TSH slightly higher after levo trial

[Hypo88]

Hi sorry to bother you again - having started a small dose levothyroxine for 6 weeks my TSH is slightly higher than before - it went from 7 upto 10 when I was hoping it would go down ? any advice would be appreciated!

[SlowDragon Administrator]

That's pretty common when you start on low dose

How much are you taking?

Standard starter dose is 50mcgs, then by 6-8 weeks your probably ready for dose increase.

But correctly got blood tests first

TSH of 7 showed you were pretty hypo

Do you have FT4 and FT3 results as well

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

Is this how you did test?

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.

Are your vitamin D, ferritin, folate and B12 at good levels?

[Hypo88 in reply to SlowDragon]

Thanks

Blood tests both am fasting

Dose was 25mcg

Gp only tested TSH altho prior to taking any meds free Ts were good and centralised according to medichecks

Vit levels are all within range albeit b12 an ferritin towards lower end

[SlowDragon Administrator in reply to Hypo88]

How low was ferritin and B12

Ferritin needs to be halfway in range. Eating liver once a week will help improve the levels

B12 above 500, and is linked to folate levels too

You may need to supplement a good vitamin B complex and perhaps a sublingual B12

If you are taking vitamin B complex, or any supplements containing biotin, remember to stop these 3-5 days before any blood tests, as biotin can falsely affect test results

endo.confex.com/endo/2016en...

endocrinenews.endocrine.org...

Always get actual results and ranges on every test

Vitamin D, needs to be around 100nmol

[Angel_of_the_North in reply to Hypo88]

Often taking too low a dose can make you worse as it tells your thyroid to take a rest but doesn't give you enough hormone even to make up for the small amount your thyroid was managing to produce.

[shaws Administrator]

Too low a dose and TSH continues to rise. TSH is from the pituitary gland and if thyroid gland is struggling it tries to help by sending out more Thyroid Stimulating Hormones.

[Hypo88 in reply to shaws]

Thanks was hoping it would of been within the recommended ref range after 6 weeks of tking but maybe need to take more than 25

[SlowDragon Administrator in reply to Hypo88]

25mcg is barely enough for a mouse. In fact many endo's avoid it, it's such a small dose, it knocks your own Thyroid production down, but doesn't add enough to make a difference. 50mcg is standard starter dose

[Angel_of_the_North]

I keep wondering where all these totally useless doctors we keep hearing about are coming from.