GP appointment

[Kazke]

Hi I have seen GP today and he has started me on 25mcg levothyroxine with a retest in 6-8 weeks is this right?

TPO antibody 770 (<34)

TSH 33.4 (0.2 - 4.2)

Free T4 10.1 (12 - 22)

Free T3 3.2 (3.1 - 6.8)

Thanks for advice.

[SlowDragon Administrator]

Normal starting dose is 50mcgs unless you have been hypo a long time or are elderly or frail

TSH of 33 is quite high. GP is perhaps being over cautious

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.

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

Vitamin levels can be low and would be helpful to test vitamin D, folate, ferritin and B12 soon. Possibly with next blood test.

Read as much as possible about thyroid disease

Reading daily Posts here, plus Thyroid Uk home of this support group are good place to start

[Kazke in reply to SlowDragon]

Thanks I think GP is dosing on weight. I have vitamin and mineral levels checked

[Nanaedake in reply to Kazke]

Dosing on weight only offers a clue on the total amount of replacement levothyroxine, not on the starting dose. 25mcg is a very small dose to start on. When is your next blood test booked for? I would ring GP and ask if dose could be increased to 50mcg otherwise it will take forever and a day to reduce your TSH to an acceptable level. Most people don't feel well until TSH is around 1.

[Kazke in reply to Nanaedake]

Thanks I haven't had it booked it yet because practice can only book up to 4 weeks in advance

[Nanaedake in reply to Kazke]

Same as my surgery. A real pain for those who need 6 weekly blood tests.

[SlowDragon Administrator in reply to Kazke]

Post vitamin results and ranges if you have them

You mean your a slim hypo ?

We have had quite a few recently, often struggle harder to get diagnosed and treated. Medics tend to think we have to be fat to be hypo (not true)

Your antibodies are very high this is Hashimoto's, (also known by medics here in UK more commonly as autoimmune thyroid disease).

About 90% of all hypothyroidism in Uk is due to Hashimoto's

With Hashimoto's, until it's under control, our gut can be badly affected. Low stomach acid can lead to poor absorption of vitamins. Low vitamin levels stop thyroid hormones working.

Essential to test vitamin D, folate, ferritin and B12. Always get actual results and ranges. Post results when you have them, members can advise

Poor gut function can mean struggle to gain benefit from food and difficulty increasing weight

Poor gut function can lead leaky gut (literally holes in gut wall) this can cause food intolerances. Most common by far is gluten

According to Izabella Wentz the Thyroid Pharmacist approx 5% with Hashimoto's are coeliac, but over 80% find gluten free diet helps significantly. Either due to direct gluten intolerance (no test available) or due to leaky gut and gluten causing molecular mimicry (see Amy Myers link)

But don't be surprised that GP or endo never mention gut, gluten or low vitamins. Hashimoto's is very poorly understood

Changing to a strictly gluten free diet may help reduce symptoms, help gut heal and slowly lower TPO antibodies

thyroidpharmacist.com/artic...

thyroidpharmacist.com/artic...

amymyersmd.com/2017/02/3-im...

chriskresser.com/the-gluten...

scdlifestyle.com/2014/08/th...

drknews.com/changing-your-d...

[Kazke in reply to SlowDragon]

No not slim just short