TSH

[floss76]

Currently on 75mcg Levo. Previous blood test for TSH was 0.89 (0.27-4.2). Latest blood test for TSH is now 2.41. So it is creeping up again. I asked my doctor today for another increase. She has agreed to 75/100mcg alt days. I have been experiencing palpatations for the last 2 weeks, not sure if this is why.

[SlowDragon Administrator]

Palp Can be due to being UNDER medicated.

As you have Hashimoto's you need B12, folate, ferritin and vitamin D tested

When were these last done?

Dizziness can be low B12

As you have Hashimoto's are you on strictly gluten free diet?

If not, ask GP for coeliac blood test (making sure to eat high levels gluten in weeks before test)

Bloods should be retested 6-8 weeks after each dose increase

All thyroid blood tests should ideally be done as early as possible in morning and fasting. Do not take Levothyroxine dose in the 24 hours prior to test, delay and take immediately after blood draw. This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip, best not mentioned to GP or phlebotomist)

Make sure to get vitamin levels tested at same time, if not been done

TSH should be under 1.5 to be adequately treated, and FT4 in top third of range and FT3 at least half way in range

[floss76 in reply to SlowDragon]

Hi SlowDragon,

My B12, folate and Ferritin were last tested in March this year. Vitamin D was September this year which was low at 28. I have been prescribed 3200 iu daily for 3 months then 800iu after.

I did ask the GP today about B12 but was told that this does not cause palpatations. At least she agreed to an increase in levo. And yes, I have now adopted a gluten free diet along with my Son. Thank you for your response.

[SlowDragon Administrator in reply to floss76]

Do you have the results of ferritin B12 and folate from March?

Frequently they are too low, but within range so GP won't treat

suggest you get vitamin D retested to check it's now high enough

It's trial and error what dose each person needs. With gluten intolerance and Hashimoto's we often need high dose

Once you Improve level, very likely you will need on going maintenance dose to keep it there.

Many with Hashimoto's find we need higher maintenance dose than expected.

Local CCG guidelines

clinox.info/clinical-suppor...

GP should retest vitamin D

Private testing via NHS postal kit if necessary £29

vitamindtest.org.uk

Push to get folate, ferritin and B12.retested when Thyroid is retested in 6-8 weeks