Thyroid blood testing questions.

[Hades10109]

Hello, I recently found out my tsh were high, over 10, but these results were old so was sent for more bloodwork. My tsh levels were a bit high but not enough for treatment. I know they can flucuate so I asked to be sent for more. I am not feeling as weak and sick as I normally do, is that going to make a difference on the results? And is there a certain time of day I should get my blood work done? She sent me for my TSH, free T4 and T3. Is that everything she should be checking for? Or should she be checking free T3 aswell. I also have almost all hypothyroid symptoms and have for about 10 years so am not getting them checked for nothing. Any info is appreciated, thank you.

[gimel]

With all those symptoms and your possible high TSH level you really do need to get the tests done, as recommended by both Red_Star and myself.  If you want to be confident about this information, I highly recommend reading at least the first two pages of the following link, and more if you want to get into the discussion and scientific evidence for all that is recommended.  

http://www.thyroiduk.org/tuk/TUK_PDFs/The%20Diagnosis%20and%20Treatment%20of%20Hypothyroidism%20%20August%202017%20%20Update.pdf

When you have test results, please post them along with reference ranges and we will be glad to help interpret and advise further.

[gimel]

Please tell us about the symptoms you have.  Feeling better is not going to be an issue with accuracy of tests.
TSH only starts to rise late in the day, so anytime in the morning/early afternoon is okay.  

The tests that you need are TSH, Free T4 and Free T3, not Total T3.   Free T3 is the biologically active thyroid hormone metabolized in body tissues.  Total T3 is not nearly as revealing as Free T3, so insist on Free T3.  In addition with the prior high TSH you should also be tested for the possibility of primary hypothyroidism (Hashimoto's Thyroiditis).  Two tests may be required:  Thyroid Peroxidase antibodies (TPO ab) is the one that usually shows up.  If it is negative, then the second test is Thyroglobulin antibodies (TG ab).  In addition it would be good to test for Vitamin D, B12 and ferritin.  

These tests should go a long way toward identifying any thyroid issues.: however, symptoms are the most important consideration in diagnosing possible hypothyroid ism.  That is why I started by asking about your symptoms.

[Hades10109]

My symptoms are fatigue, depression/anxiety,i'm cold alot (expecially in the mornings), i'm sore quite often, i've also noticed numbness/tingling in my hands/feet sometimes(not sure if that is hypothyroid symptom) constipated often, the last couple months ive also been noticing tightness around the left part of my chest, racing heart, and have experienced angina a couple times over the last year. My hair is thinning and has been like this since I was a teenager but that might be hereditary, i'm very pale and i've been experiencing a weird rash or dry skin patches all over my hands(they come and go) also don't know if that is a symptom but just trying to think everything that has been happening to me. I've felt like this since I was probably 20 and am now 30, but the last two years I have been a lot worse.

[Hades10109]

I also have low testosterone, if that makes a difference.

[Red_Star]

The August 2012 study entitled "Clinical Significance of TSH Circadian Variability in Patients with Hypothyroidism" (Sviridonova MA, et. al) showed an average morning TSH level in the subclinically hypothyroid group was 5.83 mU/L and in the afternoon was 3.79 mU/L; 73% TSH circadian variability.  

The average morning TSH level in the hypothyroid group taking levothyroxine was 3.27 mU/L and in the afternoon was 2.18 mU/L; 64.7% TSH circadian variability.  Morning: 8 - 9 am. Afternoon: 2 - 4pm.

Test your thyroid labs in the morning. I prefer to fast before testing. Labs to request include TSH, free T4, free T3, thyroid peroxidase antibodies (TPOAb), thyroglobulin antibodies (TgAb), vitamin D, iron studies including  ferritin, vitamin B12.