Thyroid UK
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Is it ok and will they increase it?

Hi all, was diagnosed with Hashimotos about five months ago. When started on thyroxine 25mg my TSH was 6.7. ( top of range 4.40) . When retested at six weeks it had actually gone up to 6.8. I had to see a different dr who said I had to wait 3 months to be retested and now TSH is 3.8. Will they just say it’s in normal range or is it worth pushing to maybe try 75? . Thank you +++😊

3 Replies
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Saz88,

Dose should have been increased after 6 weeks. TSH 3.8 means you are undermedicated on 25mcg and GP should increase dose to 50mcg. You should have a follow up thyroid test 6-8 weeks later to check levels. Arrange the blood draw early in the morning when TSH is highest and fast (water only) as TSH drops after eating and drinking.

The goal of Levothyroxine is to restore the patient to euthyroid status. For most patients that will be when TSH is 0.3 - 1.0 with FT4 in the upper range. FT4 needs to be in the upper range in order that sufficient T3 is converted. Read Treatment Options in thyroiduk.org.uk/tuk/about_... Email dionne.fulcher@thyroiduk.org if you would like a copy of the Pulse article to show your GP.

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First, how do you feel?

Usually we don't feel better until TSH is around one and FT4 towards top of range

If that's the case ask for 25mcg dose increase, retesting after 6-8 weeks, not 6months

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, lowest FT4 and most consistent results

Have you got High Thyroid antibodies?

Have you had vitamin D, folate, ferritin tested?

I see you have VERY LOW B12 6 months ago

Did GP do full testing for Pernicious Anaemia and then give B12 injections? You should have had folate tested too

Thyroid hormones can not work when any of these four vitamins are too low

Reply

Hi both, sorry been away with work so unable to see. I do feel better than did but wonder if I could feel still a bit less tired, find it a bit easier to lose weight, really noticing and finding cold unbearable. I may ask for phone consultation rather than just stick on meds and mention the article you said.

They are retesting all other bloods Monday so will see re B12 etc .

Thanks again

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