Optimal levels for hashimotos

[Bailey147miller]

Hello everyone. As I live in Spain can anyone let me know if there is a table with optimal levels for hashimotos. Although my spanish is reasonable I don't want to go armed with a ton of info and tie myself in knots. Due a blood test in the next week so want to be able to explain exactly what I want testing and what the approx levels could be There is so much info that I'm a bit confused Thanks so much for your help

[SlowDragon Administrator]

For full Thyroid evaluation you need TSH, FT4, FT3 and also very important to test vitamin D, folate, ferritin and B12

All thyroid tests should ideally be done as early as possible in morning and fasting. When on Levothyroxine, take last dose 24 hours prior to test, and take next dose straight after test. This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip, GP will be unaware)

What supplements do you take?

[Bailey147miller in reply to SlowDragon]

I had a private blood test which showed vitamin b12 was on the low side so I take a supplement. Unfortunately it didn't show vit d levels. Iron was in range. Ths was 5 but T3 was in range. No minerals were taken into account. On the whole I don't feel too bad but I didn't have symptoms before diagnosis so I know I don't feel as good as I did before. The only symptoms was 20 lbs weight gain which has not increased on the thyroxine. I put this down to old age as I'm 72 and was telling everyone my metabolism was sluggish. Even on slimming world I lost nothing

[SlowDragon Administrator in reply to Bailey147miller]

TSH should be under 2 when on Levothyroxine

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...

FT4 towards top of range and FT3 at least half way in range

How much Levothyroxine are you currently taking?

All thyroid tests should ideally be done as early as possible in morning and fasting. When on Levothyroxine, take last dose 24 hours prior to test, and take next dose straight after test. This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip, GP will be unaware)

Is this how you do your tests ?

For full Thyroid evaluation you need TSH, FT4, 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

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.

Just vitamin D test £29

vitamindtest.org.uk

[Bailey147miller in reply to SlowDragon]

Thanks for the reply. I'm currently on 25 mg a day Monday to Friday and 50 on Saturday and Sunday. How can I show you my last blood levels taken in August privately in the UK. Impossible to copy and paste and no camera icon to upload from my photos. I've wracked my brain and got nowhere lol

[SlowDragon Administrator in reply to Bailey147miller]

You can edit your original post at top to add photo

You can't add a photo in a reply

Alternatively you can make a new post and add photo to it

More people would see a new post

25mcg is very small dose. Anyone over 50 years old is started on 25mcg, but it should be increased to standard starter dose of 50mcg, after first blood tests at 6-8 weeks....assuming blood tests show need. Which your results do

Bloods are retested 6-8 weeks after each increase

Dose goes up in 25mcg steps until TSH is under 2, most patients need it around one, or less

NHS guidelines saying standard starter dose is 50mcgs and that most patients eventually need somewhere between 100mcg and 200mcg Levothyroxine

(Most common is probably 100mcg or 125mcg)

beta.nhs.uk/medicines/levot...

Always take Levo on empty stomach and then nothing apart from water for at least an hour after. Many take early morning, on waking, but it may be more convenient and possibly more effective taken at bedtime.

verywell.com/should-i-take-...

Other medication at least 2 hours away, some like HRT, iron, calcium, vitamin D or magnesium at least four hours away from Levothyroxine

Many people find Levothyroxine brands are not interchangeable.

Once you find a brand that suits you, best to make sure to only get that one at each prescription. Watch out for brand change when dose is increased or at repeat prescription.

Many patients do NOT get on well with Teva brand of Levothyroxine. Though it is the only one for lactose intolerant patients

[Bailey147miller in reply to SlowDragon]

Had to make a new post. Thanks for your help

[Mupppet in reply to SlowDragon]

These are the instructions given in Germany. For years I was treated in Germany with this experience i find it sometimes scary how little GPs know about basics regarding thyroid problems.