I take 75mcg levo

[Glitzychick]

Hi I was diagnosed in March 2018 with underactive thyroid. To be honest when I was told I have underactive I felt so relieved to find my symptoms (tiredness, goitre, difficult swallowing, feeling cold, puffy eyes) had a cause to them.

I had constipation since 2011, it has been treated with laxatives but they took ages to work. I also take painkillers for aches and pains, also period cramps. And corticosteroids for recurring eczema.

The reason I have come here today is, can hypothyroidism resolve so quickly within 2 months? Please see both sets of results:

Mar 2018

TSH 30.2 (0.2 - 4.2)

FT4 10.1 (12 - 22)

May 2018

TSH 4.0 (0.2 - 4.2)

75mcg Levothyroxine doesn't really seem to have helped with my symptoms and my doctor says it would take a while for hypothyroidism to stabilise, can it really have sorted it?

Thankyou

- Elizabeth

[shaws Administrator]

It is how we, the patient, feels on particular doses not where the numbers fall after a blood test.

The aim is a TSH of 1 or lower with a Free T4 and Free T3 in the upper part of the range. You need more increases of levo 25mcg each time until TSH is 1 or lower. Labs rarely test FT4 and FT3 so if you're not improving you may have to get your own. We have two labs, Medichecks and Blue Horizon who do home pin-prick tests. You make sure you are well hydrated and allow a gap of 24 hours between last dose of levo and the test and take afterwards.

Many doctors think that once TSH is 'in range' his job is done but it isn't TSH of 1 or lower is the aim. Your top of 'in range' is 4.2 which is too high although GP might think it is fine.

Taking the TSH is fine but it is from the pituitary gland and it rises when becoming hypo. Once taking thyroid hormones the TSH will reduce but some doctors don't know the aim is 1 or lower. The most accurate test is Free T4 and Free T3 but you don't need them yet (you'd have to get private ones) until you have had rises in levo and a lowering of TSH.

GP should also test B12, Vit D, iron, ferritin and folate too.

[Glitzychick in reply to shaws]

Thankyou! My GP requested the FT4 and FT3 but they haven't come back. I had vitamins checked do I post these? Thankyou again!

[Glitzychick in reply to shaws]

I wasn't sure if I should have had Blue Horizon tests done, they were done a few weeks ago. Can I post? Thankyou!

[shaws Administrator in reply to Glitzychick]

Certainly post your results with the ranges.

[greygoose]

Glitzychick, it hasn't been sorted at all. Your TSH is still much to high. The aim of thyroid hormone replacement (levo) is to bring your TSH down to 1 or under. And, your Free T4 up over mid-range. They didn't even bother to test your FT4 in May, so you have no idea of your thyroid status, but if you're still having symptoms, and your TSH is too high, then it's doubtful that the FT4 is in the right place.

75 mcg is still a low dose, and you need an increase. But so many doctors are reluctant to prescribe enough levo to make you well because they don't understand how it works. So, you've got to get tough with your doctor, and insist on an increase in dose.

If I were you, I wouldn't do a Blue Horizon test just yet. It's obvious that your Frees are going to be low because your TSH is high. Wait until it comes down to under 1, and then test.

[Glitzychick in reply to greygoose]

Blue Horizon results

*THYROID STIMULATING HORMONE 5.2 mIU/L (0.2 - 4.2)

FREE THYROXINE 13.3 pmol/L (12.00 - 22.00)

FREE T3 4.0 pmol/L (3.1 - 6.8)

*THYROID PEROXIDASE ANTIBODY 375 IU/mL (0 - 34 negative)

*THYROGLOBULIN ANTIBODY 2101 IU/mL (0 - 115)

[greygoose in reply to Glitzychick]

Yes, as I said, you're under-medicated. Most people need their FT3 up the top of the range to feel well. So, you're a long way off being sorted.

Andy, you have Hashi's. So you really need your TSH at zero. So, you really do need an increase in dose.

But, what I was saying was, it's not worth doing another BH test until your TSH goes down below 1, so doing another one, now - as you suggested to shaws - would be a waste of money.

[Glitzychick in reply to greygoose]

Thankyou I was just a bit confused with my symptoms and that was why I tested

[greygoose in reply to Glitzychick]

I understand. But now you know you're very hypo, so I would wait awhile, if I were you. Symptoms can be confusing because so many of them swop over from hypo to hyper. We can't rely on them 100%.