Thyroid function tests : Hi all, The GP has... - Thyroid UK

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Thyroid function tests

Porridge98 profile image
17 Replies

Hi all,

The GP has printed off a form for me to take to the hospital tomorrow to check my TSH levels.

I’ve noticed on the form it says, ‘thyroid function tests’. Does this include T3 and T4? I know last time I only had a result for TSH.

If so, do I need to fast? My test isn’t until 4pm.

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Porridge98 profile image
Porridge98
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17 Replies
HealthStarDust profile image
HealthStarDust

TFT doesn’t always include FT4 or FT3 even when they are supposed to. Eg. My TSH has been under range and “suppressed” more than once, and twice nothing more than a TSH result was gained.

Forestgarden profile image
Forestgarden

The nhs generally only test TSH. If that is out of the normal range they may then go on to test ft4. In very rare circumstances (usually when specifically requested by endo) they'll also test ft3. I think I've had my ft3 done twice by nhs in the last 10+ years. Personally I wouldn't fast and if you take your meds first thing in the morning I'd go ahead and take them.

greygoose profile image
greygoose in reply to Forestgarden

And then if they do test FT4, she'll have a false high-result. It doesn't hurt to delay taking them for a couple of hours.

Porridge98 What time is your blood draw? Eating before it can lower the TSH, which is not what you want. And certainly don't drink tea or coffee, because that will lower the TSH. So, if you can, have your breakfast after the blood draw, if you can wait that long.

Forestgarden profile image
Forestgarden in reply to greygoose

The blood draw is 4pm

greygoose profile image
greygoose in reply to Forestgarden

Arrrrrrrrrrggggggggggghhhhhhhhhhh!

Porridge98 it's really not a good idea to have your TSH tested at 4 pm. It's going to give you a low TSH which is really not what you want when seeing an endo. Is there no chance of changing it for an early morning test? Doctors just don't seem to understand that TSH varies throughout the day.

Porridge98 profile image
Porridge98 in reply to greygoose

Thank you for your response, the alternative option was 6.40pm in May! 😵‍💫🤦🏼‍♀️

Forestgarden profile image
Forestgarden in reply to Porridge98

The main thing is you're getting to see an endo. The bloods may or may not be useful....

SlowDragon profile image
SlowDragonAdministrator

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

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Porridge98 profile image
Porridge98 in reply to SlowDragon

I’ve woken up with a cold! Would this impact the test? Should I rearrange?

serenfach profile image
serenfach

Only if they test your blood for inflammation. You can always tell the Endo that the time was wrong to get an accurate test (and if the TSH is low you can lie and say you took your Levo late morning due to your cold!).

Porridge98 profile image
Porridge98 in reply to serenfach

Thank you! My fertility clinic actually prescribed the thyroxin, I’ve never spoke to the GP or an endo, so actually it works in my favour if TSH is low as can then start IVF meds. I’m only borderline anyway (4.2), but needed to be under 2.5 to start meds. So hopefully I’ll get a more favourable result with a later test and a stuffy nose!

serenfach profile image
serenfach

The normal population TSH level is around 1. If you are 4.2, you are underdosed by a large margin. To get to 2.5 you will need to increase your dose of thyroxin.

Porridge98 profile image
Porridge98 in reply to serenfach

I’m not sure I understand? My TSH was 4.2 before I started thyroxin, I’ve been on 50mcg for 4 weeks now, so this test is a follow up to see if my levels have dropped.

serenfach profile image
serenfach

Ok, 4 weeks is a bit too soon to see the TSH level, it should be about 6 weeks, but 4 weeks will give you an indication as to whether the thyroxin is working.

You will probably need to test every 6 weeks with small increases of thyroxin until your TSH levels are "normal" which should be around 1 when taking thyroxin. But of course you can start the IVF as soon as your levels are 2.5.

I wish you good luck with your IVF.

Porridge98 profile image
Porridge98 in reply to serenfach

I would have waited longer but we have 1k of IVF meds in the fridge that are going to expire soon, so I’m hoping for some improvement to my levels so I can start this cycle!

Porridge98 profile image
Porridge98

TSH was 0.99, so thyroxin is working and reduced my levels within 4 weeks. 🙌🏻

Jaydee1507 profile image
Jaydee1507Administrator in reply to Porridge98

You may well find that if you restest after another 6-8 weeks your level will have risen again.

6-8 weeks is the earliest to assess blood results after a dose change but things can continue to change as the dose settles even 12 weeks afterwards.

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