Help with test results for GP appt

[Ladybird29]

Hi I’ve recently been diagnosed with an underactive Thyroid. I’ve been feeling ill for a very long time but my symptoms were put down to perimenopause and depression by my GP. I’ve listed the results that resulted in the diagnosis and subsequently prescribed Levo at 25mg. I’ve been taking this for six days now and I feel all my symptoms have gotten worse. After reading up, I realise that this might be due to undermedicating or that it might take longer it to kick in. I have more blood tests (TSH and fT4) in 5 weeks. I asked for antibodies and T3 to be taken then as well. They agreed to the antibodies but not the T3. I may have that done privately. I wondered if someone would have a look at my results and give me some advice as to what it all means please and whether 25mg is appropriate, as I have a ‘mildly underactive Thyroid’ according to the GP’s secretary? I have a phone consult with my GP tomorrow (first one since diagnosis, they just did a prescription for me for the Levo) and I want to make sure I ask all the right questions and have all the right information. Many thanks.

Test Results October 2018

Serum C reactive protein level <4mg/L [0.0 - 6.0] Serum ferritin level 124.2 [10.0 - 291.0]

TSH 9.39 [0.35 - 5.5] fT4 9.1 [10.0 - 19.8]

Serum Vitamin B12 450 [211.0 - 911.0] Serum folate 15.51 [>5.38]

Serum total 25-hydroxy Vitamin D 60.0 nmol/l (notes on results say: below 30 is deficient, 30-50 may be inadequate in some people and above 50 is sufficient for most of population

I had some tests in March 2018 (for comparison although was experiencing symptoms at this time):

Serum C reactive protein level <4mg/L [0.0 - 6.0] Serum ferritin level 80.6 [10.0 - 291.0]

TSH 1.56 [0.35 - 5.5] fT4 14.9 [10.0 - 19.8]

Thanks again

[greygoose]

You were not 'mildly under-active' in the real world, only on the NHS! You are hypo when your TSH gets to 3, so over 9 is pretty hypo. But, if you are over 50, you will be put on the rediculously low dose of 25 mcg. Hopefully, you will get an increase in five week's time.

A vit D level of 60+ may be sufficient for most of the population, but not for hypos. You need it much higher than that. B12 could be higher, too. It should be at least 550.

[Ladybird29 in reply to greygoose]

Thank you greygoose. I’m 44 so I’ll ask her tomorrow for her reasoning behind the low dose. Do you think I should start to supplement with B12 and Vit D now or hang on until after the next tests in 5 weeks?

Thanks again 😊

[greygoose in reply to Ladybird29]

I think a vit d supplement would be a good thing to start now, with the on-set of winter. But, not a supplement with vit d, not a multivit, or anything like that. A vit D3 supplement. After about two weeks, it would then be a good idea to add in some vit K - MK7. And, two weeks after that, magnesium.

[Ladybird29]

That’s great advice, thank you 🙂 I suffer badly with insomnia and night time adrenalin surges, so hopefully the magnesium will help with that too.

[MaisieGray]

You may need to remind your Dr of the NICE Clinical Knowledge Summaries pertaining to initiating Levothyroxine:

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.

[Ladybird29 in reply to MaisieGray]

Thanks for the info MaisieGrey. I’ll bring this to GP’s attention. Be interesting to see how she responds.