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[Sid]

Hi

I am post menopausal and on 2 pumps of Oestrogel and have a Mirena, but I have been getting badly fatigued, am always cold, have a low body temperature and have put on weight. My GP reluctantly agreed to test my thyroid, but because the TSH came back at 4.15 (within range) the lab did not do T4. I am wondering whether to arrange a test privately through Medichecks but wasn’t sure how easy it was to get enough blood using the equipment they provide. I can see that you can pay extra to have a nurse do it, and wondered if this was necessary. Has anyone else managed to do it at home and was it tricky?  Or maybe I shouldn’t worry unduly about a TSH of 4.15 (my GP isn’t, but then he doesn’t have to go to bed every afternoon due to exhaustion!).  Thanks for your help, ladies

[ATB]

Hi. I have used medichecks for 7 years. Blood prick tests are easy to do and I’m not great with that sort of thing normally. I find them accurate as well, finger pricks for other hormones aren’t necessarily but for thyroid it is and my symptoms always correspond with the blood test results.
Your TSH, although not a good diagnostic tool, is actually too high and itself indicates hypothyroidism. The NHS I’m afraid is hopeless with thyroid care too, very outdated and also limited in medication choices. I would not advise using NHS for thyroid care personally. If it is possible, at the moment in the uk private care is far superior in this area and the NHS is not treating thyroid issues appropriately.
You want a full thyroid hormone panel that checks everything, Medi has a comprehensive one for around £80-100. They have an extra one that tests some vitamins and minerals along with hormones. That’s good to check vit D, B12 and others that are massively affected if you have a thyroid issue due to absorption issues. Once you have results you can post them in this thread, I’m good at reading them and can help you understand your situation if you like. Being in range for any hormone isn’t the only thing to look at, there are optimal levels for all of them. A normal TSH is actually 1. Your Free T3 should be in the upper quarter of the range and free T4 midway or above. I feel best when it’s exactly midway with my T3 just in the upper quarter but no higher. It’s taken years for me to understand this about myself and what dosage gets me there.

[Sid]

Thanks, ATB.  That’s hugely helpful. I’ll book a test 

[ATB]

You’re very welcome. Someone online helped me when I first started on this journey too

[joziel]

I've done a Medichecks test for ferritin and it was definitely okay to get the required amount of blood out although I was slightly intimidated by the idea at first and the size of the test tube 

With the thyroid test, the first time I had my bloods run they just did TSH as it was within normal range - but the second time I explicitly asked my GP for free T4 and she said she would write that request on the form but couldn't be sure the lab would do it, if TSH was normal. Well - they did do it (even though TSH was normal), because she requested it. So you could try your doctor again and ask them to at least request it from the lab...

[Marchlove]

Doing just TSH and T4 won’t be any good joziel. It has to be the full thyroid panel which the nhs don’t do. 

[joziel]

I think the only thing I'm missing now is the T3?

I did ask the GP about it and they said it would be incredibly unlikely for my TSH and T4 to be solidly normal and for there to be anything amiss with my thyroid. But I know by now that doctors should not be taken at face value 

[Marchlove]

As a matter of interest Joziel, if you don’t mind sharing, what were your TSH and free T4 results? x

[joziel]

My TSH was 0.95mU/l and my 'free thyroxine', which I think is free T4, was 15.5pmol/l.

[Marchlove]

Thanks for sharing Joziel.

TSH is good, do you have the ranges for the free T4 in the test you took?

Nether the less, you might need too still do the full panel to see if you are converting to free T3.

I’m not saying this is happening with you but it gives you a fuller picture of your thyroid function.

ATB- I believe vim right in what I’m saying, but correct me if I’m wrong!

X

[joziel]

The range was 10.0 to 25.0 (I was 15.5).

[Marchlove]

Sounds ok, hopefully ATB will confirm. But you don’t know your free T3 without the full panel.
I really don’t know how important it is for you to check it out right now though, as only been on a thyroid journey this year so not experienced enough to offer more advice. But the consensus seems to be that you need the full thyroid panel to completely rule out any issues x

[ATB]

Yeah you actually can have ok free T4 but free T3 not at optimal, it isn’t as common but you can. A full panel will also include reverse T3 & antibodies, which are important as well. Your free T4 is not quite halfway on the range, which it should be, so it would be a good idea for you to get a full panel Joziel. Being ‘in range’ doesn’t mean much, there are optimal places to be and based on that range you would want a Free T4 at least at 17.5. Even being a little low can indicate an issue. It isn’t glaringly obvious you are hypothyroid but you may want to double check.

[Stella2]

Hi Sid, hope you don't mind me posting on your thread, ATB kindly offered to comment on my results. I got tests through my GP. TSH: 2.1, it was 2.4 last year, and previously 1.9, T4 :16.7. also antibody positive. According to my GP that's normal.
I would be grateful for comments ATB if you can, or anyone?

[ATB]

Hey Stella, if your thyroid antibodies are above range, you have hashimoto’s hypothyroidism. I’m not used to seeing ‘ antibody positive’ so not sure what that means? The tests you need are ‘free’ T4, not total T4, and Free T3- that’s the active thyroid hormone, our body is meant to convert some of the free T4 to Free T3 for us to use ( Some people can’t convert, so they need to be given T3 along with T4 ). I can’t tell you much just with a total T4 result, I would need the free T3 & T4, plus the ranges which appear in brackets after the result. Where your result is on that range is the important part. NHS doesn’t routinely test the things I mention though, they tend to do TSH ( just a messenger and not a real hormone ) and total T4, sometimes.

For anyone that would like to learn more about interpreting lab results this link is a good start point to begin to understand. I have found over the years of reading hundreds of results that women are still individual and will have a point within the optimal parts of the range that suits them best. I’m a bit too anxious for instance, if I let my free T4 go more than midway, with the free T3 at the lower part of the upper quarter too is best for me.

https://stopthethyroidmadness.com/lab-values/