Asking for my adult son who had his blood tests results back yesterday which say normal. He has autoimmune thyroid disease and was on 175 mcg a day but because he felt very unwell he dropped to 150 mcg and began to feel much better. So for the last 6 months he’s been on the lower dose of 150. He had his test results back yesterday and his tsh was 1.5 T4- 15.6 T3- 4 sorry I don’t know the ranges but we are in London uk. His test was taken at his surgery at 2.30pm he took his levo at 6am that morning. Because he didn’t tell his Dr he had lowered his dose does this mean his test results are compromised? I don’t know how it works but I think they need to know what dose of levo thyroxine your on when they take the bloodis this correct? please can you help me advise him as he suffers anxiety for 20 years and gets overwhelmed so please advise I’m so very grateful thank you
Help for son please blood test results are they... - Thyroid UK
Help for son please blood test results are they valid if not on dose prescribed
No, they don't need to know what dose he's on. But I'm afraid his results are compromised because he took his levo that morning. So, he has a false 'high' FT4. Although, of course, we can't tell how high it is without the range. Ranges vary from lab to lab, not just town to town or country to country, so there's no way we can guess what they are.
However, testing TSH at 2.30 pm is not advisable because it will be more or less at its lowest. It would have been higher before 9 am, which is when we advise people to have their blood draw.
But, how he feels is just as important as the numbers. So, if he feels good with these results then that is possibly the right dose for him.
thank you so much for replying greygoose I just asked my son for range of tsh and it’s 0.3-4.20 thank you for helping
It's the ranges for FT4 and FT3 that are most important. Does he have those? If not, ask him to ring the surgery and request they send him a copy of his results via email. He is entitled to them so they can't refuse. I've never been asked why, but if I were I would say "for my records".
Oh fancyPants I will ask him and hope it will be ok if I can give you the ranges later when I speak to him. Because he feels well on the lower dose I’m still concerned and want to try help him so I appreciate your advice very much thank you
The way the patient feels trumps a blood result though. A blood result is a snapshot in time. The way he feels is much more indicative of how it's going. It is a shame be took his dose that morning though. From now on, all bloods to be booked before 9am and no levo for 24 hours before the test. That gives a good baseline result to work with, not one randomly skewed by time and medication.
The TSH is the least important of the three numbers - although doctors don't know that and only tend to look at the TSH. And the range is somewhat meaningless because a TSH is always a TSH and should be around 1. But it's complicated by the fact that TSH varies throughout the day, and doctors don't seem to understand that, and don't take it into account.
The most important number is the FT3. That won't be affected by the time of day nor the timing of the last dose of levo. But, without the range, we cannot tell if the level is good or not. Judging by most ranges, 4 is on the low-side, but we can't say anything for certain. And, as I said before, how he feels is most important of all.
Thank you he has given me the range of the t3 which is 0.3 - 4.20 he feels well and like you say that’s most important. They tested his antibodies as well please can I ask you if the number of antibodies are important to his wellbeing and should I let you know the antibody numbers, he is hoping he can reverse his autoimmune thyroid disease if the antibodies are low? Thank you
Ah well! That changes everything! So in that range, 4 is good, and that's why he feels well. He would have been over-medicated on the previous dose.
Does he know he has Hashi's? The antibody test is not about how high the numbers are, it's about whether they're positive or negative. If he's ever had an over-range result then they are positive, if not, then he probably doesn't have Hashi's. But, the actual numbers are irrelevant. They do not of any importance to his well-being, whether high or low.
And, no, he cannot reverse an autoimmune disease, no matter what the level of antibodies. Antibodies are the result of the disease, not the cause. The cause is anybody's guess and is rarely found. But, that's not the most important aspect. The thing is that even if it were possible to reverse Hashi's, by the time one gets diagnosed it's already too late because of the damage that has already been done to the thyroid. Thyroids cannot regenerate. And you cannot live without thyroid hormones. So, that means thyroid hormone replacement for life.
Were his antibodies positive or negative for Hashi's?
His test results are looking on the low side by most ranges although you havent given the ranges.
It might be that his low FT3 is causing his anxiety.
Has he tested key vitmins ferritin, folate, B12 & D3, if not then he really needs to.
We need OPTIMAL levels of vitamins for our thyroid hormone to work well.
Its better if hes honest about his Levo dose with GP but doesnt make any difference with validating blood results.
Thank you jaydee1507 I have just spoken to him on phone and the ranges are tsh 0.3-4.20 T4 0.3-4.20 T3 2.4-6 because he took his levo at 6am and had his test at 2.30 pm was not a good thing I’ve just found out from reply’s. He had a full blood count yesterday as well I don’t think they did vitamins but will check with him. If low t3 can cause anxiety that could be the reason. Appreciate your reply thank you so much for your help
If he can make an account and become a member here its easier to chat directly with the person than via a third party.
The FT4 range cant be the same as TSH range so cant be right.
Likely he would do a lot better supplementing vitamin levels and possibly getting some T3 added to his levo.
In future he needs blood tests run at 9am or earlier without taking Levo that day until after the test.
Suggest he retest including vitamin levels
Which brand of levothyroxine is he taking
Bloods should be retested 6-8 weeks after each dose change or brand change in levothyroxine
ALWAYS
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)
For full Thyroid evaluation he 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 with autoimmune thyroid disease
For good conversion of Ft4 (levothyroxine) to Ft3 (active hormone) we must maintain GOOD vitamin levels
What vitamin supplements is he taking
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
Medichecks Thyroid plus BOTH TPO and TG antibodies and vitamins
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Blue Horizon Thyroid Premium Gold includes BOTH TPO and TG antibodies, cortisol and vitamins
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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
Monitor My Health also now offer thyroid and vitamin testing, plus cholesterol and HBA1C for £65
(Doesn’t include thyroid antibodies)
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10% off code here
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Anxiety
Gluten free diet may help
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
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