What should thyroid level be. I have been diagnosed with under active thyroid .

[Jeanjenx24]

[shaws Administrator]

Welcome to our forum

The levels vary but to be diagnosed as hypothyroid the TSH must have risen. Some doctors medicate if TSH is above 5 and patient complains of clinical symptoms. The Official British Thyroid Association's Guidelines says to medicate when the TSH reaches 10. Of course, by that time I think you would feel pretty unwell.

Some links for information:-

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

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

thyroiduk.org.uk/tuk/treatm...

Did your GP say to take your thyroid gland hormone (Levothyroxine I should imagine) on wakening with a full glass of water and not have breakfast for about an hour. You can drink water. You usually have another blood test in 6 weeks with another increase and so on until you feel better.

If your GP hasn't tested Vitamin B12, Vit D, iron, ferritin and folate ask for these to be done as they are usually deficient.

I hope you feel better soon.

[Ellie-Louise in reply to shaws]

Hi Shaws, is that really how to take Levothyroxine? No-one has told me anything about how to, apart from to take it first thing. I take mine with a sip of water before drinking my tea, then I have breakfast about 20 mins or so later while checking email.

[shaws Administrator in reply to Ellie-Louise]

You have to take levo on an empty stomach with a full glass of water, so that it goes directly into your stomach as sometimes it can swell if you don't take enough water. Some people eat breakfast about 1/2 hour later but others leave it about an hour. Food can interfere with the uptake of levo.

Some find it preferable to take levo at bedtime, if so they should have last eaten two hours beforehand - as your stomach should be empty. Again you take it with one glass of water. This means that you can take your breakfast as soon as you get up a.m.

If you are having a thyroid gland blood test and take your meds in the morning, you should not take your meds until after the blood test as it can skew results. Have the test as early as possible. Take your meds afterwards as long as you have left 2 hours after eating.

If taking meds at bedtime, you miss the night's dose and take it after blood test. You can also take your dose as usual at bedtime or some might take half dose.

[Ellie-Louise in reply to shaws]

That's extremely helpful, thank you. Actually I am about to make an appointment for my annual blood test now, so I shall take note of what you said and make sure I do it correctly. xx

[Hidden]

Hi Shaws, like Ellie-Louise I was told to take Levo first thing in the morning. My packet of Levo states to "take with water before food" but no timing given so I take mine and then get the breakfast ready and eat! So who exactly recommends that we take our tablets way before eating? Do different manufacturers of Levo give different instructions?

[helvella Administrator Thyroid UK in reply to Hidden]

Different manufacturers do indeed give differing instructions. Though the three UK manufacturers give fairly similar instructions. If you have not got copies, you can see the PILs here:

medicines.org.uk/emc/search...

The lack of any advice on the time gap is, in my view, a serious omission.

There is excellent evidence that both iron compound and calcium compounds affect levothyroxine - probably from binding to the levothyroxine before it has been absorbed. Quite a number of people have breakfasts containing both iron and calcium (e.g. Special K with milk), so keeping levothyroxine away from breakfast is soundly based.

The prescribing information from the most-prescribed USA brand of levothyroxine says this:

Food Interactions

Consumption of certain foods may affect levothyroxine absorption thereby necessitating

adjustments in dosing. Soybean flour (infant formula), cotton seed meal, walnuts, and dietary

fiber may bind and decrease the absorption of levothyroxine sodium from the GI tract

rxabbvie.com/pdf/synthroid.pdf

Not exactly comprehensive, but welcome to see something said.

More information about numerous interactions can be found here:

thyroidmanager.org/chapter/...

It is also the case that relatively recent research has endorsed bed-time dosing as an option. There are many views on this, some positive, some negative. I take mine at bed-time.

healthunlocked.com/thyroidu...

We have also seen quite a number of people who had not realised that any separation is required, who have had that pointed out here. Some have certainly noticed very significant changes by ensuring there is a good gap.

Some people suggest consistency is more important - because, over time, your dose will have been adjusted to take into account any such interactions. In my view this is difficult to achieve - for example when routines change (holidays?), when diet changes (trying to lose weight?), during other illness (lost appetite?).

Rod

[Hidden in reply to helvella]

Thx Rod, some excellent reading there, I will study it further. And I will change my routine from now on. It's a pity that the time gap isn't standardized on all the packets of Levo, and that the Dr's don't tell you either. Maybe they don't know!