Heading the right way or not?

[rachie881]

Hi, I started levothyroxine on June 21st, 50mg.

Results then were

Tsh 10 (0.3-5). T4 14 (9.0-25.0)

16th Aug. Tsh 8 (0.3-5) T4 16 (9.0-25)

Does this look right? I'm not sure how the numbers work, thanks x

[jimh111]

Yes, this is heading in the right direction. You TSH should come down to 1 or 2 and your fT4 up to around 22. This will probably take a dose of 100 mcg or more. Your doctor should review you in the next week or two and adjust you dose. It's important to let the doctor know how you are doing. You should be feeling a little better by now.

[rachie881 in reply to jimh111]

I wish I was feeling better, hopefully soon I will do.

[jimh111 in reply to rachie881]

It may be that your hypothyroidism is progressing quickly which would explain why your TSH has not dropped a lot. I would see your doctor and ask for your dose to be increased to 100 mcg now. Patients used to be to started off on 25 or 50 mcg and increased by 25 mcg every six weeks or so. This just prolongs the recovery. A more modern approach is to start the patient off on 100 mcg and assess them after four weeks and then titrate in 25 mcg steps. The only exceptions are if the patient is elderly or has a heart condition. I would askt your doctor to put you on 100 mcg and follow up in four to six weeks. There's no merit in dragging things out.

[Hidden in reply to jimh111]

I felt quite bad (some of the time, it fluctuated from day to day) before treatment, and my highest TSH was only just under 6, so 8 is still much too high!

[jimh111 in reply to Hidden]

It could be that your thyroid output is erratic but on the way down, so an increased dose would be appropriate.

[shaws Administrator]

You should have had a blood test every six weeks with an increase of 25mcg afterwards.

The aim is an increase of 25mcg every six weeks until TSH is around 1 and yours is still too high.

Are you aware that blood tests should be at the earliest, fasting (you can drink water) and allow a gap of 24 hours between dose and test and take afterwards.

If GP hasn't tested B12, Vit D, iron, ferritin and folate, ask for these to be tested at the same time.

[rachie881 in reply to shaws]

I didn't know about fasting, or not taking a dose. I'm on vit-d as that was low. Iron ferritin and folate all ok.

I'm fighting to get b-12 tested, it was low a while back but still within range, thanks.

[shaws Administrator in reply to rachie881]

Doctors appear to only look at the TSH and maybe T4. The TSH is highest early a.m. and drops throughout the day and may mean you don't get a rise in dose as you deserve and maybe even a reduction in levo. That's why an early a.m./fasting test is advisable.

[shaws Administrator in reply to rachie881]

Your doctor should do B12, Vit D, iron, ferritin and folate and tell him (if you've not had them for a while) that deficiencies may prevent thyroid hormones working properly). Not that I know that for sure but it is no good having one thing optimum and the others below or even deficient. Vit D and B12 are pro-hormones and deficiencies will give us problems.

[rachie881]

Thanks everyone. Finally got a phone consult with g.p. I had to push but got a raise from 50 to 75mg Levo.

He says the antibodies at 867 (>60) were normal, i thought it was high indicating possibly hashimotos? Or have I misunderstood?

Thanks again.