TSH testing after a levo trial

TSH 4.4 0.50 - 5.00

TPO Antibody 228 0.00 - 6.00

I have finally been prescribed a 2 month trial of 75mg of levo which follows self medicating at 50mg a day for 2 weeks to prove to my doctor that a trial would be worth a try. I was warned that there is a risk of heart attack , blood clots and stroke by taking levo if it is not needed but as most of my symptoms, with the exception of head pressure, brain fog, and my brain being on a spin cycle, have greatly improved I said I would accept the risk.

My GP wants me to have my TSH tested after the trial to determine whether I should continue with levo. When I asked if it would be better to get free T3 and T4 tested instead I was told that was a waste of time as I am now taking levo. Is this the case? And if so how will the TSH level alone be a true indication of the benefit of continuing with levo?

4 Replies


I really don't understand why doctors trot out this rubbish. If she doesn't think you need Levothyroxine and that taking it unnecessarily is so dangerous why does she prescribe it? If she's prescribing it because she thinks you do need it why try to scare you?

I would love to see any evidence that your GP has to show that taking Levothyroxine causes blood clots! Overmedicating can cause atrial fibrillation and osteoporosis but no one is suggesting she should over medicate you and 50mcg is very unlikely to do so.

The true benefit of continuing with Levothyroxine is the relief of your hypothyroid symptoms. TSH dropping from 4.4 will indicate whether 50mcg is adequate or not. I can't agree with your GP that testing FT3 and FT4 is a waste of time and as my endo orders them I don't suppose she does either.

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_... Email louise.roberts@thyroiduk.org.uk if you would like a copy of the Pulse article to show your GP.

Thyroid peroxidase antibodies are positive for autoimmune thyroid disease (Hashimoto's). There is no cure for Hashimoto's which causes 90% of hypothyroidism. Treatment is for the low thyroid levels it causes. Many people have found that 100% gluten-free diet is helpful in reducing Hashi flares, symptoms and eventually antibodies.



For maximum absorption Levothyroxine should be taken with water 1 hour before, or 2 hours after, food and drink, 2 hours away from other medication and supplements, and 4 hours away from calcium, iron, vitamin D supplements, magnesium and oestrogen.

It takes 7-10 days for Levothyroxine to be absorbed before it starts working and it will take up to six weeks to feel the full impact of the dose. Symptoms may lag behind good biochemistry by several months.

You should have a follow up thyroid test 6-8 weeks after starting Levothyroxine. Arrange an early morning and fasting (water only) blood draw when TSH is highest, and take Levothyroxine after your blood draw.


Your doctor is an idiot. change doctor

You have antibodies.. you have Hashimoto's of course you need levo a

Seriously. Change you doctor. You have a condition that won't go away you'll need a doctor to help you deal with it and this one is a moron.

Yes doctor getting it wrong again! It's the TSH reading that can be wrong after starting meds.

Ok, so a more appropriate plan of action is to give the levo 4-6 weeks and then get tested for TSH, free T3 and T4 and TPOAb. I will have to get them done privately so are they the only tests I need to have?

And when I get tested do I just stop taking levo for 24 hours?

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