Thyroid UK
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Been prescribed 25 micrograms of Levothyroxine

Hi All

I went to GP this morning and he said I was producing enough thyroxine but my body was having to work hard to produce it.

My T3 and T4 are on the low side of normal and TSH was 6.7.

He said I could trial 3 months of Levo and prescribed 25 micrograms daily and then have a blood test in 2 months.

My Vit D is low despite taking prescribed supplements twice a day. He has now altered this to a larger dose taken weekly.

I asked about antibodies (I didn't realise there were different types of antibodies, so I don't know which one he was referring to) but he said my level was 151 and should be below 60. I don't seem to be able to find any information on this. Does this point to Hashimodos?

I'm disappointed the dose is so low but at least he was open to prescribing Levo.

The chemist said I should be on a medical exemption for prescriptions but as its only a trial I didn't think this was true at present. Am I right that I should wait for an 'official' diagnosis?

I feel there has been a step forward, if only baby steps at the minute

10 Replies

Hi ysands :) explains all about your condition which is the most common type of hypothyroid complaint. Thyroid UK is the go to place to find out more about your condition

There's nothing to be done really except see how you get on with levo, which will need increasing until your symptoms are resolved. This has to be done slowly.

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Thank you Rapunzel. So does the presence of antibodies point towards Hashimotos?

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Oh, lord above! Do these doctors have a competition to see who can come out with the most stupid remark? If your thyroid was producing 'enough' T4, your TSH wouldn't be 6.7, it would be around 1. What does he think the roll of the TSH is? I think you're going to need to be very careful of this doctor, because he doesn't understand much about thyroid.

Also, either he's extremely ignorant, or he's setting you up to fail. A dose of 25 mcg for three months is not going to achieve anything useful. Too low a dose can make you feel worse than you were before, and doctors can use that as 'proof' that the problem isn't your thyroid. A normal starter dose is 50 mcg.

Keeping you on too low a dose for three months, is also going to work against you. You should be tested after 6 weeks, and the dose increased by 25 mcg. Does he even know that? Or, is he setting you up to fail?

So, what to do? In your place, I would take the 25, and go back after six weeks, and say you feel a little better, the levo is helping, but, you feel you need an increase in dose. Play him at his own game! Call his bluff. If he refuses, then he is just trying to prove that your symptoms are 'something else'.

I would imagine the antibodies he is referring to are TPO ab. That's what they usually test. And, yes, if they're positive, you do have Hashi's. You could try a gluten-free diet, to see if that makes you feel any better.

When you go for your next test, make the appointment early in the morning - before 9 am - and fast over-night. Leave a 24 hour gap between your last dose of levo, and the blood draw. That way you will get the highest possible TSH - which is really all they look at. And, hopefully, you will get a diagnosis and an increase in dose. :)



Thank you. He is a good GP and does actually listen but obviously this is not his field of expertise!

I will take the 25 and get tested on 1st June (he marked the blood card for June). It will be fasting as I want my cholesterol measuring too (was 9!) but I will not take the levo before I go.

Thanks for your input. Much appreciated


You're welcome.

To be honest, it's almost impossible to find a doctor whose field of expertise it is. But, I do wish they wouldn't come out with these stupid statements when they have no idea what they're talking about. They don't seem to realise they could be harming people's health with their ignorance. :)

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Always get a print-out of your results with the ranges for your own records and you can post if you have a query. Also he should check B12, Vit D, iron, ferritin and folate. These need to be optimum too as we can be deficient which will result in other symptoms.

It's not the doctor's fault they are badly trained these days, so we, the patient, has to read/learn and educate the doctor.

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Thanks for your reply. I am lucky my GP does listen and is willing to learn. It takes about a month to get an appointment with him and his surgeries always run late because he takes his time with each patient. So I am not unhappy with him but I am cross at the NHS guidelines and path lab that make diagnosis so difficult.

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Blood tests for thyroid hormones should always be the earliest possible, fasting (you can drink water) and allow 24 hours between last dose of levo and the test and take afterwards. This gives the best results for the patients. TSH is higher earlier a.m. and taking hormones before tests skew results.

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ysands An over range TSH and low free Ts mean hypothyroidism and antibodies of 151 (range <60) means autoimmune thyroid disease aka Hashimoto's. So yes, you have Hashimoto's Hypothyroidism.

Hashi's is where antibodies attack the thyroid and gradually destroy it. The antibodies can fluctuate which means that symptoms and test results can fluctuate. But they won't go away until your thyroid is destroyed.

Don't let your GP withdraw your prescription for Levo. Personally I would apply now for your exemption certificate.

You can help reduce the antibodies by adopting a strict gluten free diet which many members have found helps enormously.

Gluten/Thyroid connection -

Supplementing with selenium L-selenomethionine 200mcg daily and keeping TSH suppressed also help reduce antibodies.

Hashi's information:

You might not feel any benefit from 25mcg Levo, you might even feel worse, but hopefully you'll get an increase soon. When you book the appointment for your next test, book the very first appointment of the morning, fast overnight (you can have water), and leave off Levo for 24 hours. This gives the highest possible TSH which is what we need when looking for an increase or to avoid a reduction. Make sure that after your increase you are retested 6-8 weeks later, and this should continue until you are optimally medicated and symptoms abate.

Always make sure that conditions are the same every time you have a test, ie earliest appointment, fasting, and leave off Levo for 24 hours. As well as giving the highest possible TSH it also means that you have an accurate comparison of results so keep a record and not how you feel, dose, etc.

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Thank you that explains things more clearly. I will look up the links you have posted. Much appreciated


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