Hi

[luminesence]

Newbie here, am I likely to be overmedicated if I increase from 50mcg levothyroxine to 75mcg levothyroxine? Diagnosed 2012 with hypothyroidism. Thanks

TSH 10.4 (0.2 - 4.2)

FREE T4 13.8 (12 - 22)

[humanbean]

No. You need the increase. You are currently undermedicated.

Increasing your dosage of Levo should decrease your TSH and increase your Free T4 and Free T3.

Patients with hypothyroidism usually feel best with their TSH at around 1 or below, Free T4 in the upper half of the reference range, and Free T3 in the top third or quarter of the range. However, these are only guides to ideal levels as determined by patients. They aren't set in stone. Where you feel well is the best guide.

[SlowDragon Administrator]

No you are under medicated.

The aim of thyroid replacement hormone is to reduce TSH to around one and FT4 towards top of range.

Do you also have high thyroid antibodies? You need to know. Did GP or Endo ever test these? If not ask that they are tested.

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

Very likely to have very low vitamin levels as you have been inadequately medicated. These may need supplementing to assist thyroid hormones to work

If antibodies are 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

[luminesence in reply to SlowDragon]

Yes

TPO ANTIBODY 375 (<34)

TG ANTIBODY 266.3 (<115)

FERRITIN 12 (15 - 400)

FOLATE 3.2 (4.6 - 18.7)

VITAMIN B12 158 (180 - 900)

VITAMIN D 10.3

CALCIUM 2.11 (2.20 - 2.60)

CALCIUM ADJUSTED 2.11 (2.20 - 2.60)

GP sending me for counselling due to unexplained symptoms

[SlowDragon Administrator in reply to luminesence]

FFS we have had so many recently where idiot GP or endo says it's mental when it's as clear as day that you have physical illness

All your vitamin levels are below range and need treatment

See SeasideSusie detailed vitamin advice to similar

healthunlocked.com/thyroidu...

healthunlocked.com/thyroidu...

These are too low because you are under medicated

You need dose of Levo increased by 25mcg and retesting after 6 weeks

Can you see a different GP. Taking a friend or supportive family member along too

Your antibodies are 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.

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

Your GP obviously doesn't have a clue

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...

Dr Toft, past president of the British Thyroid Association and leading endocrinologist, states in Pulse Magazine,

"The appropriate dose of levothyroxine is that which restores euthyroidism and serum TSH to the lower part of the reference range - 0.2-0.5mU/l.

In this case, free thyroxine is likely to be in the upper part of its reference range or even slightly elevated – 18-22pmol/l.

Most patients will feel well in that circumstance. But some need a higher dose of levothyroxine to suppress serum TSH and then the serum-free T4 concentration will be elevated at around 24-28pmol/l.

This 'exogenous subclinical hyperthyroidism' is not dangerous as long as serum T3 is unequivocally normal – that is, serum total around T3 1.7nmol/l (reference range 1.0-2.2nmol/l)."

You can obtain a copy of the articles from Thyroid UK email [e-mail]. print it and highlight question 6 to show your doctor.

[Angel_of_the_North in reply to luminesence]

You also need your GP to deal with your abysmal foalte and B12 levels - should be tested for pernicious anaemia and your low ferritin (needs to be at least 70 ) - should have a full iron panel to test for iron deficiency anaemia and it looks as though you are so vitamin D deficient that you need loading doses right away. Calcium is also very low, probably because of severe vit D deficiency.

[Angel_of_the_North]

No. You are severely undermedicated now. The aim of treatment is to get rid opf symptoms which usually happens when Free T4 and Free T3 are in the top quarter of their ranges and TSH is below 1 (or even suppressed).