Hello I am on 50 mcg of thyroxine and I feel awful on it. At what dose should I ask about T3, as I dont think my body is converting the T4 to T3? My doctor only did tests for TSH and T4. Should I go and see an endocrinologist for more complete tests, or keep increasing the levothyroxine?
Thank you
How long have you been taking just 50mcg? It's only standard starter dose.
Can you add most recent blood test results
TSH and FT4 are a start, but you also need to know FT3 and if you have high thyroid antibodies
Also vitamin D, folate, ferritin and B12
Nice guidelines saying how to initiate and increase. Note that most patients eventually need somewhere between 100mcg and 200mcg Levothyroxine
cks.nice.org.uk/hypothyroid...
You likely just need a dose increase. TSH should be around one (or slightly less) and more importantly FT4 towards top of range and FT3 at least half way in range
Official NHS guidelines saying TSH should be between 0.2 and 2.0 when on Levothyroxine
(Many of us need TSH nearer 0.2 than 2.0 to feel well)
See box
Thyroxine replacement in primary hypothyroidism
pathology.leedsth.nhs.uk/pa...
For full Thyroid evaluation TSH, FT4, TT4, FT3 plus TPO and TG thyroid antibodies. Plus vitamin D, folate, ferritin and B12.
Essential to test thyroid antibodies plus vitamins
Private tests are available. NHS often refuses to test FT3 or antibodies
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.
Medichecks have offer on today
All thyroid tests should ideally 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. (Patient to patient tip, GP will be unaware)
If antibodies are high this is Hashimoto's, (also known by medics here in UK more commonly as autoimmune thyroid disease). About 90% of all hypothyroidism in Uk is due to Hashimoto's
Hi I got my blood results printed and as usual only got minimal tests. They are as follows SERUM TSH O.18mu/L
Serum free T4 16.9 pmo1/L
Serum ferritin 45ug/L
I have no clue what they mean. I explained I felt anxious & racing heart & bp raised. I have to go back in 4wks for retesting & she said she’d request t3 testing and reduced me to 75mg Levo thyroxine
Just these tests are inadequate to tell
You need full testing, especially antibodies
Ferritin looks low. Eating liver once a week should help improve levels
Thank you
Nada678,
If you post your recent TSH and FT4 results and ranges we can tell you whether you are adequately dosed on 50mcg. If you are undermedicated you should keep increasing Levothyroxine dose.
You will have to order a private TSH, FT4 and FT3 result to determine whether converversion is good or poor. Your GP will almost certainly need a recommendation from a NHS endo before prescribing T3 and not all endos support it.
If you have results for ferritin, vitamin D, B12 and folate post them too.
Hi Clutter How do I get a private FT4 and FT3 or whatever I need to determine if my body is converting T4 to T3?
Nada
Nada78,
thyroiduk.org.uk/tuk/testin... Medichecks are offering 15% discount throughout March if you include the code MED15. They also offer #ThyroidThursdaydiscounts which may be 20%.
Nada768 there is no history of your thyroid journey in your Profile, i.e. when diagnosed, with what etc. There is only your name.
When were you diagnosed? With what? i.e. hypothyroidism or hashimoto's.
50mcg of levothyroxine is a starting dose and you should have had a blood test every six weeks with an increase of 25mcg until your TSH is 1 or lower.
All blood tests have to be at the very earliest possible, fasting (you can drink water) and allow 24 hours gap between last dose and test and take it afterwards. This keeps the TSH at its highest as doctors seem to only look at the TSH and T4 result and ignore patients' symptoms. The purpose of taking thyroid hormones is to restore our metabolism to normal and that we feel well with no clinical symptoms at all.
Your GP should also test B12, Vit D, iron, ferritin and folate as deficiencies also cause symptoms.
I think the majority of doctors have no idea how to treat hypo patients except test TSH and T4.
If we want to get well we have to read, learn and ask questions in order to do so.
Always get a print-out of your results with the ranges for your own records and you can post if you have a query.
Is there a promo code that can be used for medichecks testing?
Every Thursday Medichecks have an 'offer' of some sort. I believe their 'sets' are reasonably priced. You must make sure you are well hydrated a couple of days before drawing blood and arms have to be warm so that it is easy. It is home pin-prick tests or they can arrange where you can get blood drawn.
I have just seen the following on TUK and there's a special offer:
medichecks.com/blog/celebra...
Thank you, yes I got the code. I will be doing the home prick test.
Make sure to include vitamin D, folate and B12 (unless you can persuade GP to test)
If my GP is only interested in TSH and T4, what should I do with Medicare results?
Medichecks results, - bring them here for advice. If anything is very out of range then GP will either accept your results or run a retest using NHS labs
Personally, my GP accepts all my Medichecks test results. NHS won't test FT3 and as I am taking T4/T3 combo, it's essential to test FT3. Not had an NHS test for 5 years.
It's essential to test FT3 and antibodies for everyone on any thyroid hormone replacement. False economy not too.
Same applies to vitamin D, folate, ferritin and B12
Hi SlowDragon
Do you get T3 from your GP or elsewhere? Thank you
Prescribed on NHS (more on my profile)
Yes I’ve gone for the £59 one
What to expect when on Levothyroxine?
Do I still need Levothyroxine
Heart problems, unclear test results
Levothyroxine absorption variability??
Thyroid problems ruled out?
