New to Hypothyrodism, please help

[Lrden]

Hello I have had blood tests recently which are

Serum tsh level 5.1, range 0.1-4

Serum free T4 level, range 9.5 - 17.5

I originally went to the doctors with numbness in my fingers and hair loss (I already suffer from androgen hair loss but it's got much worse).

I'm female and 48 years old, do my blood results indicate my thyroid could be the cause of symptoms? I've also put approx 1 stone on for no apparent reason.

I've think I've got a fairly complicated medical history, past menopause at approx 43 with no symptoms and unaware, have high blood pressure, suffer from kidney stones and was diagnosed with pulmonary sarcoidosis in January of this year.

I'm struggling to fit all meds and vitamin supplements in and am currently taking 50mcg of levothroxine in the morning but at the same time as bp meds.

I would prefer to take thyroxine at bedtime but take Utrogestan (progesterone HRT) at bedtime.

Any thoughts or guidance would be much appreciated, sorry for the long story.

Thanks

[lady_eve]

Your TSH is obviously a little high compared to the reference range, and at first blush I'd expect that to be lower as you are already taking levothyroxine. I notice that you omitted the FT4 result, although you quote the range. Can you add that in? There will be lots of people here happy to comment and probably better qualified to do so than I.

[Lrden in reply to lady_eve]

Hi lady_eve thanks for your reply, sorry my post should have said doc agreed to give 50mcg after result of 5.1 came in. He wasn't going to do anything until I showed him my list of symptoms.

The serum free t4 level was 12.5

Thanks

[greygoose]

If you are taking your blood pressure meds at the same time as your levo, then your absorption of levo will be compromised. You should leave at least 2 hours between the two.

Should you even be on blood pressure meds? High blood pressure can be a symptom of under-medication.

[Lrden in reply to greygoose]

Hi Greygoose, thanks for the reply. The doctor just said avoid caffeine for 30 mins and food for 2 hours nothing about avoiding taking with other meds so that is good to know.

Ive got a 6 week blood test, is it correct that if I take the Levo at 6.30am I should delay on day of test until after blood test if test at 7.30am?

I'm reluctantly on bp meds I've had high bp for about 2 years bottom level was averaging in high nineties. I had a bleed behind one of my eyes and after that I was put on candesartan 4mg.

not sure if it was just the bleed or the iritis I had in my eyes but I've now got an epiretinal membrane on my eye down to scarring do as much as I would like to come off the bp meds I'm frightened the high bp could cause more damage.

[greygoose in reply to Lrden]

I'm afraid your doctor is a bit confused. You should leave at least one hour before having coffee. However, you can also eat after one hour - it's two hours after food that you should wait to take your levo, not before.

It is true that you should take your levo after the blood draw, otherwise, you will just be testing that morning's dose, not what normally circulates in your blood.

So, it sounds as if your blood pressure situation is complicated. It might improve, though, once your thyroid hormones are optimal.

[Lrden in reply to greygoose]

Thanks

[SlowDragon Administrator]

Do you have high antibodies which is Hashimotos

Also have you had vitamin D, folate, ferritin and B12 tested

These are commonly low and can stop Thyroid hormones working

Post results and ranges if you have them

TSH is too high, so you need dose increase

[Lrden in reply to SlowDragon]

Hi SlowDragon, thanks for your reply. I've only been tested for T4 and serum TSH, no antibodies.

Is Hashimotos different from an underactive thyroid?

I've got access online to blood results and cannot see a test for Vit D but can see the following:

Serum calcium 2.19, range 2.15-2.6

Serum folate 17, range >5.4

Serum ferritin 230, range 10-291

Serum B12 470, range 160-820

Because of the hair loss I take a high level multivitamin, Hairfollic and a probiotic to help with absorption.

As I'm on predisolone and have osteopenia I'm also on a Adcal D3 calcium and vitamin d3

The doctor was reluctant to even put me on the levothyroxine 50mcg how will I know when I'm on the right dose, will the numbness in fingers go away and hair loss stop?

[SlowDragon Administrator in reply to Lrden]

I would ask GP to test vitamin D and ask for thyroid antibodies to be tested

Or alternatively get private test

Vitamindtest.org.uk £28 postal kit - just 4 drops blood on a card

Looking for vitamin D to be around 100nmol (UK units)

Magnesium is very important too - loads of us find it very beneficial

naturopathconnect.com/artic...

If GP remains unhelpful

thyroiduk.org.uk/tuk/testin...

Medichecks Thyroid plus ultra vitamin or Blue Horizon Thyroid plus eleven are the most popular choice. DIY finger prick test or option to pay extra for private blood draw. Both companies often have money off offers. DIY finger prick test or option to pay extra for private blood draw or

All thyroid tests should be done as early as possible in morning and fasting and don't take Levo in the 24 hours prior to test, delay and take straight after. This gives highest TSH and most consistent results

Always take Levo on empty stomach and then nothing apart from water for at least an hour after. Many take on waking, but it may be more convenient and possibly more effective taken at bedtime

verywell.com/should-i-take-...

Many people find Levothyroxine brands are not interchangeable. Once you find a brand that suits you, best to make sure to only get that one at each prescription.

Ferritin, B12 and folate look ok at moment, but B12 especially is likely to fall the longer you are on Levo

Perhaps just test vitamin D now.

Wait to see what GP test results are for thyroid. You will need dose increase of 25mcg and retest in further 6-8 weeks if TSH is still high. Looking for TSH to be around one or slightly less, FT4 near top of range and FT3 at least halfway

If your antibodies are high this is Hashimoto's. Changing to strictly gluten free diet helps reduce symptoms significantly for many

[Lrden in reply to SlowDragon]

Hi SlowDragon thanks for all the info really helpful, if I take Levo at 6.30am and blood test is next day at 7.30am is that ok if I just delay tablet on day of test?

Is there a preferred brand of levo?

Unfortunately I take a HRT tablet Utrogestan at bedtime otherwise I would prefer to take levo at bedtime.

[SlowDragon Administrator in reply to Lrden]

Yes so if you normally take Levo at 6.30 am do so the day before, but not on day of blood test. Just take immediately after blood draw.

Different people get on with different brands. Many have found new Teva really bad, but a few find it fantastic (it's the only lactose free one)

Personally I stick to Mercury Pharma. Used to be Eltroxin, but was discontinued when MP stopped it. Now Eltroxin has been restarted, but a few have tried it and say it's not as good as before

The main thing is (unless you notice real problem with one brand) just stick on any of them. Brands all give slightly different absorption/uptake, so if you get different brand at each prescription in effect your dose keeps changing.

[Lrden in reply to SlowDragon]

Thanks

[Lrden in reply to SlowDragon]

Hi SlowDragon

I've had my ) week retest results and they are serum tsh 1.4 range 0.1 -4 and serum free T4 level 13.3 range 9.5 -22.

Are these results good? Seeing doctor tomorrow will ask for antibodies and vit d test thanks