Annual thyroid review blood test

[Suedan]

I am hypo and was diagnosed about 2 years ago on Levo since. I recently needed to go to Dr's for a problem that had been bothering me for some time but as per hoped it would clear up on its own.

Whilst there the GP decided I was about due for a blood test to review my hypothyroid etc at it had been almost a year since last one. Wellll, I went and got a printout as I have learned that you need to do this due to errors that can ocur and there is an A4 list of results which I have to say mean nothing to me apart from the Vit D (which incidentally is looking more healthier at 110 nmol/L) and serum TSH level (3.6 mu/L).

Does anyone else think this is unusual that there are no results for T4 or antibodies?

I'm confused - again

Sue x

[RedApple Administrator]

At my annual review, my GP always does an FBC (Full blood count) so I'd guess that's what your long list of results is about.

With regard to thyroid, TSH is the only thing tested. Antibodies are not usually tested at annual reviews, and T4 will only be done if TSH is out of range. As you TSH was 3.6, that's probably within range.

[Suedan in reply to RedApple]

Thanx -makes sense when someone who knows what they are talking about says it.

Yep you are probly right about the long list - nothing there to worry about I'm sure. Well the GP hasn't raised any concerns as yet so its probly ok

Sue x

[helvella Administrator Thyroid UK]

Most people who have had one antibody test never get a second antibody test. It is considered as useful for identifying that there is (or is not) an autoimmune cause and that is that.

A few people do get repeat antibody tests for various reasons - including the possibility that you could go positive having originally been negative. But even then few doctors consider that charting antibody levels is useful or meaningful exercise. Though some people do think it is.

My thought is that in order to be truly useful it probably needs to be done quite frequently so you can try some approach, see if the levels change, continue with same or change approach. It is all too easy to make false assumptions and come to wrong conclusions when tests are very spread out.

Most often, Free T4 is not done if TSH is within reference range - even if requested by GP. You TSH is very likely too high - if it is reflecting your medication accurately, then I'd suggest you need a dose increase.

[Suedan in reply to helvella]

Thanx - interesting that you think THS is high though as the range states 0.4 - 4.9 so I just assumed that mine was ok. Incidentally I have just noticed that there is a slight variation in the ranges from my previous test range of 0.30 - 4.60, what in your opinion would be the reason for this?

Hope you don't mind all the questions, I have a real problem taking all the info in.

Sue x

[RedApple Administrator in reply to Suedan]

Your TSH is ok, in as much as it is within range. But the real issue is, how do you feel?

If you feel good, then that TSH is fine for you. However, many people would still have hypothyroid symptoms until their TSH is below 2. So if you don't feel well you could request that your GP increases your thyroid medication dose, to see if it helps.

[Suedan in reply to RedApple]

Thanx - it would explain why I have been getting more tired and needing to go bed earlier. Tend to start yawning at about 2pm and needing to sleep at about 8pm. Apart from the continuing weight gain and constipation of course, the general sluggishness and feeling cold etc, etc..... well u no what I mean lol

thanx again

Sue x

[shaws Administrator in reply to Suedan]

If you are on medication, and if you still have symptoms you should aim for a TSH below 1 or even suppressed. This is an extract from an article by Dr Toft, ex of the British Thyroid Association

6 What is the correct dose of thyroxine and is there any rationale for adding in tri-iodothyronine?

The appropriate dose of levothyroxine is that which restores euthyroidism and serum TSH to the lower part of the reference range – 0.2-0.5mU/l.

In this case, free thyroxine is likely to be in the upper part of its reference range or even slightly elevated – 18-22pmol/l. Most patients will feel well in that circumstance.

But some need a higher dose of levothyroxine to suppress serum TSH and then the serum-free T4 concentration will be elevated at around 24-28pmol/l.

[Suedan in reply to shaws]

Thanx Shaws. I have tried a higher dose of Levo but the side effects are so bad had to reduce it, trying to find a happy(ish) medium now.

Just started adding some other vits and supplements to see if these help as Vit D3 has helped with some of the symptoms. Early days will see how it goes.

Sue x

[shaws Administrator in reply to Suedan]

Levo didn't make me feel well. In fact I had more symptoms on it but am fine now.

Hope you find a dose/meds which suit.