Testing TSH

[DisCBR]

Just wondering if anyone else has been told after one blood test that their thyroid is stable and won’t retest for a year! I thought when you first started blood tests were meant to be done every 3 months. That TSH through GP was monitored. Quite surprised that they think I’m stable after one blood test. Been on 50mcg since April of Levothyroxine.

[SlowDragon Administrator]

You are correct …..GP is wrong

What were results BEFORE starting on levothyroxine

What were next results

50mcg is only the standard STARTER dose

Which brand of levothyroxine are you using

just testing TSH is completely inadequate

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

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

Also both TPO and TG thyroid antibodies tested at least once to see if your hypothyroidism is autoimmune

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)

For good conversion of Ft4 (levothyroxine) to Ft3 (active hormone) we must maintain GOOD vitamin levels

What vitamin supplements are you taking

Also VERY important to test TSH, Ft4 and Ft3 together

What is reason for your hypothyroidism

Autoimmune?

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

[SlowDragon Administrator]

Sorry should have read your previous post first

healthunlocked.com/thyroidu....

Have you given GP copy of private test results

With very low Ft4 and below range Ft3 it should be blindingly obvious that you are in desperate need of next increase in Levo to 75mcg daily.

If GP still won’t increase levothyroxine you will need to get prescription elsewhere

Retest again 2-3 months after increase to 75mcg daily

Likely to need further increases over coming months

Here’s link for how to request Thyroid U.K.list of private Doctors emailed to you, but within the email a link to download list of recommended thyroid specialist endocrinologists who will prescribe T3

Ideally choose an endocrinologist to see privately initially and who also does NHS consultations

thyroiduk.org/contact-us/ge...

Have you had coeliac blood test yet

Get that done BEFORE trialing strictly gluten free diet

[SlowDragon Administrator]

Which brand Levo are you currently taking

Ideally always get same brand

And don’t change brand as dose increases

Try to only ever change one thing at a time

Change dose or brand

[tattybogle]

correct , it's simply not possible to say anything is 'stable' when you only have one point of testing, which is why the NHS guidelines say this:

"1.4 Follow-up and monitoring of primary hypothyroidism

Tests for follow-up and monitoring of primary hypothyroidism

Adults

1.4.3

For adults who are taking levothyroxine for primary hypothyroidism, consider measuring TSH every 3 months until the level has stabilised (2 similar measurements within the reference range 3 months apart), and then once a year.

1.4.4

Consider measuring FT4 as well as TSH for adults who continue to have symptoms of hypothyroidism after starting levothyroxine."

nice.org.uk/guidance/ng145/... Recommendations#follow-up-and-monitoring-of-primary-hypothyroidism

[DisCBR in reply to tattybogle]

Thank you I’ll show this on my next GP visit