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[Blackcat122]

Hi, I'm 66, female.Diagnosed with chronic kidney disease stage 3, 2022

Just had blood test results back from gp as I've had a few concerning symptoms lately, out of breath easily, aching leg muscles when walking, itching scalp and underarms, generally feeling exhausted most of the time

My results came back abnormal for tsh 6.1mlu/l range (0.3-4.5)

Free t4 13.5 pmol/l range (10-22)

T3 not tested

I've not seen my gp yet to discuss but could I ask a few questions as I know nothing about thyroid problems

Do these results suggest subclinical hypothyroidism?

Could these results have been influenced by taking a supplement containing biotin, 60ug

Will I be given treatment considering I have ckd stage 3 also

Thanks for listening

Susan

[greygoose]

Hi Blackcat122, welcome to the forum.

The TSH suggests full-blown hypo being over 6, but your GP will say sub-clinical because he probably knows nothing about it, either, and will most likely want it to go over 10 before he will diagnose.

But, what time of day was the blood draw for this test? That makes a difference.

Taking biotin can make a difference, too, but on which test, and by how much is impossible to say. You should stop the biotin about a week before the test.

And impossible to say whether you will get a diagnosis with those results due to your kidney problems. Depends how clued up your GP is.

[Blackcat122 in reply to greygoose]

Thanks for your reply.The blood test was taken about 2.30pm

I didn't know that it could change depending on the time if day

Thanks Susan

[greygoose in reply to Blackcat122]

TSH is at it's highest around midnight. But, obviously you can't have a blood draw then. It drops slowly until about 9 am, and then drops sharply til midday, when it's at its lowest. Then it starts to rise again.

So, at 2.30 pm, it wouldn't have been at its lowest, but impossible to calculate how high it would have been before 9 am. It was pretty high, anyway. We always recommend having the blood draw just before 9 am, if possibly, and fasting. Could make all the difference between a diagnosis and no diagnosis.

[Blackcat122 in reply to greygoose]

Thanks greygooseIf I have to have it retested I'll make sure it's a morning appointment

Thanks Susan

[greygoose in reply to Blackcat122]

You're welcome.

[SlowDragon Administrator]

as poor kidney function can be directly linked to being hypothyroid you definitely need FULL thyroid testing

Low GFR is strongly linked to low thyroid levels and is reversible when thyroid levels are improved

ncbi.nlm.nih.gov/pmc/articl...

The GFR is reversibly reduced (by about 40%) in more than 55% of adults with hypothyroidism

Many medics unaware of the link

Yes important to stop any supplements that contain biotin 5-7 days before any blood tests

With a blood test with TSH over 5 you will need a second test in another 6 weeks

This should include vitamin testing and thyroid antibodies

See link here

Starting levothyroxine - flow chart

gps.northcentrallondonccg.n...

For full Thyroid evaluation you need TSH, FT4 and FT3

Plus 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)

Essential to test vitamin D, folate, ferritin and B12

Lower vitamin levels more common as we get older

How old are you?

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

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...

Medichecks and BH also offer private blood draw at clinic near you, or private nurse to your own home…..for an extra fee

Only do private testing early Monday or Tuesday morning.

Tips on how to do DIY finger prick test

support.medichecks.com/hc/e...

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...

[Blackcat122 in reply to SlowDragon]

Thank you for replyingI'm 66, b12, ferritin, vit d and folate tested at the same time as thyroid, all OK.

The test was taken about 2.30 pm

Thanks again, Susan

[SlowDragon Administrator in reply to Blackcat122]

So TSH would have been higher if tested at 8-9am

How much higher …..difficult to say

At least over 7

Possibly nearer 9

Please add actual vitamin test results and ranges

[SlowDragon Administrator in reply to Blackcat122]

Optimal vitamin levels

Vitamin D at least over 80nmol

Serum B12 at least over 500

Active B12 at least over 70 (private testing only)

Folate towards top of range

Ferritin at least over 70

[Blackcat122 in reply to SlowDragon]

Thanks SlowDragonVit d 107 (>50)

B 12 901 (150-1000)

Folate 17.6 (2-18.8)

Ferritin 69.8 (12-250)

No test for active. B12

Hope this helps

Susan

[SlowDragon Administrator in reply to Blackcat122]

So yes your vitamin levels are good

Presumably you supplement?

If yes…….what exactly

[Blackcat122 in reply to SlowDragon]

At the time ofthe test I was taking boots hair skin and nails supplement and a vegan omega 3

[SlowDragon Administrator in reply to Blackcat122]

Are you vegan?