After 6 weeks on 25MG of levothyroxine, TSH has risen, what next?

After struggling with health issues for over three years now, my GP finally agreed to give me a trial of Levothyroxine after my last blood test results showed a TSH of 6.5. I have been taking it now for six weeks and had a follow up blood test yesterday and my TSH levels have actually risen. Looking at the results TSH was the only thing that was tested.

Volume of Specimen Collected: N/A

Specimen Desc : SERUM

Reasons for Request:

On thyroxine - trial dose.

Serum TSH level OR 6.86 mu/L (0.3-4.7)

(RH)-Dr/nurse will discuss result at next routine appt, 29/06

Suggests inadequate Levothyroxine dose/concordance

I have just looked back through my last 3 years of blood test results and can see abnormal TSH levels continually rising from 3 up to 6.86 where I am today.

I also notice that I had a B12 test and that was flagged as abnormal along with a Vitamin D test where I was borderline too but I was told verbally that it was fine?

R VITAMIN B12 OR 949 ng/L (170-700)

Red blood cell folate 340 ug/L (126-651)

Serum vitamin D 55 nmol/L

(RH)-Dr/nurse will discuss result at next routine apt, 24/10

<25nmol/L- Vitamin D deficiency

Consider treatment

25-50nmol/L - Vitamin D may be insufficient. Consider

supplementation and dietary and lifestyle changes.

>50nmol/L - Vitamin D sufficiency

I guess the question is what will I be told next week at my appointment. This is a trial of Levothyroxine that I am on and GP was considering taking me off it before this last test. Also should I start with other supplements too?

Thanks

Chris

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Chris,

Your GP should increase your Levothyroxine, hopefully to 75mcg which should have been prescribed in the first place as 25mcg is demonstrably an inadequate dose.

Ask for ferritin, vitamin D, B12 and folate to be tested before you supplement to get a baseline. These are often deficient or very low in hypothyroid patients. B12 over range should have been investigated unless you were supplementing. Vit D 75-200 is considered optimal, high end of range preferably.

vitamindcouncil.org/vitamin...

b12deficiency.info/what-to-...

Some labs won't test FT4 and FT3 unless the GP is very insistent. If you want to check your FT4 and FT3 status you can order private tests from Blue Horizon and Genova via thyroiduk.org.uk/tuk/testin...

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I would be very wary of being kept on a low dose of Levo .

I spent 12 years on 50 mcgs with my GP telling me there was nothing wrong with my thyroid.Thankfully I found this support group when my TSH was over 4 and I wasn't feeling well.I approached my GP for a rise in thyroxine and blood tests for B12,folate and D3. Thankfully he started listening when I told him I had joined a support group as I felt I needed more information.He gradually raised my Levo to 75 mcgs and then 100..

I really had to stand up for myself though ( politely and respectfully) ...I'm afraid it's what we have to do.

You will learn a lot from reading posts here and asking for help as you go along.

Eventually when I was asking a lot of questions my GP thankfully passed me over to an Endocrinologist........you can always ask here for recommendations of good Endos in your area. It isn't fair that we should be left struggling with ill health because many of our GPs don't look beyond the TSH lab results and seem to forget we are their patients who live in our bodies and have symptoms!!!!

Good luck with your appointment and I hope you soon make some progress.