Ft4 not monitored by nhs

[nosy]

Doc won't test ft4 though I need it for monitoring levothyroxine. Get bad stomachs and end up in a and.e if ft4 too high. Has nhs stopped doing ft4 for monitoring

[SlowDragon Administrator]

Unfortunately this is increasingly the case and virtually impossible to get Ft3 tested on NHS

Thousands of U.K. patients forced to test privately

Bloods should be retested 6-8 weeks after each dose change or brand change in levothyroxine

How much levothyroxine are you taking

Do you always get same brand Levo at each prescription

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

VERY important to test TSH, Ft4 and Ft3 together

Also both TPO and TG thyroid antibodies tested at least once to see if your hypothyroidism is autoimmune

What is reason for your hypothyroidism

Is it Autoimmune?

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

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 annually

Low vitamin levels are extremely common when hypothyroid, especially with autoimmune thyroid disease

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

What vitamin supplements are you taking

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

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...

If you normally take levothyroxine at bedtime/in night ...adjust timings as follows prior to blood test

If testing Monday morning, delay Saturday evening dose levothyroxine until Sunday morning. Delay Sunday evening dose levothyroxine until after blood test on Monday morning. Take Monday evening dose levothyroxine as per normal

Monitor My Health (NHS private test service) offer thyroid and vitamin testing, plus cholesterol and HBA1C for £65

(Doesn’t include thyroid antibodies)

monitormyhealth.org.uk/full...

10% off code here

thyroiduk.org/testing/priva...

Just TSH, Ft4 and Ft3 test - £32

monitormyhealth.org.uk/thyr...

10% off code here

thyroiduk.org/testing/priva...

Randox FULL thyroid test including both thyroid antibodies just £29

Test at home or in clinic

randoxhealth.com/en-GB/at-h...

IMPORTANT......If you are taking vitamin B complex, or any supplements containing biotin, remember to stop these 5-7 days before ALL BLOOD TESTS , as biotin can falsely affect test results

[BB001]

NICE recommendations on managing hypothyroidism state that fT4 only needs to be tested if TSH is out of range (and that fT3 only needs to be tested if both TSH and fT4 are out of range). Monitormyhealth.org.uk do the cheapest fT4, fT3 and TSH test. I found that Monitormyhealth.org.uk results mirror my NHS GP blood test results. See thyroiduk.org to get a 10% discount.