Is this enough to make me feel ill and be diagnosed ?

[Troya18]

Hi

I was diagnosed with underactive thyroid on 28th Dec and prescribed levothyroxine

Found out today my

TSH is 5.34

T4 is 13.9

The TSH is only slightly above normal range is this enough for me to have been diagnosed and explain why I've been feeling so ill ?

Thanks , completely in dark about all this ?

[Clutter]

Troya18,

Yes. If TSH was over range and you were symptomatic your GP was right to diagnose hypothyroidism and prescribe Levothyroxine.

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_...

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.

It takes 7-10 days for Levothyroxine to be absorbed before it starts working and it will take up to six weeks to feel the full impact of the dose. Symptoms may lag behind good biochemistry by several months.

You should have a follow up thyroid test 6-8 weeks after starting Levothyroxine. Arrange an early morning and fasting (water only) blood draw when TSH is highest, and take Levothyroxine after your blood draw.

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

[Troya18 in reply to Clutter]

Hi, thanks what number is considered to be in the upper range for the FT4? . I've been taking my meds at night time

[Clutter in reply to Troya18]

Troya18,

It depends what the top of range is. Usually over halfway through range to a couple of points under the top of range is considered good.

[Marz]

It may be good to have anti-bodies checked with your next blood test to rule out Hashimotos. Anti-TPO is the one they test on the NHS but there is also Anti-Tg.

Have you had B12 - Folate - Ferritin and VitD tested ? If so and you have the results do post them for comment

[Eddie83]

TSH is a poor diagnostic tool, and virtually worthless for treatment. Upon finding that you are hypothyroid, you should have had the full panel TSH/FT3/FT4/rT3/TPOAb/TGAb. Hashimoto's is the leading cause of hypothyroid, so antibody tests are mandatory ... otherwise the doc is not doing his job.

[Clutter in reply to Eddie83]

Eddie83,

It doesn't work like that in the NHS. FT3 is rarely tested in primary care and even when requested by endocrinology labs are unlikely to test unless TSH is suppressed. TPOab may be tested in primary care but TGab rarely is. rT3 is not tested on NHS.

[SlowDragon Administrator]

On Levothyroxine TSH needs to be low in range. Most patients need it somewhere between 0.2 and 1 to feel well

Essential to test FT4 and FT3 too, plus thyroid antibodies

Vitamin D, folate, ferritin and B12 can be too low if been under medicated

So For full evaluation you ideally need TSH, FT4, FT3, TT4, TPO and TG antibodies, plus vitamin D, folate, ferritin and B12 tested

Ask GP for 25mcg dose increase and bloods will need retesting in 6-8 weeks. Request that all these are tested then

Private tests are available if GP unhelpful

thyroiduk.org.uk/tuk/testin...

Medichecks Thyroid plus ultra vitamin or Blue Horizon Thyroid plus eleven are the most popular choice. DIY finger prick test or option to pay extra for private blood draw. Both companies often have money off offers.

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...

List of hypothyroid symptoms

thyroiduk.org/tuk/about_the...

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: at

[e-mail]

[Troya18]

Omg 😲 my head is spinning from this complicated illness feel so down and fed up , frightened I'm going to be huge, exhausted and foggy brained for ever

Thank you all for yr information , much appreciated