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Thyroid Test- Few Doubts

Discussion in 'Health Issues' started by Needtobestrong, May 15, 2018.

  1. Needtobestrong

    Needtobestrong Platinum IL'ite

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    im hypothyroid and taking treatment with Thyronorm.
    Those who are hypothyroid, how often do you check your thyroid function?
    The endocrinologist had told me long ago that TSH and Free T4levels needed to be checked regularly.
    Have one doubt, should the thyroid tablet be taken on the day of giving blood sample or should it be skipped ?
    Does blood test have to be done on empty stomach /early morning? Or can I give it on full stomach in afternoon or evening?
    Just couple of months ago, I took thyroid test in the afternoon, and I had taken my medicine early morning that day..the TSH in the test report was slightly higher., than earlier reports.. And I got worried.
    I want to do this right the next time I take a test, because I need to go for a review with the endocrinologist after that...depending on test results he may change the medication or medicine dosage so it's important.
    There are so many people having thyroid issue in this forum , can u pls clarify my doubt?
     
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  2. goldenhoney87

    goldenhoney87 Silver IL'ite

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    Hi needtobestrong
    fasting TSH sample may be preferred to random or postprandial estimations as normal fasting values would obviate the need for retesting.Taking a T4 medication the morning before your lab test will not be an issue, as most doctors adjust the dosages according to the TSH, which stays stable after T4 dosing. However, to get a reading of your T4 levels that is reflective of most of the day, you would want to postpone your T4 medication until after the lab test
     
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  3. coffeecups

    coffeecups Gold IL'ite

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    Hi, being a doctor, I can give you the following advice.
    Hypothyroidism is having low thyroid hormone levels. Dr treats you with thyroxine( thyroid hormone supplement) for this condition. Main aim is to bring you back to euthyroid state and maintain it. ( Euthyroid means normal thyroid functioning)
    The investigation that a Dr generally asks for is TFT - Thyroid function test. It includes t3, t4 and tsh. Some Drs are more specific. They ask for free T4 and TSH alone. Among these two, TSH is more important.
    If you are already on thyroxine, your TSH should be within normal range. If it is higher, it means you are still hypothyroid despite medication. In otherworsot, thr dose you are on is insufficient. So, the Dr increases your dosage.
    If the TSH is within normal range, the Dr won't change your dose. Simple.
    The test is best given as fasting sample. But recent medical literature says, even a non fasting sample is equally good. But, some labs and some Drs are very specific that you give a fasting sample.
    And you should take thyroid medicine even on the day you are supposed to give the blood sample. Reasons for this is -
    Thyroxine tablet has a long half life of one week. So, your blood levels of the thyroid hormones won't fluctuate based on one day dose. Eg, you miss the dose on the day of giving test, nothing to worry about.
    Any more doubts, do ask. I will try explaining
     
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  4. DDream

    DDream Finest Post Winner

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    It is better to take this test every six months or based on the suggestion by the doctor. Once its is near normal level it can be scheduled for every one year. So far no one told me to fast before blood test. I think fasting has nothing to do with it. They may also do ultrasound in situations where its needed. If you have hashimoto ( auto immune) then you may have to take it life long every morning atleast 30 minutes before eating any thing. Generally normal TSH levels are below < 5.0 mIU/L. But all my doctors insist it to be alteast close to 1 or below. Next time request your doctor to check vitamin D levels also. Recent studies suggest some link of this vitamin to autoimmune component of this problem. If your TSH levels are high, doctors may ask you to increase the amount of thyroid medicine.
     
    Last edited: May 15, 2018
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  5. Needtobestrong

    Needtobestrong Platinum IL'ite

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  6. Needtobestrong

    Needtobestrong Platinum IL'ite

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    Thanks for the detailed reply. U mentioned that u are a doctor., so one doubt which I have is: in case I check the thyroid levels and TSH and free T4 levels are found to be within normal levels, then will my metabolism come to normal? If levels are normal will I be able to lose weight by following proper diet restriction and exercise?ive been stuck in a weight loss plateau since many months and can't help thinking whether my thyroid is the culprit..I'm pretty sure I didn't face this much difficulty in losing weight a few years ago before I was diagnosed with Hypothyroidism..
    Also if the thyroid levels in any patient are normal with medication can medication dosage be reduced or stopped? ( I'm aware that this it varies on case to case basis and I'm asking very general question but ur reply would give me a ray of hope and more determinedly efforts to keep TSH in control ).
     
  7. coffeecups

    coffeecups Gold IL'ite

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    Normally uncorrected hypothyroidism causes weight gain. Thyroid is needed for normal body metabolism. When you have normal Tsh and T4 during treatment with thyroxine, it means you are brought to euthyroid status. So, your metabolism will be good like any other person. And euthyroid state doesn't cause difficulty in losing weight. Try to see if you can include new exercises and modify your lifestyle. I don't think a well treated thyroid issue would be a problem in losing weight.

    Reg your second concern, can I decrease or go without medications once euthyroid status is achieved?
    You must remember that it is with external support ( thyroid medicine) that you have reached this euthyroid status. So, a drastic decrease in dose ( let's say, from 100 to 50 mcg) or complete stopping of drugs, is going to harm you as your body will fumble with thyroid hormone synthesis.
    Having said that, it all depends on the underlying cause of hypothyroidism. In most cases, it is auto immune. In such cases, the support needed will be very long / life time. This is more common in middle age women.
    There are sometimes temporary causes. In such cases, your Dr himself will taper the dose slowly and stop.
    But the underlying goal should be maintaining euthyroid status.
    Good luck
     
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  8. Needtobestrong

    Needtobestrong Platinum IL'ite

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    Thank you..u have explained this concept so nicely.
     
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  9. coffeecups

    coffeecups Gold IL'ite

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    Thank you !
     

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