First post - a little help please :)

[AEFY]

Morning all,

I've been on thyroxine for a few years, I'm also T1 and coeliac so autoimmunily challenged

I had an update for my thyroid levels last Friday, my results are

TSH 0.07 (?!)

T4 11.8

My Dr wants to increase thyroxine as I dont feel amazing (all classic hypo symptoms Cold, tired ect)

Thoughts please?

[shaws Administrator]

Welcome to our forum,

I think you're fortunate to have a doctor who wants to increase your dose and I think I'd go along with him.

Did you do the following before you had a blood test?

Was the blood test taken at the very earliest possible and fasting? Did you leave about 24 hours between your last dose of levothyroxine and the test and take it afterwards?

When you post your results it's helpful if you also state the ranges because labs differ throughout the UK and it makes it easier to comment.

If you've not had the following, ask for these to be done the next time as we need them to be optimum:-

B12, Vit D, iron, ferritin and folate.

[AEFY in reply to shaws]

Thanks shaws , ranges are:

TSH 0.3-4.2

T4 9.0-19.0

Blood test was 8.20 am, yes was fasting. was less than 12 hours post dose as I take thyroxine in the evening just before bed. I've never been told to wait until afterwards to take pills?!

I'm having a repeat test in 6 weeks and upping dose to 125 per day.

[shaws Administrator in reply to AEFY]

He's right to increase as your T4 is low and you need sufficient to provide T3 which is the active hormone.

If people take an evening dose they are advised to miss this and take after test and their night dose as usual.

[AEFY in reply to shaws]

any comment about the TSH? as I'm most concerned about that

[shaws Administrator in reply to AEFY]

There's no need to be concerned as many feel best with a TSH 1 or lower. Rumours surround TSH, i.e. heart etc but Thyroid Cancer patients have to have a suppressed TSH. This is an excerpt from a doctor who treated more holistically.

"Many endocrinologists talk of using the TSH and thyroid hormone levels to "fine tune" hypothyroid patients’ thyroid hormone dosages. Considering how much the hormone levels vary, however, it’s obvious that the concept of fine tuning is mistaken. For the sake of their patients’ health, endocrinologists should promptly abandon the notion."

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

Others will respond also.

[SlowDragon Administrator]

Get vit D, B12, folate & ferritin checked

Common to be low if hypo......and especially if coeliac.

We can't use our thyroid homones if any, or all of these are low. They normally need to be right at top of range to feel good. Always make sure you get copies of blood test results, including ranges.

How refreshing to see a Dr ignoring low TSH and also looking at the low T4, therefore treating the patient not just dosing according to the TSH

[greygoose]

Once you are on thyroid hormone replacement, it doesn't matter how low the TSH goes. It is irrelevant unless it goes high.

Thyroid Stimulating Hormone - that's all it does (more or less), stimulates the thyroid gland to make more hormone when levels are low. When you are taking the hormone orally, the gland does not need to be stimulated, so you don't need TSH.

[AEFY in reply to greygoose]

Makes more sense! thanks greygoose

[greygoose in reply to AEFY]

You're welcome.

[shaws Administrator in reply to AEFY]

It's a pity many doctors/Endos refer to the TSH alone and wont increase even if we have clinical symptoms and take more notice of it than our symptoms.. greygoose is right about the function of the TSH.