I was just wondering how bad my thyroid results actually are. I've only just been diagnosed but have had poor TSH levels for many years. They have fluctuated between 6 and 9, which I know is over but would like to know how bad this is. Also, I've been subscribed to the lowest dose of levothyroxine, from reading other posts, would this be enough? I have to go for blood tests again in 3 months to check my levels, is that to long a wait?
Any input would be helpful, thank you
prince_huggy
Starting dose should be 50mcg unless a child, elderly or with a heart condition.
NICE Clinical Knowledge Summary:
cks.nice.org.uk/hypothyroid...
Initiation and titration
The dose of levothyroxine (LT4) should be individualized on the basis of clinical and biochemical (thyroid function tests) response. Treatment must be monitored regularly to determine an adequate dose and to avoid both under-treatment and over-treatment.
The initial recommended dose is:
For most people: 50–100 micrograms once daily, preferably taken at least 30 minutes before breakfast, caffeine-containing liquids (such as coffee or tea), or other drugs.
This should be adjusted in increments of 25–50 micrograms every 3–4 weeks according to response. The usual maintenance dose is 100–200 micrograms once daily.
For people aged over 50 years and people with cardiac disease or severe hypothyroidism: 25 micrograms once daily, adjusted in increments of 25 micrograms every 4 weeks according to response.
Once a stable thyroid-stimulating hormone (TSH) level is achieved and an adequate dose determined, arrange follow up to check thyroid function tests (TFTs) at 4–6 months and then annually.
However, as it takes 6 weeks to feel the full effects of a dose change, it's more sensible for repeat tests to be carried out every 6 weeks until levels are where they need to be for you to feel well, 3 months is too long.
TSH normally has to reach 10 before diagnosis is made in the UK. If yours has fluctuated between 6-9 then you are hypothyroid but lucky to actually be prescribed Levo here. Some people have TSH over 100+ when diagnosed.
When booking thyroid tests, always book the very first appointment of the morning and fast overnight (water allowed) . This gives the highest possible TSH which is needed when looking for a diagnosis, an increase in dose or to avoid a reduction. TSH is highest early morning and lowers throughout the day. It also lowers after eating. Also, take your Levo after the blood draw because if you take it before then your FT4 will reflect this and show higher than what is normally circulating. We usually advise 24 hours between last dose of Levo and blood draw so if you take your Levo in the morning then delay until after the test, or if you take it at night then delay that dose until after the test. These are patient to patient tips which we don't discuss with doctors or phlebotomists.
The aim of a treated hypo patient generally is for TSH to be 1 or below or wherever it needs to be for FT4 and FT3 to be in the upper part of their respective reference ranges when on Levo if that is where you feel well.
Take your Levo on an empty stomach - one hour before or two hours after food is recommended (rather than the 30 minutes in the NICE Summary), with a glass of water only, no tea, coffee, etc, and water only for one hour either side.
Take Levo 2 hours away from other medication and supplements, some need 4 hours, as they can affect Levo's absorption.
Thank you so much, answered all my questions but raised more.
"Take Levo 2 hours away from other medication and supplements, some need 4 hours, as they can affect Levo's absorption."
Bit hard this, as I take a few in the morning which also require that I take them 1 hour before food.
I take citalopram, lansoprazole (this is definitely needed before food) and vitamin D in the morning. Do you know if any of these would affect the taking of Levo?
prince_huggy
Citalopram and Lansoprazole you would need to take as far away as possible from Levo - opposite ends of the day really. And do you really need the Lansoprazole? Most Hypos have low stomach acid, not high, and the symptoms are virtually the same. Of course, don't just come off your Lansoprazole, if you do come off it then it must be slowly.
The following supplements need to be taken 4 hours away from Levo:
Vit D
Magnesium
Iron
Calcium
Many members here do one of two things -
1) Take Levo at bedtime - if you have your main meal in the evening then leave 3 hours before taking Levo, and remember only water one hour each side.
2) Take Levo in the early hours of the morning. I need the bathroom a couple of times during the night, so that's when I take mine, some time between 3am and 6am usually.
Also, are you taking Vit D's important cofactors as recommended by the Vit D Council -
vitamindcouncil.org/about-v...
D3 aids absorption of calcium from food and K2-MK7 directs the calcium to bones and teeth where it is needed and away from arteries and soft tissues where it can be deposited and cause problems.
D3 and K2 are fat soluble so should be taken with the fattiest meal of the day, D3 four hours away from thyroid meds.
Magnesium helps D3 to work and comes in different forms, check to see which would suit you best and as it's calming it's best taken in the evening, four hours away from thyroid meds
naturalnews.com/046401_magn...
Check out the other cofactors too.
I take the Lansoprazole each morning to counteract the aspirin I have to take in the evening, due to thining of my arteries. So I guess, yes it is needed. I wouldn't be able to take the Levo of an evening because my meals are not at a set time, due to mine and my wife's different work patterns. I am currently taking Vit D but my levels are OK, so no need to any more. I forgot to mention I was taking that in the morning too, as didn't think it was relevant.
At night I take anti statins, allopurinol, aspirin, cod liver oil and antihistamines.
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