times.

[DownAndDesperate in reply to greygoose]

I asked and he said they’re done at 10.30 every time. He gets them done regularly because he’s on lithium and the tests have ti be very precise.

[greygoose in reply to DownAndDesperate]

OK, but at 10.30 the TSH would be lower than it would at 9 am. However, impossible to tell by how much.

But, if he's taking lithium, it wouldn't be at all surprising if he has a thyroid problem. That's what lithium does.

[DownAndDesperate in reply to greygoose]

I don’t know if he’s able to change his appointment time, particularly as he does the school run but I’ll make sure any private tests we do are before 9am. Thanks.

[greygoose in reply to DownAndDesperate]

You're welcome.

[SlowDragon Administrator]

For full Thyroid evaluation he needs TSH, FT4 and FT3 tested

Also both TPO and TG thyroid antibodies tested at least once to see if possible hypothyroidism is autoimmune

Also

Very important to test vitamin D, folate, ferritin and B12 at least once year minimum

Looking at his weight low vitamin D highly likely if not taking any vitamin D supplement

What vitamin supplements is he taking

About 90% of primary hypothyroidism is autoimmune thyroid disease, usually diagnosed by high TPO and/or high TG 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.

Significant minority of Hashimoto’s patients only have high TG antibodies (thyroglobulin)

Low vitamin levels are extremely common when hypothyroid, especially with autoimmune thyroid disease

20% of autoimmune thyroid patients never have high thyroid antibodies and ultrasound scan of thyroid can get diagnosis

In U.K. medics hardly ever refer to autoimmune thyroid disease as Hashimoto’s (or Ord’s thyroiditis)

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

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

Private tests are available as NHS currently rarely tests Ft3 or all relevant vitamins

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

[DownAndDesperate in reply to SlowDragon]

Thanks for your very thorough answer. The tests are taken at a psychiatric clinic we’re both under because he takes lithium so they’re at a set time really. I know they have tested at least folate which is low. I’ll see what tests they’ve done and then look at private ones if they’re not sufficient. He currently doesn’t take any supplements - he’s very bad at taking things because of memory and executive dysfunction, lack of self care and tv due to depression/bipolar/audhd

I’m aware of how rubbish the testing is. I was told I was fine until the hospital tested antibodies etc and I was finally diagnosed. This was about 10 years ago now. I had a doctor when I was pregnant say ‘you’re very antibody-y, aren’t you??’ (I have several autoimmune conditions). Weirdly I did private testing recently and my thyroid antibodies were below the reference range so someone who runs one of these Facebook groups told me I didn’t have Hashimoto’s. I wonder if it’s down to the LDN I’ve been taking for a few years lowering antibodies. But you can’t actually get rid of Hashimoto’s, can you? Sorry for the tangent.

Thanks again for your help

Melissa

[SlowDragon Administrator in reply to DownAndDesperate]

Yes if you had high antibodies in the past, even if now negative, you still have Hashimoto’s

[DownAndDesperate in reply to SlowDragon]

I thought so. Thanks for confirming.

[SlowDragon Administrator in reply to DownAndDesperate]

hashimoto’s can be misdiagnosed as bipolar or be linked to it

Depression obviously linked to low thyroid levels

ADHD also linked to hashimoto’s

[DownAndDesperate in reply to SlowDragon]

I’ll have to look into those things. He’s only really showed signs of hypothyroidism over the last few years though.