Opinion on these results please.

[Bartyparty00]

Hi there,

My GP ordered blood tests for me, just routine due to long term condition (asthma), its a new scheme the surgery is undertaking and I'll be called annually for a check up.

Anyway, here's my thyroid result

Serum TSH 0.41 mU/L( 0.3- 5.0)

Serum free T4 10.9 pmol/L (7.9 -16)

I should mention I had partial thyroidectomy ( removal of R side) leaving parathyroid almost 12 years ago due to multinodular goitre. I still have huge goitre in situ covered in nodules but my gp says results are normal.

Any opinions, I'm due to see Endo consultant later in the year.

Many thanks 😊

[SlowDragon Administrator]

Just testing TSH and Ft4 is inadequate, especially when on regular asthma medication as this can affect/lower TSH

Was test done early morning

Do you have any symptoms

When were vitamin levels last tested

What vitamin supplements are you taking

Have you ever had thyroid antibodies tested

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 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)

NHS only tests TG antibodies if TPO are high so may need private testing

20% of autoimmune thyroid patients never have high thyroid antibodies and ultrasound scan of thyroid can get diagnosis

when was last ultrasound scan done?

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

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...

[Lynneypin in reply to SlowDragon]

I didn’t know regular asthma meds could affect thyroid results.. thanks.

[TiggerMe Ambassador]

Your fT4 is low... Free T4 (fT4) 10.9 pmol/L (7.9 - 16) 37.0%

How do you feel?

As SD says you really need a full thyroid panel

[Bartyparty00]

Hi SD and TM,

I have trouble with vit D and here's my advanced thyroid test result via medichecks from June. Do these points further to Hashimotos?

I feel exhausted, flaky, anxious, trouble sleeping, odd palpitations, and lots of others - but these symptoms have been put down to perimenopause by GP.

Loving your advice x

Results

[SlowDragon Administrator in reply to Bartyparty00]

High CRP - test for inflammation

Had you been ill recently

Has GP tested CRP since this

Vitamin D.

Were you supplementing any vitamin D before this test. U.K. government recommends everyone supplement vitamin D at minimum of daily from early October to end of April. Many people need to supplement all year, more in winter than summer.

How much vitamin D are you now taking

GP should have prescribed 1600iu everyday for 6 months

NHS Guidelines on dose vitamin D required

panmerseyapc.nhs.uk/media/2...

GP will often only prescribe to bring vitamin D levels to 50nmol.

Some areas will prescribe to bring levels to 75nmol or even 80nmol

leedsformulary.nhs.uk/docs/...

GP should advise on self supplementing if over 50nmol, but under 75nmol (but they rarely do)

mm.wirral.nhs.uk/document_u...

But improving to around 80nmol or 100nmol by self supplementing may be better

pubmed.ncbi.nlm.nih.gov/218...

vitamindsociety.org/pdf/Vit...

Once you Improve level, you will probably need on going maintenance dose to keep it there.

Test twice yearly when supplementing

Can test via NHS private testing service

vitamindtest.org.uk

Vitamin D mouth spray by Better You is very effective as it avoids poor gut function.

There’s a version made that also contains vitamin K2 Mk7.

One spray = 1000iu

amazon.co.uk/BetterYou-Dlux...

It’s trial and error what dose we need, with thyroid issues we frequently need higher dose than average

Vitamin D may prevent Autoimmune disease

newscientist.com/article/23...

Web links about taking important cofactors - magnesium and Vit K2-MK7

Magnesium best taken in the afternoon or evening, but must be four hours away from levothyroxine

betterbones.com/bone-nutrit...

medicalnewstoday.com/articl...

livescience.com/61866-magne...

sciencedaily.com/releases/2...

Recipe ideas

bbc.co.uk/food/articles/mag...

Interesting article by Dr Malcolm Kendrick on magnesium

drmalcolmkendrick.org/categ...

Vitamin K2 mk7

betterbones.com/bone-nutrit...

healthline.com/nutrition/vi...

[Bartyparty00 in reply to SlowDragon]

Hi,

Yes, id had a chest infection so i asked gp to retest crp after I'd recovered and it was back to normal.

Yes, I'm taking vit d better you spray as recommended by local nutritionalist. The level is coming up. I'll retest after Xmas.

Thankyou for your advice xx

[SlowDragon Administrator in reply to Bartyparty00]

Ferritin can be falsely high with high CRP

Thyroid levels look good

Consider retesting annually

[Bartyparty00 in reply to SlowDragon]

Thankyou SD, I'm amazed my thyroid works, only half left and the rest is all lumpy! No thyroxine at the moment as Consultant thinks structure vs function. Its doing OK so watch and wait- I see him annually and magically, have had the same Consultant for nearly 25 years! It has been a while since I've had a scan or needle biopsy so I might ask for those next time.

Your knowledge on things thyroid is so helpful, thankyou for sharing . 😊