Is a TSH of 2.86 too high? I need some help pl... - Thyroid UK

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Is a TSH of 2.86 too high? I need some help please!

momo33 profile image


I had my yearly blood test and have asked for the results to be printed off before my doctor's appointment on Friday. My TSH has gone up from 1.2 to 2.86 in the last 12 months and I feel that I need more levo, but my doctor indicated that he intends to keep me on the same dosage (plus he is a sucker for saying that if I'm in the 'reference range' then i'm fine). I had it in my mind to always keep my TSH around one, as that is when I feel at my best. My thyroid peroxidase antibodies are now 355. Last year that were 304. All he tested was TSH and antibodies.

Does anyone have any evidence that I can take with me to my appointment to convince him to increase my dose? Plus do you know how much more levo I should ask for? Will 50mcg be too much and make me have hyper symptoms? I'm really worried that I'll get sick again and am scared that i'll end up back where I was a couple of years ago if he refuses to up my dose.

Any info/advice would be appreciated so much.

Thanks so much.

momo x

17 Replies

Hi reallyfedup123,

Thanks for that! I'll print it off. I feel so anxious about battling this out with my doctor; I need all the help I can get! Thanks again.

shaws profile image

The following is by one of our Researchers and am sure you will be delighted to send your GP a copy.

Also highlight the phrase about TSH in the following - by a Hormone Specialist.

We have to educate doctors otherwise we remain symptomatic and have to heal ourselves by asking questions and some sourcing their own thyroid hormones.

Before blood tests and levothyroxine were introduced as the 'perfect solution' we were diagnosed by our clinical symptoms alone and prescribed NDT until symptoms were resolved.

momo33 profile image
momo33 in reply to shaws

Hi Shaws, that's all great information. I will indeed take it with me to show my doctor. Yes, you're right about educating doctors. I had no idea that it would be so hard to get them to pay attention and at least try help. That's why I'm so grateful for this site! Thanks again for the links! momo x

It's doubtful that an increase of 50 mcg will give you hyper symptoms, but it might be a bit too much for your system. A bit of a shock, so to speak. With any hormone it's better to increase slowly, the body deals with it better. And, for T4, that means an increase of 25 mcg.

Yes, it's a real struggle. Believe it or not he was a lot more useful than the endocrinologist I saw. She said that my TSH would need to reach 10 for her to recommend treatment!

hi greygoose, that's good to know. I wouldn't want to have a nasty reaction to introducing too high a dosage at once. Fingers crossed that he'll increase my meds. Thanks for your kind help x

SlowDragon profile image

Dose of Levothyroxine should be increased in 25mcg steps until TSH is under 1.5 and FT4 towards top of range and FT3 at least half way in the range

New NHS England Liothyronine guidelines November 2018

See page 8 - 2nd paragraph and repeated page 12 point 1

Ask GP for 25mcg dose increase in Levothyroxine and to test vitamins below

Your high antibodies confirm you have Hashimoto's, low vitamin levels are extremely common

Low vitamins are direct result of being under medicated

Improving vitamins by regular supplementing is very often necessary

Vitamin D at least above 80nmol

B12 above 500

Folate towards top of range

Ferritin needs testing

Poor gut function can lead leaky gut (literally holes in gut wall) this can cause food intolerances. Most common by far is gluten. Dairy is second most common.

According to Izabella Wentz the Thyroid Pharmacist approx 5% with Hashimoto's are coeliac, but over 80% find gluten free diet helps, sometimes significantly. Either due to direct gluten intolerance (no test available) or due to leaky gut and gluten causing molecular mimicry (see Amy Myers link)

Changing to a strictly gluten free diet may help reduce symptoms, help gut heal and slowly lower TPO antibodies

Ideally ask GP for coeliac blood test first

momo33 profile image
momo33 in reply to SlowDragon

Hi SlowDragon,

Thanks very much for your helpful and informative response. I currently supplement vitamin D but not B12. I also take iron tablets due to low ferratin. That is interesting about gluten intolerance. I'll definitely look in to that. I really hope the doctor agrees to increase my medication; thank you for all your helpful links. Now I have plenty of information to fire in his direction on Friday at my appointment! momo x

SlowDragon profile image
SlowDragonAdministrator in reply to momo33

Have you had vitamin D retested since started supplementing?

How much vitamin D do you take?

How low was it before started supplementing?

Important to test folate and B12 first BEFORE start supplementing

Low ferritin and low vitamin D suggests gut function is impaired. Ask GP for coeliac blood test before considering trying strictly gluten free diet

Low vitamin D and low B vitamins are linked

Also read up on importance of magnesium and vitamin K2 Mk7 supplements when taking vitamin D

Do NOT supplement any vitamin K if you take any blood thinning medication including aspirin

Vitamin C and bones

Magnesium supplements can help with constipation too. Calm vitality magnesium powder is cheap and easy to use. Starting on low dose (at least 4 Hours away from Levo) increase slowly until constipation improves

momo33 profile image
momo33 in reply to SlowDragon

hello SlowDragon,

I have been taking vitamin D for a year now. I don't remember if I was low or not, but figured that taking a supplement to boost my levels wouldn't do any harm, especially in the colder season. I take 4000IU a day. My folate and b12 levels were okay, I think, but the low ferritin has been an ongoing problem. It was 5 two years ago, and I've managed to increase it to 25, which is my current level through a diet and a gentle supplement that I can tolerate.

Thanks forthe tip about the magnesium. I will definitely look into that as I need all the help I can get lol! Thank you for the links and for taking the time to answer my questions.

momo x

momo33 profile image
momo33 in reply to momo33

also, I had no idea that vitamin C played such a vital part in bone health! Facinating and shocking! I'll be buying some supplement asap!

Hi, momo,

Perhaps I missed it, but what is your current dose?

And what symptoms are you experiencing that are prompting you to want a dose increase?

momo33 profile image
momo33 in reply to roxanaleah

hey roxanaleah, my current dose is 100mcg. I am a bit run down and tired, and constipation is another symptom that has made an ugly return. I just generally feel better when my TSH is around one, so hopefully my doctor will agree to help!

SlowDragon profile image
SlowDragonAdministrator in reply to momo33

Thyroid hormones need ferritin at least half way in range

How much ferrous fumerate is GP prescribing? Do you take it with vitamin C at same time?

Are you vegetarian?

How to improve iron levels

What's the range on that recent ferritin result?

Persistent low vitamins despite supplementing, suggests gluten intolerance or coeliac disease

Obviously gluten intolerance is extremely common with autoimmune thyroid disease

momo33 profile image
momo33 in reply to SlowDragon

Hi SlowDragon, thanks for your reply. I'm not taking an iron supplement from my gp because it causes horrendous constipation and I have issues which mean that level of constipation isn't an option for me (hemorroids...). So, instead I take a ferrous bisglycinate 20mg a day (by Solgar). I was vegetarian but gave that up 2 years ago when I found out that my ferratin was at 5, lol. Glad I did otherwise I'd still feel half dead! I have also cut out dairy 3 hours prior to my evening meal when I take my supplement as well as tea/coffee.

SlowDragon profile image
SlowDragonAdministrator in reply to momo33

Many people find iron causes constipation

Increase in iron rich foods should help, especially liver (you can hide it in shepherds pie etc if you don't like it)

Gluten intolerance is extremely common problem

Your TSH is too high

Push GP for dose increase, (use this document to help)

or insist on referral to endocrinologist

Email Thyroid UK for list of recommended thyroid specialists first

momo33 profile image
momo33 in reply to SlowDragon

Thanks for the help! Much appreciated :)

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