Preparing for your appointment

Ask for your test results

First of all, find out whether you have had any previous thyroid tests done. The most common thyroid tests are (TSH) thyroid-stimulating hormone, Free T4 (FT4 – your level of thyroxine in the blood) and Free T3 (FT3 – your level of triiodothyronine in the blood. T3 is the active hormone.)  Sometimes thyroid antibody tests will have been done – thyroid peroxidase (TPO) and thyroglobulin (TgAb).

Unfortunately, many doctors only do the TSH test although some will do TSH, FT4 and thyroid antibodies .  It is very rare to have an FT3 test done to check if you are converting your thyroxine (T4) into triiodothyronine (T3).

Sometimes the receptionist will give your results to you over the phone but you will probably need to go into the surgery and ask for your test results. You have a right to see your medical records under the Data Protection Act 2018. Read more information on the General Data Protection Act.

Check your results

Some doctors will tell their patients that their test results are normal.  However, it would be better for you to ask for your exact results i.e. your level as well as the ranges. Be aware that different areas in the country use different test ranges so one TSH test range might be 0.5 – 5.0 but in another area the TSH range might be 0.4 – 4.0.  The same goes for all other thyroid tests.

Although your results may be classed as normal, there are conditions that could explain your symptoms:

• Borderline hypothyroidism – one or more of your results are near the bottom or top of the range
• Subclinical hypothyroidism – you have a high TSH and a normal FT4
• Subclinical hyperthyroidism – you have a low TSH and normal FT4.  Often doctors do not inform their patients of this
• Hashimoto’s disease – (the autoimmune  form of hypothyroidism )  – you have high thyroid antibodies
• Graves’ disease – (the autoimmune form of hyperthyroidism ) – you have high thyroid antibodies
• Central hypothyroidism – (low levels of TSH, FT4 and FT3) – this is caused by a pituitary  problem

Other tests that can be useful

Check to see if you have had the following tests done and make a note of your results:

• Vitamin B12 – the symptoms of vitamin B12 deficiency are very similar to hypothyroidism. The range for vitamin B12 is very wide and you may find improvement with supplements ¹
• Vitamin D – there is a link between vitamin D deficiency and autoimmune thyroid disease and thyroid cancer ²
• Selenium – low selenium can impact on your thyroid health by causing non-conversion of T4 to T3 ³
• Folate – deficiency in folate causes similar symptoms to hypothyroidism ⁴
• Iron – iron deficiency anaemia is found in patients with hypothyroidism. The symptoms are very similar to those of hypothyroidism ⁵
• Ferritin – links have been found with ferritin deficiency and hypothyroidism ⁶
• Zinc – zinc and other trace elements such as copper and selenium are required for the synthesis of thyroid hormones ⁷
• Magnesium – low serum magnesium is associated with increased risks of positive anti-thyroglobulin antibodies and hypothyroidism ⁸
• Cholesterol – high cholesterol is often a sign of hypothyroidism ⁹

Your symptoms

Tick off all the symptoms you have on our Hypothyroid Symptoms List or Hyperthyroid Symptoms List, adding any you have that are not listed and rate them on a 1-10 scale with 10 being the worst.

Do this at regular intervals – at the same time as you have tests done is a good idea – and then you can see how you are feeling and tie this in with test results. This will also help you know at which level you feel best for future reference.

Keep a diary

Start to keep a diary of all your thyroid test results and their ranges and any other tests plus your pulse rate and weight so that you can see if there are any changes over time i.e. whether your levels have slowly been going up or down or whether you have been putting on or losing weight.

Also, make a note of the following:

• Do your symptoms follow a pattern?
• When did the feelings or symptoms begin?
• Is everyday life, for example sleeping, walking, working, family life more difficult because of these symptoms?
• Do you have any particular concerns?
• Is there a family history that you think might be relevant i.e. did/does your mother, grandmother, sister or brother have thyroid disease?
• What medicines, treatment or supplements have you’ve tried? Make sure you include things you have been taking for other problems.

Get informed

Find out as much as you can about the thyroid before your appointment so that your doctor can see you are well informed. Copy information from our Information Pack, thyroid books or research papers and highlight the relevant areas so that you can show these to your doctor.

Questions

Make a list of questions you want to ask your doctor in a notepad.   Make sure you have space for the answers. Add to the list as you remember things. Read more information on the questions you can ask.

Your medications

Make a note of all the medications you are on (or take them with you). Don’t forget to list any vitamins, minerals or supplements you are taking.

Support

Organise to take someone with you if you can.  Someone who knows you well and has seen how you are now – as opposed to how you were in the past – is always a good idea.

Visiting your doctor

Your doctor is likely very busy so, if you need to have an in-depth chat, make sure you book a longer appointment if you can.

For more support check out our online community:

http://www.healthunlocked.com/thyroiduk

Date updated: 04/05/21 (V1.5)
Review date: 16/04/22

References

1. Vitamin B12
   NHS
   Symptoms – Vitamin B12 or folate deficiency anaemia
   https://www.nhs.uk/conditions/vitamin-b12-or-folate-deficiency-anaemia/symptoms/
2. The Role of Vitamin D in Thyroid Diseases
   Kim, Dohee
   International journal of molecular sciences vol. 18,9 1949. 12 Sep. 2017
   https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5618598/
3. Selenium and Thyroid Disease: From Pathophysiology to Treatment
   Ventura, M., Melo, M., & Carrilho, F.
   International journal of endocrinology , 2017
   https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5307254/
4. Vitamin B12
   NHS
   Symptoms – Vitamin B12 or folate deficiency anaemia
   https://www.nhs.uk/conditions/vitamin-b12-or-folate-deficiency-anaemia/symptoms/
5. Characteristics of anaemia in subclinical and overt hypothyroid patients
   Erdogan, M., Kosenli, A., Ganidagli, S., Kulaksizoglu, M.
   Endocrine Journal 2012;59(3):213-20. Epub 2011 Dec 27
   https://www.ncbi.nlm.nih.gov/pubmed/22200582.
6. The relationship between iron status and thyroid hormone concentration in iron-deficient adolescent Iranian girls
   Eftekhari MH1, Keshavarz SA, Jalali M, Elguero E, Eshraghian MR, Simondon KB.
   Asia Pac J Clin Nutr. 2006;15(1):50-5
   https://www.ncbi.nlm.nih.gov/pubmed/16500878
7. Zinc Deficiency Associated with Hypothyroidism: An Overlooked Cause of Severe Alopecia
   Ambooken Betsy, MP Binitha, and S Sarita
   International journal of trichology, 2013, Jan-Mar, 5(1), 40–42
   https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3746228/
8. Severely low serum magnesium is associated with increased risks of positive anti-thyroglobulin antibody and hypothyroidism: A cross-sectional study
   Wang K, Wei H, Zhang W, et al
   Scientific Reports vol. 8,1 9904. 2 Jul. 2018
   https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6028657/
9. Effects of Thyroid Dysfunction on Lipid Profile
   C.V Rizos, M.S Elisaf, and E.N Liberopoulos
   The Open Cardiovascular Medicine Journal vol. 5 (2011): 76-84
   https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3109527/