Hashimoto's blood test and cortisol tests - Thyroid UK

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Hashimoto's blood test and cortisol tests

D911 profile image
D911
11 Replies

I have been asked by my GP Surgery to provide them with the list of blood tests I believe are correct for a patient with Hashimoto's. I don't seem to be able to find it. Would someone be kind enough to show me where I may find it please? Is it the same as under active blood test or are there 'extras' added in?

During the course of the conversation about my hashimoto's, I was told I could not have folate and can only be prescribed Folic acid. Folate can only be got/sought through diet? Is that correct?

The GP also suggested I had a cortisol test done. Does anyone have any thoughts on this please? How it may relate to the Hashimoto's?

If it holds any relevance, I take, T3, T4, Citalopram, B12 injections, Folic acid and HRT.

Lastly, given I'm submitting a 'wish list', is there anything else I should be asking for and why?

I may not get any of it but don't ask don't get!

Thanks all

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D911
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SlowDragon profile image
SlowDragonAdministrator

Do you always get same brand levothyroxine at each prescription

How much levothyroxine are you taking

How much T3

Which brand

Do you normally split your T3

Bloods should be retested 6-8 weeks after each dose change or brand change in levothyroxine or T3

For full Thyroid evaluation you need TSH, FT4 and FT3 tested

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

Are you currently taking any vitamin D

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 and last dose levothyroxine 24 hours before test

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

T3 ….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

Post all about what time of day to test

healthunlocked.com/thyroidu...

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

SlowDragon profile image
SlowDragonAdministrator

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 supplements

thyroidpharmacist.com/artic...

B vitamins best taken after breakfast

Igennus B complex popular option. 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 5-7 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...

SlowDragon profile image
SlowDragonAdministrator

Hashimoto's affects the gut and leads to low stomach acid and then low vitamin levels

Low vitamin levels affect Thyroid hormone working

are you already on strictly gluten free diet?

Or dairy free

Poor gut function can lead leaky gut (literally holes in gut wall) this can cause food intolerances.

Most common by far is gluten.

Dairy is second most common.

A trial of strictly gluten free diet is always worth doing

Only 5% of Hashimoto’s patients test positive for coeliac but a further 81% of Hashimoto’s patients who try gluten free diet find noticeable or significant improvement or find it’s essential

A strictly gluten free diet helps or is essential due to gluten intolerance (no test available) or due to leaky gut and gluten causing molecular mimicry (see Amy Myers link)

Changing to a strictly gluten free diet may help reduce symptoms, help gut heal and may slowly lower TPO antibodies

While still eating high gluten diet ask GP for coeliac blood test first as per NICE Guidelines

nice.org.uk/guidance/ng20/c...

Or buy a test online, about £20

Assuming test is negative you can immediately go on strictly gluten free diet 

(If test is positive you will need to remain on high gluten diet until endoscopy, maximum 6 weeks wait officially) 

Trying gluten free diet for 3-6 months. If no noticeable improvement then reintroduce gluten and see if symptoms get worse

chriskresser.com/the-gluten...

amymyersmd.com/2018/04/3-re...

thyroidpharmacist.com/artic...

drknews.com/changing-your-d...

Non Coeliac Gluten sensitivity (NCGS) and autoimmune disease

pubmed.ncbi.nlm.nih.gov/296...

The predominance of Hashimoto thyroiditis represents an interesting finding, since it has been indirectly confirmed by an Italian study, showing that autoimmune thyroid disease is a risk factor for the evolution towards NCGS in a group of patients with minimal duodenal inflammation. On these bases, an autoimmune stigma in NCGS is strongly supported

nuclmed.gr/wp/wp-content/up...

In summary, whereas it is not yet clear whether a gluten free diet can prevent autoimmune diseases, it is worth mentioning that HT patients with or without CD benefit from a diet low in gluten as far as the progression and the potential disease complications are concerned

restartmed.com/hashimotos-g...

Despite the fact that 5-10% of patients have Celiac disease, in my experience and in the experience of many other physicians, at least 80% + of patients with Hashimoto's who go gluten-free notice a reduction in their symptoms almost immediately.

Similarly few months later consider trying dairy free too. Approx 50-60% find dairy free beneficial

With loads of vegan dairy alternatives these days it’s not as difficult as in the past

Post discussing gluten

healthunlocked.com/thyroidu...

D911 profile image
D911 in reply to SlowDragon

Thankyou I’m going to go through all these links

greygoose profile image
greygoose

That's absolute rubbish about only being able to get folate through diet and only being able to prescribe folic acid. Actually, it's sort of the other way round: you can't get folicid through diet because it is synthetic folate. But doctors always prescribe folic acid because it's cheaper than methylfolate. This he may have got a bit confused, there!

D911 profile image
D911 in reply to greygoose

Yes - that’s what I thought too - I’m much better at putting it all in writing - I lose my nerve when speaking in person and doubt myself

greygoose profile image
greygoose in reply to D911

So, write her an email explaining about the folate vs folic acid confusion. ;)

Jazzw profile image
Jazzw

Am I the only one feeling a sense of despair at reading this? A GP wants the patient to find out what thyroid blood tests are required and then to top it off, spouts utter rubbish about folate?

What the heck is happening to medical training? Is it just that there are now very few experienced doctors to learn from because they’ve all taken early retirement after getting completely disillusioned with medicine?

D911 profile image
D911 in reply to Jazzw

Here’s where I am with this…….I get a voice, I’m not being shut down and without them saying they haven’t got a clue, they’re saying they haven’t got a clue so I’m seeing the positive in it……..🤷‍♀️

Jazzw profile image
Jazzw in reply to D911

Oh, there’s a positive to be sure. Like me being able to shut down the GP who tried tell me that having a suppressed TSH would give me, and I quote, “goggly eyes”. :-o

It’s just a sad state of affairs, that’s all.

Bluedragon profile image
Bluedragon

You could see if they’d do homocysteine? I think it’s such an important test and rarely used. If you’re on HRT, it might be helpful for them to run female hormone tests. Liver and kidney function too 😬

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