TSh results.

[Teddy-Twoshoes]

Hi, wonder if I could have some advice, have been on 25mg of Levothyroxine since October last year, My latest tsh is 0.78, my Gp advices me to up it to 50mg three times a week to get it up to around 1 , My levels last year on no medication were TSH 0.90, Free T4 13.1, free t3 4.6. Last November my tsh dropped to 0.37, after only been on it for a month, quite frankly I am confused, still not feeling better, dont think this medication is doing anything to help, my outer eyebrow has still not grown back, surely if the meds were working my symptoms would improve. Many thanks.

[Clutter]

Teddy-twoshoes,

It doesn't make sense that your GP wants to target TSH 1.0 when your TSH was lower than that before you were taking Levothyroxine. Increasing dose will reduce TSH below 0.78 and should improve FT4 and FT3 but I doubt an additional 50mcg 3 x week will make much difference in improving symptoms. You really need FT4 and FT3 results to see whether 25mcg has improved levels.

[Teddy-Twoshoes in reply to Clutter]

Thanks Clutter, My previous GP did ask the Lab to do FT4 and FT3, but they completely ignored him, I am not sure if my latest GP requested them, she wants my thyroid tested again in 3 weeks time, after upping the dose to 50mcg, I will have a word with the nurse about it, and may contact my GP via phone nearer the time to ask if she can request the other tests, it seems the Lab has a mind of its own!

[Teddy-Twoshoes]

Thanks really fed up, my serum ferritin is always around 28, goes higher if I take iron tablets, my B12 taken in January was 575 ng/L the range is 190.00- 900.00ng/L. My D3 taken in November last year was 56.5 nmol?L.

[greygoose]

Ummm, here I think we have another doctor that doesn't know up from down! If you increase your dose, the TSH will go down, not up. It's the FT4 and FT3 that go up with a dose increase. You do not want your TSH to go up, you want it to go down. But, that is totally irrelevant because the TSH is meaningless at this point. You need to see your FT4 and FT3.

25 mcg is less than a normal starting dose, and you should have been tested 6 weeks after starting it, and given an increase. And then you should have repeated that pattern until all your symptoms have gone (although I'm not sure the eyebrows ever grow back...) Obviously, this doctor is more than average ignorant about thyroid! I really think you ought to see another doctor, this one is going to do you harm!

It's not that the 'meds' aren't working, and it's not that they aren't helping, the problem is that you are not taking enough for it to do anything. You are not the only one that is confused - your doctor is the epitome of groping in the dark!

[Teddy-Twoshoes]

Thankyou Grey Goose, will make another appointment and ask again that my T3 and T4 levels are checked, I am fed up with the whole thing. Will continue on the 50mcg every other day, I am also post menopause, and trying to cope with flushes and night sweats, I am sure the levothyroxine is making them worse Do hope my eyebrows grow back, have you had the same problem, Many thanks.

[Teddy-Twoshoes]

Thanks really fed up. am make on my iron tablets ferrous fumarate.Will also ask for my vitamin D to be checked again. Many thanks.

[Teddy-Twoshoes]

Hi, had have been on 50 micrograms of Levothyroxine for a month now, my latest TsH result is 0.65, the lab will not check the FT4 and T3 if this appears to be in range, I have been this level before without been on medication, I am not really feeling any benefits and I have pointed out to my GP that this was just a trial they have put me on, also my serum feritin level is 28, i take ferrous fumarate from time to time, Vitamin D3 level is 66.6, I feel like giving up on the Levothyroxine, any advice would be welcome, thanks!

[Clutter in reply to Teddy-Twoshoes]

Teddy-Twoshoes,

TSH 0.65 indicates you are adequately dosed but we would need to see FT4 and FT3 to see whether you are optimally medicated. You can order TSH, FT4 and FT3 from Blue Horizon or Genova via

thyroiduk.org.uk/tuk/testin...

It takes up to six weeks to absorb and metabolise a dose and symptoms can lag behind good biochemistry by a couple of months or more. A month isn't nearly long enough to determine whether Levothyroxine is helping you.

Ferritin 28 is very low. Ferritin should be >100 and is optimal halfway through range. Supplement Ferrous Fumarate DAILY with 1,000mg vitamin C to aid absorption and minimise constipation.

VitD 66 is suboptimal, around 100 is optimal. Supplement 1,000iu D3 daily and increase to 2,500iu Oct-Apr when ultraviolet light is low.

Take Ferrous Fumarate and vitamin D 4 hours away from Levothyroxine.

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I am not a medical professional and this information is not intended to be a substitute for medical guidance from your own doctor. Please check with your personal physician before applying any of these suggestions.

[Teddy-Twoshoes]

Thanks Clutter, will take all this on board, really appreciate you taking the time to respond!