Bloods should be retested 6-8 weeks after each dose change or brand change in levothyroxine
For full Thyroid evaluation she needs TSH, FT4 and FT3 tested
Very important to test vitamin D, folate, ferritin and B12 at least once year minimum
Low vitamin levels are extremely common when hypothyroid, especially if not on high enough replacement thyroid hormones
What was reason for thyroidectomy?
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)
Presumably she’s not on T3 ….
But if she is …….day before test split T3 as 2 or 3 smaller doses spread through the day, with last dose approximately 8-12 hours before test
Private tests are available as NHS currently rarely tests Ft3 or all relevant vitamins
Thank you SD, very helpful, as always :). A big problem is that my friends first language isn't English.Consequently she finds this tricky to understand but she is trying her best.
I emailed a copy of your answer to her.
She is thinking of making an appointment with the private endocrinologist that I see.
He will spend time with her that the NHS don't have.
She really wants to get FULL thyroid and vitamin testing done BEFORE consultation
A) otherwise first consultation is waste of time and money
B) private testing will be cheaper than via endocrinologist
C) she may be able to improve symptoms by getting vitamin levels optimal and probably want to do that as first step anyway BEFORE booking any consultation
Ask her to join forum herself
Then she can add her most recent thyroid and vitamin test results
She is on a dose that needs to fluctuate several times a year as has a parathyroid issue too. Iron and calcium need to be frequently checked too. Her GPs will not accommodate this. She is going to see a specialist privately.
When testing iron/ferritin, if the patient takes iron supplements then they should be stopped for 5-7 days before testing if possible. It is also a good idea to avoid an iron-heavy meal the night before the test. Blood samples for testing should be taken first thing in the morning, after fasting for 12 hours before taking the blood, and before eating breakfast. Water can be drunk freely throughout.
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She is going to see a specialist privately. 
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