Help with test results: Hi there I am trying to... - Thyroid UK

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Help with test results

Millymoo333 profile image
8 Replies

Hi there

I am trying to get a better understanding of some test results before I start taking any medication recommendations from my GP. I have had some tests done this year (in Feb and August) which have shown my TSH at 8.5 and then 13.5 . Both taken before 10am. I didn’t have. FT3 but my T4 was tested at the first test which was 12.9.

Following the most recent test I decided to have my own test at Randox and their result show my TSH at 6.8 (0.35-5.5) this test was taken at 12 am. My FT4 at 10.7 (range 11.9-21.6) and FT3 at 4.40 (range 3.1-6.8) . What is concerning me is the TPO as it is at 95 (range 34HIgh)

Does this indicate hashimotos?

My GP prescribed me Levo because of the TSH being 13.5 but i dont know if that is the right course to take and I have not shown the GP my randox tests. I am only just discovering this so any advice would be much appreciated before I seek out a proper endocrinologist.

Thanks in advance.

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Jaydee1507 profile image
Jaydee1507Administrator

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.

All of the TSH tests that you have given us are over range and now your FT4 is below range on the Randox test. This points towards hypothyroidism and as you have had a series of above range TSH results the normal course of action would be to start you on Levo.

How much has your GP prescribed? Usual starting dose is 50mcgs. You take that for 6-8 weeks then retest and increase levo dose according to results. Aim for TSH of 1 or just under where most people feel well.

Positive antibodies point towards Hashimoto's disease where the thyrodi gland is slowly destroyed. There is no way of healing the damage from the autoimmune attacks so the treatment is to take Levo.

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.

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.

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 do tests as per the protocol recommended here? Recommended blood test protocol: Test at 9am (or as close as possible), fasting, last levo dose 24hrs before the blood draw no biotin containing supplements for 3-7 days (Biotin can interfere with thyroid blood results as it is used in the testing process).

Testing like this gives consistency in your results and will show stable blood levels of hormone and highest TSH which varies throughout the day. Taking Levo/T3 just prior to blood draw can show a falsely elevated result and your GP/Endo might change your dose incorrectly as a result.

Millymoo333 profile image
Millymoo333 in reply to Jaydee1507

thank you very much this is so helpful

Millymoo333 profile image
Millymoo333 in reply to Millymoo333

They have prescribed 25 mg for 8 weeks and then another blood test but of course GP hasn’t seen TPO or T3 figures

Jaydee1507 profile image
Jaydee1507Administrator in reply to Millymoo333

25mcgs is a low starter dose and some people can feel a little worse on that. It doesnt really replace enough of what your own thyroid is currently putting out.

TPO or FT3 results wont change anything at the moment. FT3 becomes more importnt when you're closer tobeing optimally replaced. Thn you can check if you're convrting the Levo you are taking.

TPO just signifies that you have Hashimotot's and doesnt change your treatment in any way. It does mean that you might benefit from a stictly gluten free diet and thats worth trying to see if it helps your symptoms at all.

Millymoo333 profile image
Millymoo333 in reply to Jaydee1507

Ok thank you it’s all very confusing but your advice is greatly appreciated

greygoose profile image
greygoose

Hi Millymoo333, welcome to the forum. :)

My GP prescribed me Levo because of the TSH being 13.5 but i dont know if that is the right course to take

It's the only course to take. Because even with a TSH of 6 you are very hypo. And, as you rightly suspected, the high antibodies do mean you have Hashi's, so things are only going to get worse, not better.

TSH is a pituitary hormone - Thyroid Stimulating Hormone. When the pituitary senses that there's not enough thyroid hormone in the blood, it increases its output of TSH to stimulate the thyroid to make more hormone. However, if the thyroid has been damaged by Hashi's, it cannot respond, so the TSH gets higher and higher - the lower the thyroid hormones, the higher the TSH.

TSH varies throughout the day, being highest before 9 am. At 12 am it would have been at its lowest point, which is why it doesn't correspond to the levels done by your GP - assuming those blood draws were done earlier, of course.

The thyroid hormones are T4 and T3. T4 is basically a storage hormone that doesn't do much until it is converted to the active hormone, T3. In a 'normal' (euthyroid) person, the would both be about mid-range with the FT4 slightly higher than the FT3. However, when the thyroid is failing - as yours is - it will increase output of T3 - and therefore less T4 - to keep you alive.

FT4: 10.7 pmol/l (Range 11 - 21.6) -2.83%

FT3: 4.4 pmol/l (Range 3.1 - 6.8) 35.14%

As you can see, that is the case with your levels. The FT4 is below range, and the FT3 is very low. And the thyroid cannot keep that up forever as it is constantly bombarded by your immune system with intent to killl.

There is not treatment and no cure for the autoimmune element of the disease, and thyroids don't regenerate, the only thing you can do is replace the missing hormones. Hence the levo, which is T4.

As for the antibodies themselves, they are just an indicator that you have the disease, they are the result of the disease, not the cause. So, the actual numbers don't matter. The test is either positive or negative, and yours is positive. And that's all you need to know.

Millymoo333 profile image
Millymoo333 in reply to greygoose

Thank you this all sounds very helpful

greygoose profile image
greygoose in reply to Millymoo333

You're welcome. :)

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