New hypothyroidism

[Hashiannie]

New hypothyroidism . TSH of 17. No treatment until I see GP end of May. Any recommendations of what is best treatment? I'm 58 and quite well on the whole but have had health probs. BMI of 23 ish and able to cycle etc but get bit tired.

[SeasideSusie Remembering]

With a TSH of 17 then you should be started on levothyroxine straight away. If you are experiencing any symptoms then delaying the start of treatment will only prolong the agony. If it was me I would ring the surgery and ask for an appointment before you go on holiday, even a telephone appointment.

If you do not have symptoms then it might be better to wait until after your holiday. For some people, starting Levo (especially if it is at only 25mcg) can make them worse at first. So really it's your decision depending on how you feel.

When you do start taking Levo, take it on an empty stomach, one hour before or 2 hours after food, with a glass of water only, no tea, coffee, milk, etc for an hour either side as it can affect absorption. Keep Levo 2 hours away from other medication and supplements (some need 4 hours) as absorption can be affected.

You can take it in the morning or at bedtime, whichever suits you best. I take mine in the early hours of the morning when I need a bathroom trip, that keeps it well away from food, other medication and supplements.

After starting Levo, you should have regular retesting every 6 weeks, with 25mcg increases in dose, until your levels are where they need to be for you to feel well. The aim of a treated hypo patient generally is for TSH to be 1 or lower with FT4 and FT3 in the upper part of their reference ranges.

You can post future results for interpretation but please always include the reference ranges (usually in brackets or to the side of the result) as they vary from lab to lab. Always ask for a print time out of your results from your surgery's reception, it is your legal right to have them and will be a useful resource in the future as you will be able to compare results and how you feel on what dose.

We hypos need optimal levels of vitamins and minerals for thyroid hormone to work properly, so it would be a good idea to have the following tested

Vit D

B12

Folate

Ferritin

Also thyroid antibodies really should be tested to know if yours is autoimmune thyroid disease caused by raised antibodies. In this case a strict gluten free diet can help reduce the antibodies.

[helvella Administrator Thyroid UK in reply to SeasideSusie]

Would they expect someone to wait four weeks or more to get a plaster cast on their broken arm? That was meant to be rhetorical - but I am having to pinch myself and wonder if it could be a real question!

Ludicrous and quite simply malpractice.

[SeasideSusie Remembering in reply to helvella]

Indeed Rod, that was my first thought. But if they start her on 25mcg and she goes on holiday she may very well feel an awful lot worse. If she wasn't going on holiday I would suggest banging their door down but as she says she feels quite well on the whole it may be best to wait. It's a difficult one!

[helvella Administrator Thyroid UK in reply to SeasideSusie]

Fully understood - but a classic situation where we end up having to make all sorts of assumptions, guesses, etc., quite simply because the medics involved have not acted as we think they should. Even if that action had been to explain that they were deferring because of the holiday and the issues you describe.

[Hashiannie in reply to SeasideSusie]

I like the idea of taking the medication at night as I'm always grazing in the day. And as you say it's important that the medication is absorbed well.

[Peanut31]

Oh my gosh, TSH of 17, mine was 12.2 and I felt absolutely terrible, god knows how you are functioning with the result of 17.

Why on earth has your GP not started you on Levothyroxine?

My surgery phoned me immediately when mine showed 12.2 and GP put me straight on 50 mcg of Levothyroxine (was going to start on 25mcg) but, I took the NHS print out with me.

Once your TSH is over 10 it clearly states on the NHS website you should be on a stater dosage of Levothyroxine 50 mcg then blood tests every 4-6 weeks with an increase.

Don’t accept a starter dosage of 25mcg, get 50mcg.

I only know this through advice on here and my own experience and research.

Best wishes

Peanut31

[Hashiannie in reply to Peanut31]

Oh that's excellent advice. Thanks Peanut. X x

[Peanut31 in reply to Hashiannie]

beta.nhs.uk/medicines/levot...

This was given to me on here, which I took to my GP.

Best wishes

Peanut31

[helvella Administrator Thyroid UK in reply to Peanut31]

I notice they are seeking comments by a survey from visitors to that page.

Maybe anyone who has the time would care to read the page and let them know what they think?

(I was pleased that both Thyroid UK and this forum are linked from the page. )