Advice on levels please??

[Rufty10]

TSH 2.2, Free T4 8.6, B12 150, Folate 2.7, Thyroid antibodies (IgG Ab) 46.2. Apparently I am normal. Ah, no, make that menopausal (FSH 19, LH 7). Sorry, I should add that I've just come from the GP to follow up on my first blood test after starting levo 2 months ago. I asked if I could increase the dose & she said that if she did that then I might feel better and wouldn't want to bring it down again. I said 'oh silly me for wanting to feel better' but instead she said she thinks it's all due to menopause (which I don't think I'm expecting for a few years yet) so maybe I should stop the levo. Any ideas???

[SlowDragon Administrator]

You are very likely under medicated

Can you add ranges to these results

Your FT4 looks very low, as does folate and B12

You also need FT3, vitamin D and ferritin tested

TSH should be around one and 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...

Dr Toft, past president of the British Thyroid Association and leading endocrinologist, states in Pulse Magazine,

"The appropriate dose of levothyroxine is that which restores euthyroidism and serum TSH to the lower part of the reference range - 0.2-0.5mU/l.

In this case, free thyroxine is likely to be in the upper part of its reference range or even slightly elevated – 18-22pmol/l.

Most patients will feel well in that circumstance. But some need a higher dose of levothyroxine to suppress serum TSH and then the serum-free T4 concentration will be elevated at around 24-28pmol/l.

This 'exogenous subclinical hyperthyroidism' is not dangerous as long as serum T3 is unequivocally normal – that is, serum total around T3 1.7nmol/l (reference range 1.0-2.2nmol/l)."

You can obtain a copy of the articles from Thyroid UK email print it and highlight question 6 to show your doctor

 please email Dionne at

[e-mail]

For full Thyroid evaluation you need TSH, FT4, TT4, FT3 plus TPO and TG thyroid antibodies and also very important to test vitamin D, folate, ferritin and B12

Private tests are available. Thousands on here forced to do this as NHS often refuses to test FT3 or antibodies or all vitamins

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.

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 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 .

[Rufty10 in reply to SlowDragon]

Thanks I will add the ranges later. I thought they would be the same as surely the target/range should be the same for everyone?? But then again, I guess each authority uses different equipment and test methods?? Though as the results don't include a method it's impossible to say. She definitely said I don't have Hashi though.

[Kell-E]

She actually said you might feel better and not want to lower your dose? Like that would be working against her aims? Huh? Personally I would get away from her if possible.

[Rufty10 in reply to Kell-E]

I switched to her as the previous one was even worse !

[Kell-E in reply to Rufty10]

Bummer...I totally understand though. Three GP's ago one was worried about my TSH and convinced I would develop cardiomyopathy and osteoporosis. She moved away and the next one was obnoxious and considered NDT to be an concoction of the Devil, even though an endo had prescribed it. I had only one 'visit' with her.

[Aurealis]

Is there a better GP at that practice?

You could increase it yourself and go back and tell her she’s right you do feel better on the higher dose (well the brain fog on the lower dose must have made it difficult to understand her instructions

So then you just need a prescription from your GP...

Good luck !!!

[SeasideSusie Remembering]

Rufty

I asked if I could increase the dose & she said that if she did that then I might feel better and wouldn't want to bring it down again

So by that token, if you go with a broken arm she wouldn't want to mend it in case you could start using it again?!!

Sometimes, I really, really don't know what to think but that really is the biggest load of twaddle I've heard lately.

I said 'oh silly me for wanting to feel better'

Good for you!

[Rufty10 in reply to SeasideSusie]

Thanks - you cheered me up!! Starting to think it's me that's being a numpty

[Dippi]

Hi there, i was told exactly the same thing, even though i finished 5 years ago! then got told change my diet! or it might even be my age..... i came out feeling so bad that i have now taken things in my own control and ordered T3, hopefully that will help as i see no other way.

[Rufty10]

Now with the ranges:

TSH 2.2, (0.35 - 5.5 mU/L)

Free T4 8.6, (7-17 pmol/L)

B12 150, (150-900ng/L)

Folate 2.7, (>3ug/L)

Thyroide peroxidase, Anti-TPO antibodies (IgG Ab) 46.2. (<9 U/ml)

FSH 19,

LH 7

Plasma viscosity 1.99 (1.5-1.72 mPa)