Urgent advise please

[SusieR68]

Our family has a history of thyroid problems, both myself and my youngest son have interactive thyroid.

My son was diagnosed 15 months ago and once it was sorted remained fairly stable.....until now. His blood test yesterday show TSH of 94.5 (0.27-4.5) and a T4 level of 6.8 (11-23).

GPs have rang and want to see him this afternoon. Any advise before we go to this appointment? What should we be asking?

Thanks

[SusieR68]

Sorry that should of read underactive, not interactive!

[Clutter]

Welcome to the forum, SusieR68.

Has your son been taking Levothyroxine regularly and away from food, drink, medicines and supplements?

[SusieR68 in reply to Clutter]

He takes 100mg levothyroxine every morning before work. He has always took his vit d (stexerol) at the same time. He was diagnosed 2 years ago with low vit d and been on GP treatment since.

[Clutter in reply to SusieR68]

SusieR68,

For maximum absorption Levothyroxine should be taken with water 1 hour before, or 2 hours after, food and drink, 2 hours away from other medication and supplements, and 4 hours away from calcium, iron, vitamin D supplements, magnesium and oestrogen.

Although taking Levothyroxine with vitD will have reduced absorption of Levothyroxine I don't believe that explains such low FT4 and high TSH. Your son will require dose increases until TSH is 0.3 - 1.0 with FT4 half to 3/4 way through range. Dose increases are usually in 25mcg increments every 6-8 weeks but it wouldn't be a bad thing to increase your son's dose by 50mcg today.

Ask your GP to check tissue tranglutaminase to rule out coeliac disease causing malabsorption and to check ferritin, vitamin D, B12 and folate too as they are often low in hypothyroid patients.

[SusieR68 in reply to Clutter]

Thanks for your reply. Yes I will do.

[Nanaedake]

Has your son had blood tests for thyroid antibodies?

[SusieR68 in reply to Nanaedake]

Not sure, I know I have and they are present. I will ask this afternoon.

[SlowDragon Administrator]

Definitely Get testing for low vitamin D, folate, ferritin and B12

Plus coeliac testing

How much vitamin D is he taking

Any other supplements?

Have he had change in brand of Levothyroxine recently?

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.