Help with Test Results Please

[RAS80]

I was hoping someone my be able to shed some light on some blood results I have had done recently? The GP has booked me in for a follow up appt but they haven't spoken with me, just sent the appt. I checked the blood test results and it appears they are following up on the Thyroid results.

I have been trying to understand what they results mean but I am very confused! I want to understand before my GP appt as anything I ever speak to the GP about I feel fobbed off, told to lose weight (I am overweight) or it's perimenopause.

So if anyone can help I would very much appreciate it.

Serum free T4 level 7.2 pmol/L [7.8 - 21.0]

Serum TSH level 6.1 mu/L [0.35 - 4.7]

What do these results suggest? Are they very abnormal? Are there more tests I should request?

Any insights much appreciated.

Thanks

[Dahliasanddaisies]

Hello, yes these test results indicate hypothyroidism. (There are hundreds of symptoms- checking out the Thyroid UK website)

They may wish to run the tests again to double check the results before starting any hormones. Ask if they will test TSH, T4, T3 and antibodies. They may not..many of us test privately. It's also worth asking for your vitamins to be checked as hypo people we tend to be low in things such as b12, folate, vitamin d, iron etc.

Don't worry or panic, just do a bit of reading about the subject.

If you can get your blood tests first thing (9am ish) that is what is recommended by members.

[RAS80 in reply to Dahliasanddaisies]

Thank you for replying.

I've had a look at the symptom list and yes I tick lots of those boxes.

I want to try and be informed (a little bit) before I go to the GP as I am concerned they will fob me off again, I have been before with some of the symptoms and I never felt they took me seriously.

How much outside of the normal range do results need to be before they look at any sort of treatment?

[Dahliasanddaisies in reply to RAS80]

You are doing the right thing. Many of us have had the same experience (myself included) Well if you read the NICE guidance on treatment of hypothyroidism, it says something like '2 x TSH results over range but under 10, 3 months apart' may warrant a trial of Levothyroxene. However many patients struggle to get their GP to start treatment with a TSH under 10.

TSH is highest in the mornings, around 9am, hence trying to have you bloods taken at this time may work in your favour. Asking for a trial is also helpful, sometimes GPs are more likely to agree to this.

I hope your GP is helpful and if you have any more questions, come back and ask! Good luck x

nice.org.uk/guidance/ng145/...

[SlowDragon Administrator]

welcome to the forum

Is this the first ever thyroid test you have had done?

What time of day was test

TSH (Thyroid stimulating hormone) …..the message from pituitary gland telling thyroid to work

TSH is highest in early morning….lowest after lunch

TSH is slightly high. GP may say it’s only marginally raised

But many people have symptoms when TSH is over 3-5

See flow chart here on when to start treatment

Starting levothyroxine - flow chart

gps.northcentrallondonccg.n...

Request further testing 6-8 weeks after first abnormal test results

Book second test for early morning

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

Also 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

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)

What vitamin supplements are you taking ….if any

Have you had any vitamin testing recently

[RAS80 in reply to SlowDragon]

Thanks for the reply.

This is the first test in a couple of years, i don't have the results from previous tests. This test was done at about 11 /11:30 ish.

I'll ask for further tests and try and get in first thing, full thyroid and vitamins.

I don't currently take any supplements.

Thanks again for the advice.

[SlowDragon Administrator in reply to RAS80]

i don't have the results from previous tests.

You are legally entitled to printed copies of your blood test results and ranges.

The best way to get access to current and historic blood test results is to register for online access to your medical record and blood test results

UK GP practices are supposed to offer everyone online access for blood test results. Ring and ask if this is available and apply to do so if possible, if it is you may need "enhanced access" to see blood results.

This currently only applies in England, not across the whole of the UK. Nether Scotland nor N.Ireland have released an NHS app for patients. (Scotland supposedly due in December '24.) Wales has an app, but only for booking appointments, repeat prescriptions and amending personal details

Link re access

patients-association.org.uk...

healthunlocked.com/thyroidu...

In reality some GP surgeries still do not have blood test results online yet

Alternatively ring receptionist and request printed copies of results. Allow couple of days and then go and pick up.

This test was done at about 11 /11:30 ish.

TSH would have been higher if tested 8-9am

Ft4 is below range too

You need further testing

[RAS80]

Thought I'd try and update this post!

I went to my GP appt, he put me on Levothyroxine 50mg straight away, no questions asked. I was abit taken aback as most of the things I had read for my NHS trust was my levels wouldn't be enough to be prescribed anything yet. So I kind of forgot all the questions I had prepared! Further bloods need taking in the new year.

Not sure if I'm feeling any benifit yet. I'm never sure if my symptoms are my age, my weight or thyroid.

[helvella Administrator in reply to RAS80]

You should have another test six to eight weeks after starting your levothyroxine.

Not sure exactly when you started and that the date might clash with Christmas - so make sure you get an appointment sorted asap.

Too many members have been started and then left on that starting dose for far too long.