Increased Dosage

[Jonesey]

My dose has been increased from 50 to 75mcg Thyroxine because my TSH has risen beyond acceptable range.

I am more tired and have gained weight. Why is this?

[Jackie]

Hi,

If you re under treated this is to be expected.You do not say how log you have been on treatment? Quite common to take up to a year with repeat bloods and rises in drugs until OK.It is correct to do it slowly for safety, but I know frustrating. The second thing is always ask receptionist or hospital consultant`s secretary for a print out of results with ranges ,most different for all blood tests.They do check with a doc, but routine.Important to keep them for your own records. Quite common to be worse before better. If T4 is high in range, especially if tSH above range, very likely you need some T3 on a script with the Levo( T4). However, first you need TSH, T4 and Free T3 tested, Essential, then if put also onto T3 ( taking split dose 12 hours apart) retest, all after 4-6 weeks. Then think about the other relevant tests. T3 helps all the symptoms but especially weight and lowers the TSH.

Plenty more things but that is the first thing to do.

Best wishes,

Jackie

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[Jonesey]

Hi Jackie

Thank you for your advice. I have been on 50mcg for two years. Put on 75mcg 6 weeks ago.

Had routine 6 monthly test and TSH had risen to 6.36 from 2.33 (range 0.35 - 5.5).

FT4 is 14.1 down from 14.9 (range 9.0 - 25.0).

FT3 is 3.5 down from 3.7 (range 3.5 - 6.5).

I understand it's best if T4 is near top of range and wondered if this had something to do with worsening symptoms.

I'm lucky to have a really good doctor so will query with her when I get results of blood test done yesterday. Just wondered if it was normal to feel worse.

Thanks again.

x

[helvella Administrator Thyroid UK in reply to Jonesey]

FT4 dropping below range would be very likely to make to feel bad and have worsening symptoms. Similarly with FT3.

I don't wish to suggest your doctor is less than brilliant in every other way, but most people here would think 2.33 was too high for TSH when on levothyroxine treatment. That is, many people need it to be below 1, sometimes below the bottom of range - 0.35 - in order to feel well.

Also, are you aware that you should not take levothyroxine in, say, the 12 hours before blood is drawn for testing?

I would also like to know that you have been tested for B12, folates, iron/ferritin and vitamin D.

Rod

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[Jonesey]

Thank you Rod. I have been tested for B12 etc.

D3 deficient and iron/ferritin, which have been corrected with supplements. Yes, I made sure I left a minimum of 12 hours before blood test.

I agree, I would like TSH nearer 1. I'll speak to doc and see what she says.

Thank you again