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Thyroid UK
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i was diagnosed with an underactive thyroid 5 weeks ago and stared on 75mg levo and 5mg folic acid. i have just got a copy of my results and would appreciate if someone could have a look at them for me as i feel worse now than ever. thanks

tsh 33.71mu/l(0.27-4.2) free t4 5.8pmol/l(12-22) vit b12 410ng/l (197-771) folic acid 2.7ug/l(3.9-26.8) Ferritin 47ug/l (13-150) Iron 16.2umol/l (10-30)Cholesterol 5.55mmol/l(2.8-5.0)

9 Replies

Welcome to the forum, Kat023surprise.

TSH 33.71 is high and FT4 5.8 low and confirms primary hypothyroidism. 75mcg Levothyroxine is an adequate starting dose but will probably need raising as the starting dose is rarely the dose we end up taking.

The goal of Levothyroxine is to restore the patient to euthyroid status. For most patients that will be when TSH is 0.4 - 1.0 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_...

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.


B12 410 is unlikely to be deficient but won't have been working well while you were folate deficient. 5mg folic acid will usually correct folate deficiency in a couple of months.

Ferritin is optimal halfway through range so I would supplement 1 x 210mg Ferrous Fumarate iron tablet which should be taken with 1,000mg vitamin C to aid absorption and minimise constipation. Take iron 4 hours away from Levothyroxine.

Cholesterol will almost certainly drop when you are optimally dosed on Levothyroxine. It's very common for cholesterol to be high when hypothyroidism is first diagnosed and prior to thyroid blood tests high cholesterol was one of the clinical symptoms used to diagnose hypothyroidism.


thankyou very much for replying. i have been feeling worse in the past few weeks with tiredness and pains in my joints especially my legs. going for repeat thyroid blood tests next week. have just started to take selenium 200 ug as i read this can help


kat023surprise Pains in joints could very well be low Vit D. Ask your GP to test this. If he wont you can get a private fingerprick blood spot test from City Assays vitamindtest.org.uk/

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It is surprising for us who have been very unwell and undiagnosed to find we feel much worse when beginning levothyroxine. I did. Sometimes it is because we are not yet on a dose to relieve all symptoms.

Did you make the appointment for the very earliest possible, fasting (you can drink water) and allow a 24 hour gap between last dose and test and take afterwards.

Always take any other supplements etc about 4 hours apart from levothyroxine.

Always get a print-out of your results with the ranges.

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Are these results from AFTER 5 weeks on thyroxine? Or before you started?

Are you taking folic acid daily? Or just once a week?

Taking a good vitamin B complex would help improve folic acid and B12 - eg Igennus Super B complex. But you must remember to stop taking any supplements with biotin in 3-5 days prior to any future blood tests. Biotin can falsely affect test results.

Ask your GP to test your vitamin D levels. Very common to be low anyway, but especially with thyroid problems

Post vitamin D result when you get it on new post.

If low you will need to supplement. Low vitamin D stops thyroid hormones working

Cholesterol will fall on its own once you get dose of thyroxine correct and lower TSH

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thankyou seaside susie


1st appointment in surgery next week. will fast and not take levo for 24 hours before. these were my initial results before starting on the levo. i take the folic acid every day. i will try and get my vitamin d tested and get some vit b complex. is it ok to take the selenium as well as the folic acid and the vit b complex?


As you are having blood test next week, I would hold off starting any supplements until after you get the results.

Only ever start one supplement at a time anyway. Then wait a week or fortnight to see what, if any, noticeable reaction - good or bad.

It would be very useful to also have your thyroid antibodies tested. About 90% of hypothyroidism is due to autoimmune thyroid disease, also known as Hashimoto's (though your GP unlikely to call it Hashimoto's, they just call it autoimmune)

Hashimoto's is diagnosed by high TPO antibodies. If cause is Hashimoto's then low vitamins are even more common

Medics often think it irrelevant to test, but patients need to know. High antibodies are what tend to make us feel unwell. Changing to strictly gluten free diet helps reduce symptoms significantly for many. But many GP's are often unaware of link between Hashimoto's, gluten, low vitamins and raised antibodies



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thankyou SlowDragon and to everyone else. hopefully will get a helpful Gp after blood results

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