blood tests

[health2015]

Hi

I called to see my doctor this morning as i am still having problems with diarrhea. I did post about in November I think, I got some good advice then, but alas the problem is ongoing. I have been booked a blood test by the GP to check for coeliac disease which also includes my thyroid. The test is not until 10.50, I couldn't get anything earlier. I am concerned about when I take the my dose of Thyroid S on the day before before my test.

Any advice would be gratefully received.

[pennyannie]

For a thyroid blood test you need a fasting blood draw by around 9.00 am and with your last of thyroid hormone replacement being 24 hours before hand -

As you are taking Thyroid S - the above should suit you - but for an accurate T3 / T4 reading you should allow 12 hours from your last dose aof anything containing T3.

It will likely be just a TSH - which will likely be low/suppressed if optimally medicated on Thyroid S - as Natural Desiccated Thyroid does not present in the blood tests as would synthetic thyroid hormone treatment options.

Is your doctor aware that you take NDT and that blood tests present different to the ' norm ' ?

[health2015 in reply to pennyannie]

Hi PennyannieThanyou for your reply.It is on my records that I take NDT, they are not happy about it. I asked for an earlier appointment, as I am aware of this, however, there wasn't one available. I am so desperate to get this diarrhea sorted out. I had bowel cancer in 2023 and took my last chemo in January last year. There was a bit of scarring on my stomach which has now changed and looking a bit more like a nodular, hence the reason I want to find out was is going on.

So my question is, should I take NDT at 10.50 the day before?

Sorry for going on, I am just concerned about what is going on.

[pennyannie in reply to health2015]

Well if they know you take NDT - its academic - as taking any form of thyroid hormone replacement containing T3 will lower / suppress the TSH -

it seems most doctors only go by TSH readings - depends what the Lab finds - it's a cost cutting exercise - if TSH in range - nothing else is measured - if TSH is outside range you then get a T4 run and then possibly a T3 - but if its on your notes you take NDT - the blood test isn't that relevant anyway -

Do you split your dose of NDT -

if you are ok taking the NDT after the blood test - rather than before - so be it - but this will not change your TSH which if optimally medicated is likely low/suppressed.

Just saying that diarrhea is associated with a faster than normal metabolism -

Do you run your own T3/T4 blood tests to know how well NDT is working for you ?

I'm not meaning to negate your concern / worry - just thinking of an obvious comment that could be levelled by someone who does not understand NDT or thyroid health issues.

[JumpJiving]

health2015 Looking at your old posts, you were taking over-the-counter adrenal supplements and asking about DHEA two years ago. Are you still taking adrenal supplements? Are you taking DHEA? Have you been tested by a qualified medical practitioner (ideally an endocrinologist) to see if you do actually have a cortisol issue of any kind? If so, what tests were done, what were the results, and what medication (if any) and supplements (if any) are you now on?

Why do I mention this? Because diarrhoea is a common symptom of low cortisol. Having said that, please do not increase use of over-the-counter supplements. Consult a qualified medical practitioner instead and be honest about everything that you are taking.

As many in the group will know, I strongly discourage using over-the-counter supplements that might interfere with cortisol levels. There can be many consequences of doing so, and suddenly stopping taking anything that messes with cortisol levels can lead to potentially fatal adrenal crisis.

[health2015 in reply to JumpJiving]

Hi JumpJiving

I have not been tested or diagnosed with cortisol issues, however I do take soleray adrenal caps which keep me calm. I work in a stressful job abd they help. I don't take them when I am not working. I will see what the blood test results are, and maybe ask for an endocrinologist appointment through my GP.

I haven't taken them this weekend, diarrhea is still the same.

[JumpJiving in reply to health2015]

 health2015 Stopping and starting anything that affects cortisol levels is not a good idea. When you take them, amongst other things, they may suppress your body's own cortisol production. When you stop, your body takes a while to catch up again (if it does at all). As a result, you may get low cortisol symptoms, which for many include diarrhoea. Book yourself an early morning (8-9am) cortisol blood test and make sure that you comply with the usual requirements for the test - no Solaray adrenal caps for ideally 24 hours beforehand, no oral HRT or OCP for 6 weeks beforehand, ideally no transdermal HRT for 6 weeks before hand, no biotin, no ashwagandha, no liquorice, no grapefruit. If you explain to your GP what you have been taking, hopefully the GP will organise the cortisol blood test, but otherwise get it done privately. If the results are below 300nmol/L, ask your GP to refer you to an endocrinologist. Whatever you do, give any remaining Solaray adrenal caps to a pharmacist to dispose of safely.

Also, as you will be aware, chemo can have all sorts of knock on effects, which includes on the endocrine system(s) and on the gut. So worth having the GP run tests if possible. Have your doctors talked to you about diet (avoiding things that are inflammatory, increasing fibre etc), taking into account any implications of your previous bowel cancer?

[tattybogle]

if you leave 24 hrs from last dose of NDT , the test results will not show how high your fT3 level is for a large part of every day . so if they are going to test fT3 , it would be better to split the dose the day before the test ( even though you normally take it all in one dose) . taking the first half as usual and the last half 8-12 hrs before test ie 11pm - 3am . this will give a more realistic idea of your average fT3 levels each day.

if they are not testing fT3 it doesn't matter, (the TSH shouldnt be much different and 24 hrs is reasonable for looking at fT4 levels).