tests results interpretation please first time post

[mo1972]

HI first time post need some advise please. Diagnosed with underactive thyroid in april 2017 and started on 50 levo, after a few months didn't feel any better but retested and TSH and level was ok, just had another retest and need to speak to doctor about results as levels are high, can anyone interpret for me please. 11/04/17 Serum TSH level5.67 mIU/L 0.4 - 4mIU/L 11/04/17 Serum free T4 level13.9 pmol/L 10 - 25pmol/L 04/07/17 Serum TSH level3.17 mIU/L 0.4 - 4mIU/L 07/02/18 Serum free T4 level13.1 pmol/L 10 - 22pmol/L 07/02/18 Serum TSH level10.66 mIU/L 0.3 - 4.5mIU/L the test on the 4/7/17 I didn't take my levo before test in the morning and on the most recent one 7/2/18 I did take my levo 3 hours before test as doctor said it would not affect test. thanks

[SlowDragon Administrator]

Dose of Levothyroxine should be increased in 25mcg steps until TSH is around or just under one (most prefer TSH between 0.8-1.0)

To have TSH of 10.6 shows you are very under medicated. Make an appointment to see GP and request 25mcg dose increase and also request that thyroid antibodies are tested, plus vitamin D, folate, ferritin and B12 if not been done before now

Important to know if you have high thyroid antibodies as this gives diagnosis of autoimmune thyroid disease also called Hashimoto's

Getting blood set done as early as possible in morning and fasting and no Levo in 24hours prior to test (delay and take straight after) is a patient to patient tip. Also recommended by some endocrinologists)

Nice guidelines saying how to initiate and increase

cks.nice.org.uk/hypothyroid...

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]

[mo1972 in reply to SlowDragon]

Thank you for that

its much appreciated