Levo: 50 TSH 2.1(0.35-5.5) and FT4 14.4(10-19.8). Is this good?

[chihiro]

I posted a few days ago about a relative that is hypo.She has asked for her tft results and they are as above.

I have no knowledge when it comes to thyroid medication and results but from things I have read on here I have a feeling the tsh is a little high and the ft4 is a bit low. I think she needs a increase of her meds.She has been on the same dose for years. She also told me that the doctor said that when she was started on meds her tsh was 5 (same ranges).

She's also taken all the advice from last week and is now taking levo first thing in the morning and waiting an hour before eating. Also taking her supplements in the evening. She has a middle ear infection and is suffering with bad dizzyness. Doctor has put her on dizzyness medication. Is it ok to take this medication with her breakfast or is that not long enough of a break? (that is an hour after levo)

Thanks in advance for any help - she is very grateful

[puncturedbicycle]

I think you're right, she needs a little more. Her tsh has only come down from 5 to 2.1. Ideally she should be given the opportunity to see if she feels better with a much lower tsh, possibly under 1. Aside from infection/dizziness, is she having other symptoms?

Nice of you to help her.

[Clutter]

Yes, I agree with you both, she is undermedicated.

Dizzyness meds would be best taken 2 hours after Levo but if they have to be taken with food an hour should probably be fine.

[chihiro]

Thank you both. She has quite a few symptoms still the worst one being fatigue.

Now how does she convince the doctor to increase her meds as she saw the results in the summer and again today when she asked for them and didn't seem to think there was anything wrong with them.

[shaws]

This is a link of clinical symptoms and you will see she has quite a few of them.

thyroiduk.org.uk/tuk/about_...

Dr Lowe states in his link that 50mcg of levo can make us worse. Go to this date November 20, 2002 even although the person has a different symptom the answer gives us the explanation of a low dose:-

web.archive.org/web/2010103...

This is an archived site and links within may not work but there are also other topics at the top of the page.

Email [e-mail] and ask for a copy of the Pulse Online article by Dr Toft ex of the BTA. You will see what the aim is for the TSH although some may be o.k. with slightly higher. She should send a copy to her GP before her next appointment to discuss this article so he has a chance to read it. Most GP's think it is o.k. to keep the TSH 'within range' unfortunately and ignore clinical symptoms.

An excerpt from Question 6:

6 What is the correct dose of thyroxine and is there any rationale for adding in tri-iodothyronine?

The appropriate dose of levothyroxine is that which restores euthyroidism and serum TSH to the lower part of the reference range – 0.2-0.5mU/l.

In this case, free thyroxine is likely to be in the upper part of its reference range or even slightly elevated – 18-22pmol/l. Most patients will feel well in that circumstance.

[chihiro in reply to shaws]

Thank you so much Shaws that is really helpful. I've emailed Louise and hopefully this will help to get her a higher dose of medication.