Help please with test results

[Rosalba]

I would greatly appreciate some advice please. I've been prescribed Levothyroxine after consulting a private doctor at a clinic specialising in bio identical hormone treatment to help deal with menopause symptoms. Along with hot flashes, I have been suffering with fatigue and anxiety for some time. The results relating to the thyroid tests were:

TSH 4.49 mIU/L Ref. Range 0.27 - 4.2

Free T3 4.5 pmol/L Ref.Range 3.1 - 6.8

Free Thyroxine 16.0 pmol/l Ref. Range 12,0 - 22.0

Thyroglobulin Antibody 23.1 Method used for Anti-Tg: Rochel Modular IU/mL ( 0 - 115)

Thyroid Peroxiidase Antibodies 10.6 Method used for Anti-TPO: Roche Modular IU/mL (0 - 34)

I am taking just 25 mcg a day and I'm 54 years old. I am wondering if someone can tell me if I'm just nudging into the range for making Levothyroxine necessary? I'm asking because, according to my NHS GP, there is nothing wrong with my thyroid. I'm a bit confused and due to see my private doctor again soon. Obviously, I don't want to be taking unnecessary medicine but I have found that despite an awful initial period, I am feeling better overall. Body temperature is much better, better mindset, better sleep and less brain fog.

[greygoose]

Well, it's not 'medication', is it, not in the normal sense of the word. It's thyroid hormone. And, yes, you do need it. You are hypo when your TSH touches 3. And both your Frees are under mid-range. Your GP doesn't think you need it because he's been trained to only diagnose when the TSH is over 10 - which is plainly rediculous, and causes a lot of unnecessary suffering. You're lucky you found a doctor that understands thyroid a bit better. Although, it would have been better if he'd started you on 50 mcg.

How long have you been taking the 25 mcg? You need to retest after six weeks, and will more than likely need a 25 mcg increase in dose.

[Rosalba in reply to greygoose]

Thanks so much for this advice which I've found very helpful. I started the regime 5 weeks ago and I'm getting tested again in 3 weeks.

[greygoose in reply to Rosalba]

You're welcome.

SeasideSusie gives very good advice below about how to proceed with the retest. Best to follow it.

[SeasideSusie Remembering]

Rosalba

Your TSH is over range. In another country you would be diagnosed hypothyroid when TSH reaches 3. In the UK we have to wait until it reaches 10.

So basically, your thyroid is struggling, and as your TSH is over range then technically you are hypothyroid.

Your GP is saying there is nothing wrong with your thyroid purely because it is less than 10, he is ignoring the fact that it is over range. He wont like the fact that you've been prescribed Levo.

Your actual thyroid hormones - FT4 and FT3 - aren't that bad but towards the lower end of their ranges. They would get lower the more hypothyroid you became, as your TSH would get higher.

It's possible that because of such a low dose of Levo, 25mcg, you may start to feel worse and need an increase. You'll have to keep an eye on your levels. Increases should be no more than 25mcg at a time. Retesting of thyroid levels should be done 6 weeks after starting Levo, and 6-8 weeks after every dose change.

For proper absorption, always take your Levo on an empty stomach, one hour before or two hours after food, with a glass of water only, and water only for an hour each side. Also, take Levo 2 hours away from any other medication or supplements, some need 4 hours, some need opposite end of the day.

When you have repeat blood tests, have them done as early as possible in the morning, no later than 9am, delay breakfast as eating can affect TSH, drink water only until after the blood draw, and leave off your Levo for 24 hours, take it after the blood draw.

[Rosalba in reply to SeasideSusie]

Thanks so much for all this helpful advice.

[SeasideSusie Remembering in reply to Rosalba]

You're welcome

[Paula101]

It's good you are feeling better, however Dr should have given you a starter dose of 50mcg. 25mcg is for children. Don't be surprised if hypo symptoms return.

You need to increase your dose at 25mcg every 6-8 weeks until your TSH is 1 or below. This level is required to alleviate hypo symptoms. Your Dr should run all the blood tests again to check you TSH levels & an increase your dose. They should check for Vit D, B12, iron/ferritin & folate. As vitamin & mineral deficiencies in themselves. cause lots of problems.

Gp's/Dr's & Endo's are not properly educated at med schools about thyroid. That's why people like yourself & I have come to this forum for advice, we have to sort out our own thyroid health unfortunately.

It's the only place to get the best advice in my opinion.

Your are actually over range & need the Levo & would actually need it wherever you were in the range. As I say TSH needs to be 1 or less to alleviate hypo symptoms.

Unfortunately Dr's will say within range is normal but it is not, because we are presenting with symptoms and feeling very unwell. They are only interested in looking at numbers on a bit of paper and not interested at treating us based on symptoms presented to them. Need to get back to the old ways of treating patients, listening to them!

Your Dr is wrong, your are unwell being hypothyroid. I would advise you change your Dr. You are after all paying someone & not getting the right treatment & that's a waste of your money. You've said yourself you've noticed changes for the better, even if it's only on 25mcg. There's a recommended list of Drs on this site if you email Thyroid UK.

I'm unable to send links I'm afraid. I'm not a expert either, so I'm just advising based on my experiences and fantastic advice & learning, picked up from this amazing forum.

Other members will come along and confirm if you have Hashimotos as I'm not familiar with the range given & also give advice on your FT3, F4 levels & advice on menopause symptoms.

All the very best to you 😊

[Rosalba]

Thank you so much for taking the time to make such a detailed and helpful reply. I'm going to find it very useful in preparing for the next stage.