Hello,
I have had a total Thyroidectomy for Thyroid cancer. My Thyroid gland was removed in two operations in 2022 and 2023, and I had RAI also. I have been having a blood test every six months the last TSH result was 0.53. I am on Levothyroxine tablets 100mg. I usually have my blood tests in the afternoon but I understand it is better to have the test done at 9am and then take the Levothyroxine after the test. If I do this am I likely to see my TSH test result higher or lower than previously?
TSH is highest very early in morning
It then drops through the day….lowest after lunch
Just testing TSH is completely inadequate
How do you feel
Any lingering symptoms?
Do you always get same brand of levothyroxine at each prescription
What vitamin supplements are you taking
For full Thyroid evaluation you need TSH, FT4 and FT3 tested
Very important to test vitamin D, folate, ferritin and B12 at least once year minimum
Low vitamin levels are extremely common on levothyroxine
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
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 and last dose levothyroxine 24 hours before 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
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Testing options and includes money off codes for private testing
Medichecks Thyroid plus BOTH TPO and TG antibodies and vitamins
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Blue Horizon Thyroid Premium Gold includes BOTH TPO and TG antibodies, cortisol and vitamins
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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
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Monitor My Health (NHS private test service) offer thyroid and vitamin testing, plus cholesterol and HBA1C for £65
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HelloAnnieJo and welcome to the forum :
Well as for the TSH it's best tested by 9.00am and having left around a 24 hour window from your last dose of T4 - as this should give the highest TSH reading possible - and suggested as we see very many forum members being under medicated because their TSH is lseen as too low / suppressed in its range.
The fact is the TSH is a very unreliable measure once on any form of thyroid hormone replacement especially when you haven't a thyroid and your HPT axis - the Hypothalamus - Pituitary - Thyroid - down regulated and broken as there is no thyroid in situ to complete this circuit feedback loop.
It is essential that you are dosed on our Free T3 and Free T4 blood test results and we generally feel best when the T4 is up in the top quadrant of its range at around 80% through its range with the T3 tracking behind at around 70% through its range.
T4 is a pro-hormone and needs to be converted in the body into T3 the active hormone that runs the body and conversion of T4 into T3 can be compromised by non optimal levels of core strength vitamins and minerals - especially those of ferritin, folate, B12 and vitamin D.
Conversion can also be down regulated by inflammation, antibodies, any physiological stress ( emotional or physical ) depression, dieting and ageing.
A fully functioning working thyroid would be supporting you on a daily basis with trace elements of T1. T2 and calcitonin + a measure of T3 at around 10 mcg + a measure of T4 at around 100 mcg -
with T3 said to be around 4 times more powerful than T4.
Some people can get by on T4 only :
Others find that at some point in time T4 doesn't seem to work as well as it once did - and that by adding in a little T3 - probably at a similar dose to that their thyroid once supported them with, they feel better with their T3 / T4 balance restored.
Others can't tolerate T4 and need to take T3 only - as you can live without T$ but you can't live without T3.
Whilst others find they feel best taking Natural Desiccated Thyroid which is derived from pig thyroids, dried and ground down into tablets referred to as grains and contains all the same known hormones as that of the human thyroid gland.
Currently your primary care doctor can only prescribe the cheapest option - T4 Levothyroxine and you need to be referred to a NHS endocrinologist to be considered for any other treatment option.
We can talk you through any blood test results you have there - ideally we need a complete thyroid blood panel which is around 10/11 bio-markers - to include a TSH - Free T3 - Free T4, inflammation, antibodies and ferritin, folate. B12 and vitamin D.
If your doctor isn't able to run this for you - there are private blood companies - listed on the Thyroid UK website - thyroiduk.org - who is the charity who supports this patient to patient forum - between them Medichecks and Blue Horizon cover most of England and can offer a nurse home visit, at a surcharge, to come and draw your blood for you - which I find the least stressful way, to manage yearly my thyroid health.
Thank you for your prompt reply. It is much appreciated.
Blood test results... Advice please if possible ..
Thyroid blood test
Advice needed please :-) 
Thyroid blood test
Thyroid blood test results
