Thyroid test results

[Manycrafts]

I have had an underactive thyroid for 30 years. My Levothyroxine dose is now 100mcg daily and was reduced from the 125 mcg during the pandemic after I lost 3 stones in weight.

I have never been given my full annual thyroid test results in the past but they have now been made accessible online.

When I had my last test this month at 8.10am, I forgot and had my thyroxine tablet at 7.45am as usual. I wonder if this short time before my test was sufficient to affect my results?

Also, although my result says 'Borderline' I'm a bit uncertain about the detail as my understanding seems to show the T4 being comfortably within the normal range, yet the TSH T3 level is a bit above the normal range suggesting more T4 is needed? This seems contradictory. As I have regained most of the 3 stones weight I lost I was expecting to need my Levothyroxine to need to be increased again, but that T4 reading suggests otherwise. Is my understanding correct and is this something that can happen? Or should I be concerned that my pituitary gland may be the issue?

My free T4 level is 18.3 pmol/L (11.5 - 22.7)

My TSH level is 5.1 MlU/L (0.55 - 4.78)

[Jaydee1507 Administrator]

Welcome to the group. If you could complete your profile it helps members understand your thyroid journey so far and be able to advise you better. Click on your image icon to start. Fill out the free text box at the top.

I forgot and had my thyroxine tablet at 7.45am as usual. I wonder if this short time before my test was sufficient to affect my results?

You are correct and what your blood results are showing is the peak of T4 entering your blood stream with the tablets you had just taken. If you left the recommended 24 hours then your result would have been much lower.

So had you not taken your Levo shortly before the test your FT4 would tally up better with your TSH which is clearly showing you need a dose increase, probably of 25mcgs.

It makes the world of difference to our treatment how we take our blood tests. These are patient to patient tips and unlikely your GP or nurse will know about this.

It's ideal if you can always get the same brand of levo at every prescription. You can do this by getting GP to write the brand you prefer in the first line of the prescription. Many people find that different brands are not interchangeable.

Always take Levo on an empty stomach an hour away from food or caffeine containing drinks & other meds. Many people find taking it at bedtime works well for them.

When hypo we get low stomach acid which means we cannot absorb vitamins well from our food, regardless of a great diet. For thyroid hormone to work well we need OPTIMAL levels of vitamins.

Have you recently or could you ask your GP to test levels of ferritin, folate, B12 & D3? 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.

Do you know if you had positive thyroid antibodies? Many with autoimmune thyroid disease aka Hashimoto's benefit from a gluten free diet. A smaller percentage of those also need to remove dairy from their diet to feel well. These are intolerances and will not show up on any blood test.

[Manycrafts in reply to Jaydee1507]

Thank you so much for your very helpful and informative reply, which has helped me to understand. I hadn't realised that levothyroxine could reach the bloodstream so quickly but that then makes more sense of my results. I was surprised that I should fast and presumably only drink water for 24 hours before a test though, as up to now I've only fasted for about 11-12 hours.

I take my bisoprolol tablet at the same time as my Levothyroxine. I checked online to be sure there is no interaction, so hopefully that is ok and don't eat till late morning anyway. No caffeine either with Bisoprolol and cough medicine has it in and has to be avoided other than plain lemon and honey. I get all different makes of tablets these days, sometimes two makes with one prescription, so I expect there are shortages. I don't like it and would prefer the same brand, as the sizes of tablet differ and some could easily be confused with my bisoprolol tablets, so I check and check again!

I make sure we have at least 5 a day in our diet, but will ask my GP if I could have those vitamin tests. At age 76, we can be deficient in some anyway and I've read insufficient B12 can cause another autoimmune condition, pernicious anaemia.

I've always wondered what kind of thyroid disease I have as I've never been told other than I'm underactive, so I don't know if I had positive thyroid antibodies. Would my GP know? I've been on the British Thyroid Register under a local hospital for many years, so would they have checked this do you think, and so have a record? I'm very interested in your remarks about Hashimoto's and gluten free and dairy. For quite a few years I have noticed that some milk and particularly cream doesn't always sit well with me and have wondered if it had become an intolerance. From childhood I've mostly eaten wholemeal bread, but for a few months now, if I have some kinds of white bread I've noticed bloating discomfort so have stopped having it, so there might be a connection there.

Thank you again for all your insight and helpfulness and for taking the trouble and time to reply, I really appreciate it!

I will see if I can complete my profile now.

[Jaydee1507 Administrator in reply to Manycrafts]

Firstly you only need to fast the day of the test, so basically have breakfast after a 9am or earlier blood test. Only drink water the morning prior to the test, no tea or coffee.

Its really only delaying breakfast.

Levothyroxine should be taken on its own. Its a very fussy hormone and won't work well if you take it with anything at all other than water. Wait for an hour before eating or drinking other than water.

Regarding diet, 5 a day will help but the low stomach acid will mean you won't benefit as much from the vitamins because your body wont absorb them, hence needing to test levels and supplement them to raise them to OPTIMAL - usually 50- 75%+ of range and higher.

Your GP might have a record of your antibodies but possibly not. You can test them privately anyway.

[Manycrafts in reply to Jaydee1507]

So what I do by making my tests first thing in a morning without eating beforehand and taking my levo after the test, I'm ok, and I don't eat or drink other than water after till late morning so that is ok too. I just take my tablets with a large glass of water and I will have to take my bisoprolol at least an hour later than the levo. The vitamin tests are really important then and I can understand about the absorption as my husband developed osteoporosis most likely because he was on antacids for reflux and they stop calcium being absorbed.