I still feel pretty crap to be honest - muscle aches, constipation, fatigue. I popped a note to the doctor’s surgery and said please can you ask the GP not to just mark these as normal as i want an increase on the basis of endo previously telling me TSH needs to be under 2.5 and I have personally felt best when mine is under 1. Advanced nurse practitioner just said I have to wait for the doctor to review results and they will decide. Well now i’m panicking because my GP previously told me as long as it’s “in range” (under 4.2), all is well.
I’m so exhausted fighting, i really am.
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RoseStar
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I have managed to get an increase to 100mcg 👏 I am on Thorne B complex, vitamin D, gentle iron and flaxseed capsules. I’ve seen a private endo yesterday as he’s not convinced I’m converting particularly well. He’s done bloods for my vitamin levels too, so I will find out in a couple of weeks
Even if we frequently start on only 50mcg, most people need to increase levothyroxine dose slowly upwards in 25mcg steps (retesting 6-8 weeks after each increase) until eventually on, or near full replacement dose
In the majority of patients 50-100 μg thyroxine can be used as the starting dose. Alterations in dose are achieved by using 25-50 μg increments and adequacy of the new dose can be confirmed by repeat measurement of TSH after 2-3 months.
The majority of patients will be clinically euthyroid with a ‘normal’ TSH and having thyroxine replacement in the range 75-150 μg/day (1.6ug/Kg on average).
The recommended approach is to titrate thyroxine therapy against the TSH concentration whilst assessing clinical well-being. The target is a serum TSH within the reference range.
……The primary target of thyroxine replacement therapy is to make the patient feel well and to achieve a serum TSH that is within the reference range. The corresponding FT4 will be within or slightly above its reference range.
The minimum period to achieve stable concentrations after a change in dose of thyroxine is two months and thyroid function tests should not normally be requested before this period has elapsed.
TSH should be under 2 as an absolute maximum when on levothyroxine
If symptoms of hypothyroidism persist despite normalisation of TSH, the dose of levothyroxine can be titrated further to place the TSH in the lower part of the reference range or even slightly below (i.e., TSH: 0.1–2.0 mU/L), but avoiding TSH < 0.1 mU/L. Use of alternate day dosing of different levothyroxine strengths may be needed to achieve this (e.g., 100 mcg for 4 days; 125 mcg for 3 days weekly).
Eating iron rich foods like liver or liver pate once a week plus other red meat, pumpkin seeds and dark chocolate, plus daily orange juice or other vitamin C rich drink can help improve iron absorption
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