Thyroid UK
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Thyroid results

Hi,

I was diagnosed with Hashi in Sep-2017. amd put on 50 mg throxine.

My recent thyroid tests are below

Free T4 : 13.0pmol/L (10-20)

TSH Level: 2 mu/L (0.5-4.4)

Free T3 Level: 4.7 pmol/L (3.5-6.5)

GP says your levels are normal but i am struggling with fatigue, depression and cold.

I have setup an appointment with Endo and was wondering if anybody can guide me what are the optimal levels where one feels better so i can discuss with the Endo

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Did you have any tests to check your Adrenal Function before you started your Levothyroxine?

My Endocrinologist had mine tested first and phoned to say results ok , start Levothyroxine .

Usually you have your 2nd blood tests after 6 weeks and dose increased by 25mcg until stable. Bloods repeated again after a further 6 weeks.

Ask your GP for blood tests for nutrients levels :

Vitamin D & Calcium

B12 & Folate

also Ferritin

while you wait to see Endo. You may have deficiencies that need prescribed supplements. Post results on here for comment when you get them.

Google search "symptoms of deficiencies in * (each one) - NHS choices" znd other sites.

You could ask you for GP to address your symptoms (or ask Endo or both).

Also, have you read through the leaflet with your Levothyroxine.

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Your are under medicated and need dose increase of 25mcg

Dose should be increased in 25mcg steps, retested 6-8 weeks after each dose increase, until TSH is around one and FT4 towards top of range and FT3 at least half way in range

Do you have Hashimoto's also called autoimmune thyroid disease diagnosed by high thyroid antibodies

Have you recently had vitamin D, folate, ferritin and B12 tested? Post results and ranges if you have

Ask that they be tested with thyroid 6 weeks after dose increase

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

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 print it and highlight question 6 to show your doctor

please email Dionne:
tukadmin@thyroiduk.org

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