Test results advice please?

[Bytheseaside]

Hello,

I've just had my results for TSH and FT4, I had the test done in the morning and didn't take my usual meds of alternate days 50/75mcg levo till afterwards.

My results showed my TSH is now slightly better at 5.44 (0.27 - 4.2)

and FT4 is 15.01 (12 - 22).

Would really appreciate your thoughts on these please, to give you a bit of background please see last two results.

I generally feel ok-ish nowhere near as tired as I used to be but still struggle with concentration.

My last results in Oct 18 were 6.34 TSH and 18 FT4 same ranges, my GP increased my meds 50mcg daily to alternate 50/75mcg. And prior to these a test showed in July as having:

July 28.76 TSH (0.27 - 4.2) and FT4 14.8 (12-22).

If I remember rightly I was taking 75mcg.

Thanks,

BTS

[SeasideSusie Remembering]

Bytheseaside

TSH: 5.44 (0.27 - 4.2)

FT4: 15.01 (12 - 22)

You are very 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.

You need an immediate increase in your Levo. 25mcg now, retest in 6 weeks, further increase with retest 6 weeks later if necessary.

Dr Toft, past president of the British Thyroid Association and leading endocrinologist, 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.

Further evidence here from Leeds Teaching Hospitals

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

It was explained in your previous thread that you have Hashi's, how this can cause fluctuations in thyroid results (and symptoms) and that dose adjustments may be necessary as and when these swings from hypo > hypo > hyper happen.

Did you get your nutrients tested as advised? What are your results for

Vit D

B12

Folate

Ferritin

Hashi's tends to cause low levels or deficiencies and it's essential to know your levels and address any shortcomings.