Thyroid UK
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Hypothyroidism

Hi

I'm new here and have been on 100micrograms of Levothyroxine for coming up 6 weeks now. Going back to Drs on Wednesday (I had a blood test on friday so will get the results of that).

1st blood test showed TSH 19.9 and the following week it had gone up to 32.2. I have recently had chemotherapy and other cancer treatments. I just have couple of queries in case anyone can help please:

1) Symptoms seem the same i.e. no better, does that mean the dose isn't high enough?

2) Do the levels only go back to 'normal range' when Thyroxine dosage is right?

3) Being this high will it take a while?

4) Anyone else found chemotherapy has this effect on thyroid function? (probably question for another post!)

Thanks for reading

Vicki

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Your TSH level wasn't particularly high. Maybe average. I haven't had cancer and others who've had thyroid cancer will respond.

After each blood test, which should always be at the very earliest, fasting (you can drink water) and allow approx 24 hours between last dose of levo and test and take afterwards. Your TSH should drop relatively quickly as your dose of levothyroxine is increased by 25mcg after each blood test till it is 1 or lower. If you've had thyroid cancer it should be suppressed.

Doctor should also test B12, Vit D, iron, ferritin and folate as deficiencies can also cause clinical symptoms.

Always get a print-out of your results with the ranges for your own records and you can post if you have any queries.

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Hi ok that’s good it’s not high, the Dr panicked me a little as she said it was very high. I didn’t have thyroid cancer I had breast cancer. As far as I know there was nothing wrong with my thyroid before cancer and cancer treatment.

Thanks for tips re blood test I was given no advice at all re fasting etc

I will ask for them to test those things thanks (I’m booking to see an endocrinologist) Yes she gave me a print out 👍🏻

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There are many members who've had TSH in the 70s, 80s etc.

We are prescribed in the UK when TSH goes to 10. In other countries they diagnose when it goes up 3+.

I'm sorry you had breast cancer and hope your recovery is swift.

TSH means thyroid stimulating hormone and it is from the pituitary gland. This is an excerpt:

It makes thyroid-stimulating hormone, or TSH, which tells the thyroid gland how much T4 and T3 to produce. The TSH level in your blood reveals how much T4 your pituitary gland is asking your thyroid gland to make. If your TSH levels are abnormally high, it could mean you have an underactive thyroid, or hypothyroidism.31 Oct 2017

everydayhealth.com/hs/healt...

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Hi Vicki and welcome to the forum.

You have asked a few questions:

1. Symptoms - it takes a while, and probably several dose increases for symptoms to ease typically. To avoid shocking the body, dose increases should be a maximum of 25mcg a time, no closer than 6 weeks apart. This process should continue until tsh is around 1, then move on to fine tuning. Which leads on to

2. Levels - within normal ranges only really applies to healthy people not on replacement thyroid hormone. Once diagnosed as hypothyroid and on levo, we generally feel better when tsh is around 1 or below, with ft4 in top quarter of range and ft in top third. We are all individuals with different responses and requirements, hence why I mentioned fine tuning above. Unfortunately many doctors appear to believe that "in range" is good enough - not so!

3. Time- as in 1 above, you are likely to need several increases and yes it could all take a while. Nothing changes quickly with the thyroid unfortunately. It may also take several months for relief of symptoms even after all blood levels are optimal.

4. Chemotherapy - I had chemo a year before finally being diagnosed with hypo. I am not sure that it has a direct effect on the thyroid, however, it does damage the gut. Especially with the auto-immune form, this can weaken the lining enough to allow a real ingress of foreign particles (main offender gluten) into the bloodstream, irritating the immune system. This can either dramatically increase the scale of an underlying existing problem, or be the initial trigger for an underlying genetic pre-disposition to auto-immune. Chemo can also leave the immune system reeling - I had severe neutopaenia, for instance, during treatment, effectively an immune system wipe-out - that can't be good and has to have the potential for a slightly skew-whiff immune system. Read up on leaky gut, especially if you have any digestive issues.

On general points, a good place to learn the basics is our parent website thyroiduk.org.

It is almost universal to have serious nutritional deficiencies with hypo, caused by low stomach acid and malabsorption due to gut issues. Fairly high (not just in range) levels of vit d, vit b12, folate and ferritin are required for thyroid hormone to be used effectively. it is also important to know if you are anti-body positive for Hashimotos auto-immune. If your GP won't test all of these, many of us use private testing through Medichecks (thyroid ultravit) or Blue Horizons (thyroid plus 11).

Good luck

Gillian

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Wow great thanks Gillian. Loads of helpful info. I also have Coeliac disease and therefore eat gluten free (12 years diagnosed now) so would like to see if there’s any other ‘connections’ (I know they’re both autoimmune)

Great will look at the other website 👍🏻

Going to see an endocrinologist privately (I have med insurance) so ask him the checking all those other things too thanks

V x

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If we have one autoimmune disease we seem to develop more. I have three.

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