Dose 25mcg levo

[Glitzy86]

I am new shouldn't I have had levo increased? Diagnosed 2011 thankyou

TSH 7.80 (0.2 - 4.2)

Free T4 10.7 (12 - 22)

Free T3 2.3 (3.1 - 6.8)

TPO antibodies 580.5 (<34)

TG antibodies 477.3 (<115)

[bantam12]

Yes definitely, you are very undermedicated and 25mcg is never going to help, presumably your GP thinks your results are fine ?! Ditch that Dr and find one who knows how to read thyroid results properly.

[Glitzy86 in reply to bantam12]

Thankyou I had letter from endo saying I should be taking 25mcg levo and is questioning my compliance

[shaws Administrator in reply to Glitzy86]

If your Endo has only prescribed 25mcg I would query his advice and send back a letter to him saying you've taken advice (as above HU NHS Choices etc) and you've been led to believe that maybes the Endocrinologist made a mistake and instead of 25mcg per day, should be nearer 125mcg so that both the inactive hormone (T4) is sufficient to raise the only Active thyroid hormone T3, and both should be near the appropriate level - in the upper part of the range. Neither should be below the bottom of the range.

[shaws Administrator]

You are extremely undermedicated and to be so for six years is ridiculous. Another doctor who knows nothing and makes a mistake by thinking that if the TSH is somewhere in the range his job is done. No it is NOT. He should have told you to have a blood test every six weeks with a 25mcg increase until your TSH was 1 or lower. Your FT4 and FT3 are both below range when they should be in the upper part of the range. You have an Autoimmune Thyroid Disease called Hashimoto's - the commonest form of hypothyroidism but treatment is the same.

Blood tests have to be at the very earliest, fasting (you can drink water) and allow a gap of 24hours between your last dose of levo and the test and take afterwards.

Phone your GP and ask for a 25mcg increase as you've had advice from the NHS Choices Healthunlocked Thyroiduk.org.uk for help/advice. your appointment now for six weeks ahead so that early a.m. test is available. Tell him both FT4 and FT3 are at the bottom of the range when they should be nearer the top and that you don't have sufficient hormones in your body to make you feel well and have relief of clinical symptoms.

thyroiduk.org.uk/tuk/about_...

thyroiduk.org.uk/tuk/about_...

thyroiduk.org.uk/tuk/about_...

Get print-outs of your tests with the ranges for your own records and post if you havbe a query.

Also request B12, Vit D, iron, ferritin and folate to be tested as well as thyroid ones at your next test.

[SlowDragon Administrator]

Have you only ever been on 25mcg? Not had dose reduced or T3 started and then stopped?

You are extremely under medicated

The aim of Levothyroxine is to increase the dose until TSH is around one and FT4 towards top of range and FT3 at least half way in range

Ask GP for immediate dose increase of 25mcg and also to test vitamin D, folate, ferritin and B12

Thyroid should be retested 6-8 weeks after each dose increase, and further 25mcg dose increases until TSH is around one

Also your high thyroid antibodies confirm you have Hashimoto's also called autoimmune thyroid disease

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

Hashimoto's affects the gut and leads to low vitamin levels

Low vitamin levels stop Thyroid hormone 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

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.

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

Link about antibodies

thyroiduk.org.uk/tuk/about_...

Link about thyroid blood tests

thyroiduk.org/tuk/testing/t...

Print this list of symptoms off, tick all that apply and take to GP

thyroiduk.org/tuk/about_the...

See Box 1. Some possible causes of persistent symptoms in euthyroid patients on L-T4

onlinelibrary.wiley.com/doi...

You need a new endo.

Email Thyroid UK for list of recommended thyroid specialists [e-mail]