Query re NHS bloods v private what's missing?

[Ownedbyamuddyspaniel]

Hi all

My previous post is here.

healthunlocked.com/thyroidu...

My GP has ordered these bloods (ignore that they say postponed this seems to be that she likes to do the forms herself).

I'm feeling increasingly fatigued and my elevated heartrate seems to be remaining elevated rather than going up and down in line with my menstrual cycle which I think is driving why I feel so awful.

My plan was that we are doing NHS bloods at the end of the month and then I was going to do the private ones to mop up what doesn't get picked up by the more limited NHS bloods.

But I think I need to get on and do the private ones now as I'm just wasting more time and Christmas will be on us soon with the shutdowns that brings.

So question - what are these NHS tests not going to pick up so I can make sure I test them?

Definitely T3. Is reverse T3 sensible to do?

Antibodies, whilst the NHS test says Antibodies it seems this doesn't necessarily do everything?

What about iron? Is there a wider panel that I ought to be looking at? I don't know what the NHS panel tests?

B12 - need to pick up Active B12?

My adjusted calcium is low on current tests so D is important - is there anything alongside that?

What about folate?

Anything else you'd think sensible (my FBC's and other results are on the other post)

I'm toying with the Blue Horizon comprehensive gold, well woman which is expensive but seems to pick up absolutely everything including cortisol and the meno bloods that I need to do private soon anyway EXCEPT that I need to get testosterone tested which isn't included. What is the view on this this package and does anyone know if it's possible to add an additional component (testosterone) rather than having to add another test type which just seems to duplicate the meno hormones?

I'm less concerned about the cost and more concerned to make sure I get a good range of tests. The GP has done an NHS endo referral but we both think they might reject it currently as labs are currently OK. If I've got an issue I need bloods that show it to justify the referral at least for the future even if I choose to book a private endo in the short-term.

Sorry this is long, thanks for any input.

[helvella Administrator]

You will find the general view here is that reverse T3 is not worth doing. It is expensive and questionable whether you can learn anything from it.

Iron studies could well vary by lab so you need to check what your NHS lab will be doing. Look for a lab handbook (or similar) online for your lab - often readily available, but not always.

helvella - Iron Panel

A short article about explaining what is meant by "iron panel" in relation to blood tests including some reference interval (range) information.

Last updated 18/07/2024

helvella.blogspot.com/p/hel...

Have you had Thyroid Peroxidase antibodies (TPOab) tested? I note that TGab are included but not TPOab.

Definitely folate.

Many private tests are Active B12 by default. Even some NHS labs do Active B12 now.

There have been some mentions of Lola testing recently. Have a look at this search:

healthunlocked.com/thyroidu...

[Ownedbyamuddyspaniel in reply to helvella]

Thanks helvella

I've not had any antibodies tested previously so this is a starting point for me.

Currently I'm chasing symptoms, TSH is 0.27 (ref range 0.27 - ) full figures on the other post.

But I've got a weird mix of hyper but more often hypo symptoms (cold, I'm so cold!) Including an enlarging gotre (benign) which the ENT consultant thought might have an autoimmune component as well as it producing thyroid hormone. Unhelpfully none of this is shown on the report so I'm going to see if there is a fuller report available as the original response is a one liner!

My niece has hypo thyroid (diagnosed at 26, she's now 40), she's reasonably sure she doesn't have hashimoto's and she is reasonably sure that she was screened for antibodies). She's in mainland Europe with a private health care system and I suspect she was properly diagnosed but will see!

I've found the lab handbook but it doesn't list what "iron studies" are, it only lists individual tests. So I'll probably have to wait and see what comes back.

I think I might go for the comprehensive blue horizon test, they've got an offer with free clinic or nurse visit for phlebotomy which reduces the overall cost.

I think I'll then buy the testosterone gold test which is reduced currently and I'll do that at a later date that also includes prolactin and SHBG as well as repeating D, B12, folate, cortisol etc. Which assuming I get some low vitamin levels initially will give me a half decent follow up next year. The GP seems to have prescribed my testosterone for long enough that I can wait a couple of months to test it.

Thank you for helping

[helvella Administrator in reply to Ownedbyamuddyspaniel]

I suggested Lola because they do a large bundle that includes testosterone. And is less expensive than Blue Horizon. But I have not gone through test by test to be sure it covers everything you need/want.

Elite 360

lolahealth.co/products/elite

[Ownedbyamuddyspaniel in reply to helvella]

Oh wow that's cheaper and does seem to be the illusive test I've been hunting that covers all I was looking for!

I did follow your link on your first reply but saw a couple of threads about odd results so I thought you were suggesting not to use them! 🤣.

They seem to include a home visit for phlebotomy which would be ideal as I'm 25 miles away from most usual locations.

Thanks helvella

[humanbean in reply to Ownedbyamuddyspaniel]

Some things that struck me about the test...

1) The iron-related bits didn't include serum iron.

2) The electrolytes doesn't include potassium.

3) The reproductive hormones are only relevant to women who have not reached menopause. Personally I resent having to pay for these tests, being post-menopausal, and would like test bundles to be available that only included tests relevant to women like me.

4) I resent having to pay for magnesium testing as well, because the test itself is unreliable, and is almost always well in range because of the way that magnesium is stored in the body. A good result doesn't rule out deficiency.

[Ownedbyamuddyspaniel in reply to humanbean]

It's the issue I've been having with all the different bundles from different providers. I hadn't found one that did everything but I was then going to end up having to do two different ones which ended up with duplication.

I do want the reproductive hormones as I'm peri and I've got to get testosterone tested to keep the prescription, I'm also interested in oestrogen levels although I know they aren't necessarily definitive of much. HRT seemed to fix my issues for 7 weeks, then it all went off and the goitre reappeared. I'm reasonably sure I'm absorbing oestrogen but it will be interesting to see a value.

I think I'm going to go with the Lola test, it duplicates some that the GP is doing but I'm also interested in the doctor's comments on some of the FBC's where there are some oddities but my GP isn't concerned about them. I can't help but feel that nobody is looking at the big picture.

[RedApple in reply to humanbean]

humanbean

Why not contact Lola and voice your opinions about their test bundles. As they're a new testing company, they may well be interested to hear from you.

[Ownedbyamuddyspaniel in reply to Ownedbyamuddyspaniel]

Oh no, Lola have postcode areas where they don't cover as they include home phlebotomy and of course I live in one of those areas! Back to the drawing board!

[helvella Administrator in reply to Ownedbyamuddyspaniel]

Oh no!

Nonetheless, I suggest you ring/email them. Despite delineating areas by postcode, there is an outside possibility that they could accommodate you/your location.

[Ownedbyamuddyspaniel in reply to helvella]

You are a star! I went back in to the Lola site to look for contact details and realised that whilst they don't cover my home address, they do seem to cover my work address 🙌

Thank you!

[Insomania]

You don’t need to repeat the iron tests, the GP has covered everything there. Folate, B12, VitD too. Personally I would avoid retesting these privately because it can cause confusion, if any look different to the NHS results, the GP may dismiss the others.

There’s a thyroid antibody missing and thyroid hormones TSH/T4/T3, that’s a good bundle to get tested.

For testosterone, I just got mine tested with Superdrug Private Dr (it was The Doctors Lab test). It was about £50 if that compares.

[Insomania in reply to Insomania]

I learnt from this forum that Cortisol testing is best done by saliva test which tests levels at 4 points through the day. I use Regenerus Lab to check it annually.