Thyroid function tests

[lambrose]

I have recently received my blood test results and have been asked to make an appointment to discuss them. My TSH level is normal but my T4 is 11.2 it was 11.8 in December also my serum folate is 2.0 and it should be 3.9 - 26.8 I feel absolutely awful I am so exhausted constantly, is this looking like under active thyroid?

[SlowDragon Administrator]

welcome to the forum

What’s the actual TSH result

What time of day was test done

Ft4 - can you add range as different labs have different ranges

If range is 12-22 (most common ) then Ft4 is below range

If range is 7-14 ….for example….it would be normal

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

Also both TPO and TG thyroid antibodies tested at least once to check for autoimmune disease

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)

Essential to test vitamin D, folate, ferritin and B12

Lower vitamin levels more common as we get older

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

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

[Jaydee1507 Administrator]

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.

What time of day did you take this test?

Exactly what was the TSH result?

What is the reference range for FT4? This is important to quote as ranges differ between labs.

Usually to begin treatment we need 2 TSH results above range or 1 above 10. Alternatively if FT4 is below range then this may be due to secondary hypo or central hypothyroidism where the pituitary doesnt call for more thyroid hormone despite it being needed. Then the FT4 drops below range and TSH remains good.

Have you had thyroid antibodies tested? NHS only tests TPO but privately you can also get Tg type tested.

GP should start you on 5mg folic acid for your low folate. Once this is finished you will need to buy your own supplement otherwise your level will just drop right back to where it is now. Usually a 400mcg methylfolate works well.

What was your B12, D3 & ferritin result?

When hypo we get poor gut absorption of vitamins which make symptoms far worse.

For thyroid hormone to work well we need OPTIMAL levels of vitamins.

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.

Recommended blood test protocol: Test at 9am (or as close as possible), fasting & 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.

[lambrose in reply to Jaydee1507]

My serum free T4 level was 11.2 the range was 12 - 22

My serumTSH level was 2.6 mu/l the range was 0.27-4.20

My serum folate was 2.0 the range was 3.9 -26.8

My MCH was 33.7 the range was 27-33

I got my bloods taken at 1pm

I don't go back to my Dr for 2 weeks yet

[Jaydee1507 Administrator in reply to lambrose]

TSH would have been higher had you tested earlier in the day. In future always book early appointments, make booking as soon as you know you need a test.

Ask GP at appointment to test B12 & D3.

Do you have the NHS app (available in England only), other wise you are legally entitled to a copy of yoru results printed out.

Push GP to start you on Levothyroxine, 50mcgs is the usual starting dose.