Changes in TSH.

[mstp]

My daughter had her TSH privately tested in April and the result was 4.5mIU/L, the highest it has ever been. The blood was taken in the evening after flying back from Seville. In June (at lunchtime) her GP tested it and the results was 1.2 which is the lowest it's ever been. She was about to increase her dose of thyroxin but is now wondering if she should keep it the same. Anyone any views on this. Big sigh: I have told her to have her blood tested first thing in the morning before eating anything or taking any meds..... so sorry if this is a waste of time.

[Jaydee1507 Administrator]

If her TSH is over 1 and she isnt feeling well then she likely needs an increase.

Does she supplement key vitamin levels or has she had them tested?

What were the results?

[greygoose]

Did she only get the TSH tested privately? Or did she also get the Frees? They don't change much throughout the day and give a clearer idea of how well she's medicated.

But, if her TSH is 1.2 at lunchtime, it's going to be a fair bit higher before 9 am, so I should think she does need an increase in dose, yes.

[jimh111]

If she is feeling hypo then increase it a little otherwise leave it the same.

[SlowDragon Administrator]

she needs FULL thyroid and vitamin testing

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

Also both TPO and TG thyroid antibodies tested at least once for autoimmune thyroid disease (hashimoto’s)

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

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

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)

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 and last dose levothyroxine 24 hours before 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

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

[mstp]

Thanks everyone. I will pass this on.