Opinions please

[kelbw77]

Hi all got drs next week so need any advice I can get just had my most recent bloods back

TSH 3.23 range 0.27-4.20

T3 4.5 range 3.1-6.8

T4 17.0 range 12-22.0

I'm currently on 75mcg Levo, iron and folic acid

thank you all in advance

[SeasideSusie Remembering]

kelbw77

You are undermedicated. The aim of a treated hypo patient generally is for TSH to be 1 or below or wherever it needs to be for FT4 and FT3 to be in the upper part of their respective reference ranges when on Levo if that is where you feel well. Your TSH is far too high, your FT4 is 50% through range, your FT3 is 38% through range.

You need an increase in your dose of Levo, 25mcg now and retest in 6-8 weeks, another increase if necessary followed by further testing after 6-8 weeks, etc.

Dr Toft, leading endocrinologist and past president of the British Thyroid Association, states in Pulse Magazine (the magazine for doctors):

"The appropriate dose of levothyroxine is that which restores euthyroidism and serum TSH to the lower part of the reference range - 0.2-0.5mU/l.

In this case, free thyroxine is likely to be in the upper part of its reference range or even slightly elevated – 18-22pmol/l. Most patients will feel well in that circumstance.

But some need a higher dose of levothyroxine to suppress serum TSH and then the serum-free T4 concentration will be elevated at around 24-28pmol/l.

This 'exogenous subclinical hyperthyroidism' is not dangerous as long as serum T3 is unequivocally normal – that is, serum total around T3 1.7nmol/l (reference range 1.0-2.2nmol/l)*."

*He recently confirmed, during a public meeting, that this applies to Free T3 as well as Total T3.

You can obtain a copy of the article by emailing Dionne at

[e-mail]

print it and highlight question 6 to show your doctor.

You can also suggest he looks at Leeds Teaching Hospital pathology.leedsth.nhs.uk/pa...

Thyroxine Replacement Therapy in Primary Hypothyroidism

TSH Level .......... This Indicates

0.2 - 2.0 miu/L .......... Sufficient Replacement

> 2.0 miu/L ..........Likely under Replacement

As you take iron, do you take it at least 4 hours away from your Levo, and do you take your folic acid 2 hours away from your Levo?

[kelbw77 in reply to SeasideSusie]

Thank you for that yes I take my Levo around 5.30am iron and folic acid with lunch then 2nd iron tablet with dinner

[SeasideSusie Remembering in reply to kelbw77]

You need to take your folic acid 2 hours away from iron as iron interferes with absorption of anything else. You could take your folic acid with breakfast.

[kelbw77 in reply to SeasideSusie]

oh ok I was never told this only ever told to not take iron near Levo thank you I will do that from tomorrow, i haven't been feeling great so thought maybe an increase was needed fingers crossed it's not too much of a battle next week

[kelbw77 in reply to SeasideSusie]

Hi spoke to the Dr today he is saying my thyroid levels are normal?! he's still waiting on my anti bodies to come back, what should i expect these to be?

[SeasideSusie Remembering in reply to kelbw77]

Kelbw77

Your doctor is saying that your levels are normal because they are within the reference range. Normal/in range doesn't mean optimal. Optimal is where you feel well and without symptoms. For most hypo patients that is when TSH is 1 or below with FT4 and FT3 in the upper part of their ranges as mentioned in my reply above.

If you feel well then fine, your current level of medication suits you.

If you don't feel well then I have given you the information above from leading authorities that tells you where your levels possibly need to be.

Your antibodies will come back either positive or negative. If positive then that confirms autoimmune thyroid disease aka Hashimoto's which SlowDragon gave information about in your previous thread here

healthunlocked.com/thyroidu...

There is no treatment for Hashi's, just for the hypothyroidism that it causes.

If antibodies are negative, then that suggests you don't have Hashi's. Post your results, with the range, when you have them for comment.

[kelbw77 in reply to SeasideSusie]

Thank you, sorry for all the questions

[SeasideSusie Remembering in reply to kelbw77]

No problem. Most doctors have little understanding of treating thyroid disease and leave many hypo patients suffering. We have to learn to help ourselves and hopefully educate our doctors at the same time.

[kelbw77 in reply to SeasideSusie]

Hiya just got my anti bodies results back

range 0-61

I'm 406?!