Levothyroxine

[Elizalee]

Hi after being refused levothyroxine by my endo I have seen a GP who has restarted me on 50mcg after endo has said I no longer need it and he discharged me. Due blood test in 6-8 weeks. Diagnosed 2011. Also been given iron tablets and loading dose of 300,000 vitamin D and B12 and folic acid tablets. Advice welcome. Thank you.

TSH 41.8 (0.2 - 4.2 mIU/L)

Free T4 12.1 (12.0 - 22.0 pmol/L)

Free T3 3.0 (3.1 - 6.8 pmol/L)

Thyroid peroxidase antibodies 355.3 (<34 IU/mL)

Thyroglobulin antibodies >1500 (<115 IU/mL)

Ferritin 12 (15 - 150)

Folate 4.2 (4.6 - 18.7)

Vitamin B12 101.5 (190 - 900)

Vitamin D 19.3 (<25 severe)

[SeasideSusie Remembering]

Elizalee You had lots of advice yesterday regarding your Hashi's and vitamins and minerals.

Folate 4.2 (4.6 - 18.7)

Vitamin B12 101.5 (190 - 900)

B12 tablets???? What about testing you for Pernicious Anaemia and B12 injections? This is most important with your level of B12. Did you check for signs of B12 deficiency? Why haven't you posted on the Pernicious Anaemia Society forum for advice as suggested? They are the experts, you really should post on their forum. Do not start taking the folic acid tablets until further investigations have been carried out.

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Vitamin D 19.3 (<25 severe) loading dose of 300,000 vitamin D

You were given all the information needed about Vit D supplements yesterday. Don't forget that once the loading doses are finished, if you are prescribed 800iu this will be totally inadequate. Get your level tested after the loading doses, privately if necessary (link was given) and post again on the forum for advice on what dose to continue with. Don't forget the cofactors, they are very important, as is the timing of taking your Vit D supplement.

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Ferritin 12 (15 - 150)

MCV 78.1 (80 - 98) and MCHC 379 (310 - 350) given iron tablets

How many iron tablets daily? Did you discuss your apparent iron deficiency anaemia?

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As for you now being restarted on 50mcg Levo, you need to ensure that you book that retest for 6 weeks' time, book the very first appointment of the morning, fast overnight (water allowed), and leave off Levo for 24 hours (do this for every thyroid test from now on, only then can you compare results accurately). Your next test results will indicate a need for an increase which should be 25mcg, then you need to keep repeating the testing/increase in dose every 6 weeks until your TSH is at the low end of the range and the free Ts at the top of their ranges, and you feel well. But you must bear in mind the fluctuations that Hashi's will cause and the possible need to adjust your dose as and when you have hypo/hyper swings, as explained.

[Elizalee in reply to SeasideSusie]

Forgot to post on other forum will do that now. Been given loading dose of B12 injections

[Elizalee in reply to SeasideSusie]

Yes discussed iron deficiency with doctor and he prescribed me 2 tablets to take every day

[SeasideSusie Remembering in reply to Elizalee]

Did you ask for an iron infusion to get your ferritin level up within a couple of days? That would then leave the iron tablets to concentrate on the iron deficiency anaemia. With your ferritin level, if you can't have an iron infusion then 3 tablets a day would be much better.

[Elizalee in reply to SeasideSusie]

I asked for an infusion but the doctor said I would need to be referred for that which would take more than a month to go through but can go back tomorrow and try and get this sorted?