Hi friends,
My doctor told me I had subclinical thyroid 6 weeks ago, he suggested me levothyroxine 25mg for my symptoms, but after 6 weeks I did blood test and my levels decreased before making it under active thyroid, any ideas what happened and how it decreased?
The dose was too low, a normal starter dose if 50 mcg.
25 mcg is enough to stop the natural production of your thyroid, but not enough to replace it, so you become more hypo. Nothing to worry about. 
But it shouldnt have decreased than before , dont u think so?
Well yes, it would. It often happens when people take too small a dose.
Look at it this way… Image your thyroid produced 35 mcg thyroid hormone a day.
You start taking 25 mcg a day.
The thyroid stops working. Meaning that it stops producing 35 mcg a day.
You are only taking 25 mcg a day, so that's 10 mcg a day LESS than you had before you started taking levo.
So you've had a decrease in thyroid hormone. Therefore your FT4 drops, and your TSH then rises, because you are now more hypo.
You see what I mean?
Doctors don't know much about thyroid, and they believe that giving levo adds on to the amount made by your thyroid. But, it doesn't always work like that.
But then 25mg does it not make it normal? My doctor gave me so that thyroid levels are normal
I've just explained that twice. No, a 25 mcg dose of levo will not make your levels 'normal'. It's too low a dose. You needed 50 mcg to start with, and a 25 mcg increase every six weeks.
25 mcg levo will never make a hypos persons' levels normal. Your doctor is very ignorant.
Plus I wasnt underactive My T4 was 9.9, now it is 4
Can you give me the range for that T4, please? Results without ranges are meaningless.
Serum free T4 level - before 25mg 9.9 and after 3.5
Serum TSh before 9.8 after (idk didnt colelct result yet)
Yes, but I still need the range. You've only given me the results. The ranges are in brackets after the results e.g.:
FT4 15 (12 - 22)
However, not all labs use the same ranges, so I need the range for the lab where your blood was analysed.
BUT, I don't need a range for the TSH! And a TSH of 9.8 is NOT subclinical. It is overtly hypo. You are hypo as soon as your TSH hits 3! You were very hypo before the levo, and your idiot doctor should have put you on 50 mcg - I hope he's done that now!
Yeah Range is ( 9.0 to 19 )
OK, so it was right at the bottom of the range. That is not subclinical, that is very hypo.
Doctor said it was subclinical ! My bad
Doctor was wrong. As I said, he obviously doesn't know anything about thyroid. So, you need to be very careful about your treatment. Keep asking questions on here.
Are you a doctor?
No, but I've had a lot of experience of this hypo business!
Oh ok
But with the low range does it just get worse or it improves? How can I take med for life time
It's not 'medication'. It's thyroid hormone replacement. It replaces the hormone that your thyroid can no-longer make enough of to keep you well.
I don't know what you mean about the low range. The point of taking thyroid hormone replacement is to raise the level of the FT4 (and the FT3, also) and lower the TSH. As your FT4 level rises, you should feel better.
But, you're going to need more than 50 mcg. Your dose should be increased every six weeks, after the retest, until you do feel better. 50 mcg is just a starter dose, and most people end up needing about 150 - 200 mcg.
Yeah He have put on 50mg now
Doctor doesnt even discuss it properly
So I think 50mg will make it better !
50 mcg will be an improvement, but not a cure. Did he tell you that you have to take this for the rest of your life?
Did he tell you to go back for a retest in six weeks?
When you go back for a retest, make sure you have an appointment early in the morning and fast over-night. Leave a 24 hour gap between your last dose of levo and the blood draw.
Dose has to increase slowly, with 25mcg increase each time. Waiting 6-8 weeks before retesting.
This happens again and again until TSH is around one and FT4 towards top of range and FT3 at least half way in range.
As greygoose says the recommended starter dose is 50mcgs unless elderly, frail or heart condition
NHS guidelines saying standard starter dose is 50mcgs
beta.nhs.uk/medicines/levot...
At next test you also need both TPO and TG thyroid antibodies tested, as well as vitamin D, folate, ferritin and B12. These are often too low due to being hypothyroid and may need supplements to improve. This helps thyroid hormones work better as well
All thyroid tests should ideally be done as early as possible in morning and fasting. When on Levothyroxine, don't take 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 thyroid 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.
Low vitamins are especially common with Hashimoto's. Food intolerances are very common too, especially gluten. So it's important to get TPO and TG thyroid antibodies tested at least once .
Most people eventually need somewhere between 100mcg and 200mcg of Levothyroxine
Link about thyroid blood tests
thyroiduk.org/tuk/testing/t...
Link about antibodies and Hashimoto's
thyroiduk.org.uk/tuk/about_...
thyroiduk.org.uk/tuk/about_...
List of hypothyroid symptoms
Hi slowdragon, Thankyou
I was tested for vitamin and ferritin they were low, I am taking calcium supplement and ferrous sulphate , the next test I did was not on empty stomach. Should I do blood test again?
Please, please, please post all of your results with the ranges on this site for answers.
hypothyroidism - Subclinical 
Help please!!! Hypothyroid now not hypothyroid but subclinical thyroid dysfunction whaaaaat
No thyroid meds
Subclinical Hypothyroidism 
Subclinical
