Lab results...help needed....

[Exetergirl]

Hi I was diagnosed in January with hypothyroidism.Started on 50 mcg Levo. Went back for blood tests last Friday, early morning, no meds before etc. It has been 6 weeks since starting the meds and slight improvement , but some things just not right i.e. Flat mood, low energy, no libido. GP has written to me on the basis of the results below or say stay on current dose.

What do you knowledgeable people think?

Serum TSH 2.90mu/L (2.27- 4.2)

Fermin 42 (13.0-150.0)

Folate 15.0 ug/l (3.9-26.8)

B12 431 ng/L (>180)

That is all I have...

Thank you

[SeasideSusie Remembering]

Exetergirl Two things - firstly, it is a long road to recovery and you need to be patient, it can take months to feel well, you have to find your optimal dose and from what your GP has said he's not going to be much help so you have to learn as much as you can, push for enough Levo and hopefully educate your GP as you go.

Your TSH is too high. The aim of a treated hypo patient generally is for TSH to be 1 or below or wherever it is needed for FT4 and FT3 to be in the upper part of their respective reference ranges.

Dr Toft, past president of the British Thyroid Association and leading endocrinologist, states in Pulse Online Magazine

"The appropriate dose of levothyroxine is that which restores euthyroidism and serum TSH to the lower part of the reference range - 0.2-0.5mU/l.

In this case, free thyroxine is likely to be in the upper part of its reference range or even slightly elevated – 18-22pmol/l. Most patients will feel well in that circumstance.

But some need a higher dose of levothyroxine to suppress serum TSH and then the serum-free T4 concentration will be elevated at around 24-28pmol/l.

This 'exogenous subclinical hyperthyroidism' is not dangerous as long as serum T3 is unequivocally normal – that is, serum total around T3 1.7nmol/l (reference range 1.0-2.2nmol/l)."

You can obtain a copy of the article by emailing [e-mail] then print it off to discuss with your GP.

So you can see you need an increase in your dose of Levo so you should ask for that on the basis of the article and your TSH result. The increase should be 25mcg then a re-test after 6-8 weeks, and depending on the result and how you feel then, another increase, re-test, etc until you feel well.

Secondly, your nutrients aren't optimal, which is what is needed for thyroid hormone to work properly.

Ferritin 42 (13.0-150.0) - this must be at least 70 for thyroid hormone to work, better is half way through range and best for females is 100-130 I have read. You need to either supplement with iron tablets (your GP won't prescribe with that level) or an easier way to raise ferritin is to eat liver once a week.

Folate 15.0 ug/l (3.9-26.8) - this is fine, it should be at least half way through it's range.

B12 431 ng/L (>180) - this is too low. Anything under 500 can cause neurological problems. Recommended level is very top of range, even 900-1000. You should buy some Solgar sublingual methylcobalamin lozenges 1000mcg and take one daily. Dissolve under the tongue to get directly into the bloodstream, don't chew or swallow, you need it to bypass the stomach for better absorption.

You should also ask for Vit D to be tested. If your GP won't do it then you can get a private fingerprick blood spot test from City Assays vitamindtest.org.uk/index.html . The recommended level for total Vit D is 100-150nmol/L.

PS - when taking B12 we need a B Complex to balance the B vits.

When taking your Levo, always take it on an empty stomach, one hour before or two hours after food, four hours away from iron, calcium, magnesium and Vit D, and two hours away from other supplements and medication.

[Exetergirl in reply to SeasideSusie]

Dear seaside...thank you. That was a big help. I do remember reading that it takes time for your symptoms to catch up with your biochemical/hormone levels...thanks again