Ths

[Vonnie10]

Hi my ths is 6.5 I’m on 100 of levo does this need changing ... thanks.

[SeasideSusie Remembering]

Yes, you need an increase in dose. 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.

However, TSH alone is not enough to give a full picture, you need FT4 and FT3 testing as well to see where your thyroid hormone levels lie, TSH is not a thyroid hormone, it's a pituitary hormone.

[shaws Administrator]

Your doctor needs to be changed as you are on an insufficient dose of levothyroxine. The aim is a TSH of 1 or lower with Free T4 and Free T3 in the upper part of the ranges.

When you go for blood tests remember the following:-

The earliest test, fasting (you can drink water) and allow a gap of 24 hours between last dose of levo and test and take afterwards.

Always get a print-out of the results, with the ranges and post if you have a query.

[Vonnie10 in reply to shaws]

I forgot that. I. Shouldn’t have it before my blood test damm it so it needs hghing or lowering I forgotten now it’s been a while. Thanks for the reply.

[SeasideSusie Remembering in reply to Vonnie10]

Taking Levo before your blood test affects FT4 result, not TSH. It's the time of the blood draw that affects TSH - TSH is highest early morning and lowers throughout the day. Eating may lower TSH and coffee also affects TSH.

[Vonnie10 in reply to SeasideSusie]

Thanks will have to get it re done

[SlowDragon Administrator]

If TSH is 6.5 you need a 25mcg dose increase in Levothyroxine and bloods retested in 6-8 weeks

The aim of Levothyroxine is to increase slowly in 25mcg steps until TSH is between 0.4-1.5

For full Thyroid evaluation you need TSH, FT4 and FT3 plus both TPO and TG thyroid antibodies tested. Also extremely important to test vitamin D, folate, ferritin and B12

Low vitamin levels are extremely common, especially if Thyroid antibodies are raised

Recommended on here that 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)

Ask GP to test vitamin levels and antibodies

Private tests are available. Thousands on here forced to do this as NHS often refuses to test FT3 or antibodies or vitamins

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 special offers, Medichecks usually have offers on Thursdays, Blue Horizon its more random

[Vonnie10 in reply to SlowDragon]

Hi slow I’ve had most levels done b12 vid d folic acid... I half understand what your saying about t3t4 reverse one cortisol spit test and the others you mentioned it’s very hard work trying to sort all that. then I got rheumatoid and ckd so I’m struggling with that to. I was on thyroid s which I got myself I went down this road about 3 years ago with my doctor about the importance of the full range of bloods.. fair enough she helped me.. then my thyroid took aback seat over these other condition. Practice nurse just done my bloods and levels got a appointment with doctor on Friday to get more levo increased but firstly I should get me bloods done without taking the levo she won’t be happy.. and other bits .thanks slowdragon .

[SlowDragon Administrator in reply to Vonnie10]

You don’t need to redo blood test .... it already clearly shows you need dose increase

The early morning and fasting advice is only if in danger of appearing over medicated with very low TSH and then GP often wanting to reduce dose