I got my bloods done as I haven’t felt any better - if anything, worse - since being on 25mg levothyroxine for hypothyroidism. Could someone please advise? I don’t really know what any of it means.
I also have pernicious anaemia which is being treated by 3-monthly injections (last time it was measured it was 426 ng/l on 19 July.
The Dr. has now increased the levothyroxine to 50mg - and I will have my thyroid function test re-done in 2-3 months for comparison.
Eddm,
TSH 4.22 is too high for a patient taking Levothyroxine, and FT4 12.6 is too low which is why your GP has increased dose to 50mcg.
The goal of Levothyroxine is to restore the patient to euthyroid status. For most patients that will be when TSH is 1.0 or lower with FT4 in the upper range. FT4 needs to be in the upper range in order that sufficient T3 is converted. Read Treatment Options in thyroiduk.org.uk/tuk/about_...
Folate is low in range. I would supplement 400mcg folic acid.
Ferritin is very low. It is optimal >100 through to halfway in range. I would supplement iron, something like Ferrous Fumarate 210mg and take each tablet with 500-1,000mg vitamin C to aid absorption and minimise constipation. Take iron 4 hours away from Levothyroxine.
VitD is adequate but will drop between now and April. I would supplement 2,500iu daily until April. Again, vitamin D should be taken 4 hours away from Levothyroxine.
______________________________________________________________________________________________
I am not a medical professional and this information is not intended to be a substitute for medical advice from your own doctor. Please check with your personal physician before applying any of these suggestions.
eddm 25mcg Levo is a starter dose usually given to children, elderly people and those with heart conditions. Maybe you should have been given 50mcg to start. Sometimes people do feel worse before they start to feel better.
Retests should be done 6-8 weeks after starting Levo and any increases in doses. Waiting 3 months is too long so make sure you get yours done no later than 8 weeks. Always book the very first appointment of the day, fast overnight (water only) and leave off levo for 24 hours, take that day's dose after the blood draw. This ensures the highest possible TSH when looking for a dose increase or to avoid a dose reduction.
Your Vit D is on the low side, the replete range is 75-200 with 100-150nmol/L being the recommended level. You could supplement with D3 5000iu daily for a few weeks then reduce to 5000iu alternate days as a maintenance dose. Retest once or twice a year to ensure you stay within the recommended range. When taking D3 we need it's important co-factors K2-MK7 and magnesium. Vit D aids absorption of calcium from food and K2 directs the calcium to bones and teeth where it's needed rather than arteries and soft tissues where it causes problems. D3 and K2 are fat soluble so should be taken with the fattiest meal of the day. Magnesium is calming so best taken in the evening.
Ferritin needs to be half way through it's range, with a minimum of 70 for thyroid hormone to work properly. As yours is very low I would ask your GP if you can have iron injections or a prescription for an iron supplement. Take iron supplements with 1000mg Vit C to aid absorption and help prevent constipation.
Folate needs to be at least half way through it's range. As you're having B12 injections you should be taking a B Complex to balance the B vits. Thorne Basic B or Jarrows B Right both contain 400mcg methylfolate which will help raise your low folate level.
Thanks for that. I'll give it 7 or 8 weeks, or sooner if doc wants to discuss the results. But the thyroid re-test I'll do in like 8 weeks.
I just wish I had a study or something that I could get him to read- this doctor wants to help me, but my concern is that, like a lot of docs, he doesn't know how.
May I advise there is no reason to wait 3mos for another test. Six to eight weeks on a stable dose is enough and if 50mcg is inadequate - as is almost certainly will be - you'll be letting yourself in for an extra month of fatigue and decline for no reason at all. So if the doc has said, 'Hey. let's do a test in, hmm, two or three or four months, what's the rush?' don't feel the need to let that lead you. You can ring up the surgery and get an appt in the book for six weeks after you begin the higher dose. If they say it is too soon do feel free to impress on the gp that you're not well and these are days you won't get back.
I must say I get a little bubble of rage every time I read of someone who has been put on 25mcg levo (of course sometimes there is a reason for it but it seems there usually is not) and is left languishing in ill health as though there is no rush at all, let's just take our time, enjoy your enforced rest. Jeez.
(Sorry for the overlap in similar advice, I was writing while SS was posting.)
May I ask what results (tsh, free t4) you had before you started treatment? I'm in a similar position. Have started 25mcg 3 weeks ago. Don't feel any better and will have new tests done soon.
When I started treatment T4 was 12.2 pmol/l and TSH was 5.83 mu/l (start of May 2016)
After 3 months (end of Jul 2016) T4 was 12.1 pmol/l and TSH was 1.72 mu/l
That's almost the exact numbers I had. So they didn't increase your medicin because your tsh dropped to 1.72? Did they not look at the free t4? Did you order this last test yourself or was it your doc? I'm worried that I will be in a similar situation, that my tsh will have gone down so they won't increase the medicin but I'm still feeling rubbish...
Yeah I asked for a new test, and I asked for the folate etc to be tested too. I mentioned that I had sought help from a forum because I can't live like this, and wrote down some bits that people had suggested.
Thanks for all the advice. Because things appear to be in the "normal range" I doubt the doc will be able to do much. If that's the case I'll fight to see a specialist who can maybe help.
Wish I could back everything up that's been suggested with evidence for the doc to read! Will search!
I'm in the 25 mcg starter dose category as well, I'm not 'elderly' unless 60 is counted as that, nor do I have heart problems, I'm due another blood test next week at the 8 week mark, although I do feel better than I did a couple of months ago, I think I'd benefit from a dose increase as I have some symptoms still, just hope I can get one!
Hope you feel better soon, definitely try to boost your other vits/minerals as it all helps. 
I'm 22! Been like this as long as I can remember! I just know I can't live like this anymore.
Interpreting Blood Test Results
Thyroid blood test results
Blood test results 
