Help, Doctors claiming blood tests are fine!! - Thyroid UK

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Help, Doctors claiming blood tests are fine!!

JCHoc profile image
15 Replies

Hi, I'm 28, not on any medication (other than contraceptive implant) and hoping to think about starting a family in the next 12-18 months after having implant removed.

I've had 2 blood tests now with the following results:

June 2024:

TSH: 5.95

T4: 14.6

August 2024:

TSH: 4.71

T4: 13.6

TPO Ab: 39

I have all the symptoms of an underactive thyroid and have been struggling for 12 months with exhaustion, weight gain, hair thinning, low mood, low libido etc.

My doctor requested the second blood test due to tsh being 5.95, however my 2nd bloods have come back and they're now saying everything is fine?

Please help with where to go from here as I feel like they're just fobbing me off. Or please tell me if my values are normal, thanks!

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15 Replies
Dahliasanddaisies profile image
Dahliasanddaisies

Well they are not normal. Have you got the ranges for these? Is the 2nd TSH just inside the range? What time did you have your blood tests? Are you taking any supplements that contain biotin?

JCHoc profile image
JCHoc in reply toDahliasanddaisies

Unfortunately they haven't given me the ranges, they say they won't treat TSH unless its above 10. No supplements and blood tests were both before 9am on empty stomach

Dahliasanddaisies profile image
Dahliasanddaisies in reply toJCHoc

That's simply against the NICE guidance and the the guidance for managing subclinical hypothyroidism in pregnancy. Have a read of the below. btf-thyroid.org/pregnancy-a...

You may need to get a private blood test to check if you have antibodies (which indicate Hashimotos) this may help in getting the GP to provide treatment.

Have you told them you want to try to get pregnant?

JCHoc profile image
JCHoc in reply toDahliasanddaisies

They did the TPO antibody test in August which gave a result of 39 - didn't tell me if it was positive or negative...

I have also booked another consultation to say I'm looking to remove my implant to start a family.

SlowDragon profile image
SlowDragonAdministrator in reply toJCHoc

they say they won't treat TSH unless its above 10.

This is absolutely INCORRECT

With two tests with TSH over 5 and symptoms you should be started on levothyroxine

Starting levothyroxine - flow chart

gps.northcentrallondonccg.n...

And if considering pregnancy TSH under 2.5

However ….next steps probably get implant removed and see what changes

Meanwhile next step get FULL thyroid and vitamin testing done privately including BOTH TPO and TG antibodies

with high TSH it’s highly likely your vitamin levels are poor

Recommended that all thyroid blood tests early morning, ideally just before 9am, only drink water between waking and 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...

your TPO result is probably just over range suggesting Hashimoto’s

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

greygoose profile image
greygoose

Hi JCHoc, welcome to the forum. :)

First of all, were the blood draws for these two tests don't at the same time of day? That is important because TSH varies throughout the day. It is highest before 9 am and at its lowest around midday.

Secondly, can you put the ranges, please? Results without ranges are meaningless, and ranges vary from lab to lab.

However, going by you TSH, you are hypo. You are hypo when your TSH gets to 3. Trouble is the NHS like it to get to 10 before they will admit that you are hypo! And the majority of doctors are incapable of thinking outside the box, and have very little knowledge of thyroid.

However, they are supposed to diagnose you if you have two consecutive out-of-range TSH about three months apart. The reason for that second test is that TSH can often be raised if you have an infection of some sort, so they need to be sure. Also, those antibodies look like they may be high, meaning you have Autoimmune Thyroiditis - aka Hashi's - but impossible to say for sure without a range.

So they're not really fobbing you off, they're just sticking rigidly to the rules. And they know nothing about symptoms.

What to do next? Keep testing. But make sure the blood draw is before 9 am. :)

JCHoc profile image
JCHoc in reply togreygoose

Thanks for your detailed response, I have booked another consultation with the doctor to try and find out the ranges. However previously they said they wouldn't treat unless TSH is above 10 with a positive TPO Ab result (hence including it on the 2nd blood test).

Both blood tests were taken before 9am however :)

greygoose profile image
greygoose in reply toJCHoc

Tell him that NICE recommends that with high antibodies, two consecutive over-range TSH should lead to diagnosis. They usually do what NICE says.

Was it the doctor that gave you these results without the ranges? Not sure they understand the importance of ranges, but I do know that a lot of doctors prefer you don't know too much about your results because then you can't argue.

Best thing to do is to ask at reception for a print-out. If it comes straight from the computer the ranges will be on there?. And if you live in the UK, it is your legal right to have a print-out, they can't refuse. :)

TiggerMe profile image
TiggerMeAmbassador

How were you before the implant? Sex hormones can effect TBG levels which is thyroid binding globulin and can lower thyroid hormone levels meaning less is 'free'

JCHoc profile image
JCHoc in reply toTiggerMe

I was on the pill (combined and mini pill) however started to really struggle with them giving me major mood swings and didn't want the risk of getting pregnant at uni with throwing up from alcohol, forgetting to take pill etc, so went on the implant. Im now on my 2nd implant and although I very rarely have periods, I've found it to be OK - not sure if my low libido is due to it though!

TiggerMe profile image
TiggerMeAmbassador in reply toJCHoc

Low libido is also a hypo symptom and you are certainly hypo... googled Nexplanon... ehealthme.com/ds/nexplanon/...

You fall into the 2-5 year zone 😕 and the age bracket

Probably best to get the implant out and let things settle also get them to check your ferritin, folate, B12 and Vit D

JCHoc profile image
JCHoc in reply toTiggerMe

Ah that's interesting, thank you. I may be looking to go down the natural cycles route since me and my partner are looking to start a family in the near future, so would give my body time to adjust!

TiggerMe profile image
TiggerMeAmbassador in reply toJCHoc

Definitely a better way to go, my daughter has swapped to this in the last year and her mid range TSH has lowered and she is optimising her vits and mins which have perked her up a treat, though she has been surprised how long it has taken to get a 'proper' period

Pregnancy in itself can trigger Hypo (did for many of us we just didn't get treated for often many years or decades afterwards 🙄) so it's good that you are aware 🙃

TiggerMe profile image
TiggerMeAmbassador in reply toTiggerMe

I'm guessing the TPO range is <35 so you are slightly high suggesting autoimmune could be a factor

TiggerMe profile image
TiggerMeAmbassador in reply toTiggerMe

You might find changing your diet helpful like cutting out gluten... check out thyroidpharmacist.com

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