Advice regarding bloods

[HuskyBlue]

I have just got my blood results back after my annual check up (taken in an afternoon). I stopped supplements 3 days prior:

Serum T4 17.2 (range 11.5-22.7)

Serum TSH 0.09 (range 0.55-4.78)

Serum ALT 45 (range 0-34)

Serum ALL 175 (30-130)

Haemoglobin 124 (range 118-158)

RBC 4.16 (range 3.85-5.20)

Haematocrit 0.350-0.455)

MCV 89.6 (80-101)

MCG 29.8 (27.0-34.0)

Red blood distribution count 14.1 (11.5-14.7)

Platelet count 181 (160-370)

Mean platelet volume 9.6 (5.90-9.90)

I had my Serum T3 tested in Nov 24 and this was 4.8 (range 2.5-5.5)

The GP said he may reduce my Levothyroxine as my TSH was out of range. Any thoughts?

Also I've read there is a link between overstatement with Levothyroxine and abnormal liver results. Has anyone else experienced this?

Any advice gratefully received.

[GlowCoach Administrator]

FT4 is only 50% of range.

To fully assess thyroid function we need TSH, FT4 & FT3 taken in the same test.

How are your vitamin levels looking and what do you supplement with?

Essential to have good vitamin levels.

[SlowDragon Ambassador]

Exactly what dose and brand of Levo are you taking

Are you taking any T3 or NDT as well or just Levo

What vitamin supplements are you taking

No results for vitamin D, folate, ferritin or B12

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)

T3 ….day before test split T3 as 2 or 3 smaller doses spread through the day, with last dose approximately 8-12 hours before test

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

[HuskyBlue in reply to SlowDragon]

The test I had in November was fasting at 10.00 am, the one in February was about 14:00 non-fasting.

I am only on Levothyroxine 100 mcg (weight 52kg). Unfortunately I seem to get a different brand of Levothyroxine every month.

I last had my B12 tested in February 2024 and it was 733 (range 211-911).

I take Better You B12 and Vitamin D.

I think I will pay for a private test done at the correct time.

[SlowDragon Ambassador in reply to HuskyBlue]

Unfortunately I seem to get a different brand of Levothyroxine every month.

Work out which brand suits you best …..and get GP to specify that brand at each prescription

or if Teva brand upsets you have note added to all future prescriptions …..”No Teva”

Government guidelines for GP in support of patients if you find it difficult/impossible to change brands

gov.uk/drug-safety-update/l...

If a patient reports persistent symptoms when switching between different levothyroxine tablet formulations, consider consistently prescribing a specific product known to be well tolerated by the patient.

academic.oup.com/jcem/artic...

Physicians should: 1) alert patients that preparations may be switched at the pharmacy; 2) encourage patients to ask to remain on the same preparation at every pharmacy refill; and 3) make sure patients understand the need to have their TSH retested and the potential for dosing readjusted every time their LT4 preparation is switched (18).

And here

pharmacymagazine.co.uk/clin...

Discussed here too

healthunlocked.com/thyroidu...

[SlowDragon Ambassador in reply to HuskyBlue]

The test I had in November was fasting at 10.00 am, the one in February was about 14:00 non-fasting.

TSH is at its lowest point in day after lunch

So refuse to reduce dose based just on low TSH

Ft4 is low

Request GP retest including Ft3 , vitamin D, folate, ferritin and B12

If GP can’t or won’t say you will test privately

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...

[HuskyBlue in reply to SlowDragon]

Thank you Slow Dragon. This will be useful for my telephone appointment tomorrow.

[sobs1962]

They always panic when your TSH is almost undetectable and some people need to have it that way to feel well. The fact they rely on TSH and very rarely test FT4 or FT3, means they're not getting the full picture and if you're a bad converter like me, you have to really fight to get them to take you seriously. Honestly they're trying not to do those tests, in case, god forbid you might need Liothyronine and they aren't staying up to date with the price and prescribing criteria, if they spent less time on the golf course and more time actually doing their job, things would be much more satisfactory and we wouldn't have to fight so hard, honestly it's totally exhausting.