Update on results, been on Levo for 6 weeks now.... but

[Peacefull]

Hi,

I have just had my first follow up blood tests after being on Levothyroxine for 6 weeks. I was feeling better initially but the positive effects have worn off, back to falling asleep at 9pm and shockingly tired

I've just had my results:

Serum thyroid peroxidaise antibody concentration 29 iu/ml (0.0 - 33.0)

- was 23 previously

Serum free T4 30.8 pmol/L (11.0 - 22.0)

was previously 15

Serum TSH 3.88 (0.27 - 4.2) above range - was 8.6 previously

The GP wants to keep me on the 25mg initial dose - i'm not sure where to go from here, i don't feel any better than when i started.

Any advice?

[SlowDragon Administrator]

Recommended on here that all thyroid blood tests should ideally be done as early as possible in morning and fasting. Last Levothyroxine dose should be 24 hours prior to test, (taking delayed dose 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)

Is this how you did this test?

Your FT4 is now very high. Too high. This may be because you took Levothyroxine before the test?

Yet your TSH remains high, too high

So you look like you have a conversion problem

Your GP should be testing FT3 as well as FT4. But they are unlikely to agree or lab may refuse to test FT3

Also essential to test vitamin D, folate, ferritin and B12

Ask GP to test these too

Antibodies are only just below range, suggests this may be autoimmune thyroid disease. High FT4 could be temporary due to Hashimoto's flare

You need TG antibodies tested as well ideally, but NHS refuses to test TG antibodies unless TPO are above range

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

What brand of Levothyroxine are you currently taking?

[Peacefull in reply to SlowDragon]

Hello and thanks for your speedy reply.

I forgot to say my test was 09.30 am fasting. D = 39.2 B12=80.8 Ferritin -= 89.6

I have just ordered FT3 and TPO from Medichecks. along with TGA, FT4 and TSH

I will find out about the brand when i get home. I Don't think i took it that morning... but with the Fog?

Thanks for all the help, we shouldn't have to go through all this... but you guys make it easier

[SlowDragon Administrator in reply to Peacefull]

We need the ranges on these results please

Best option on taking a daily medication, is to get a weekly pill dispenser.

[Peacefull in reply to SlowDragon]

Hi, Sorry i should remember to add the ranges!

B12 = 80.8 (37.5-188)

D = 39.2 (50-175)

My Brand of Levo is Teva levothyroxine

Just to add my cholesterol results as i have them

Total = 5.12 mmol/L (0-5)

LDL = 2.98 mmol/L (<3)

Non HDL = 3.65 mmol/L (<4)

HDL = 1.47 (<1.2) mmol/L

Total Cholesterol: HDL 3.48 Ratio (<4)

Triglycerides = 1.48 mmol/L(<1.7)

I have an appointment tomorrow that the GP was reluctant to give me as all my blood tests he considers 'normal'

Good call on the pill despenser, will order one now.

Thanks again for your help and support.

[SlowDragon Administrator in reply to Peacefull]

So your vitamin D is too low. Extremely common when hypothyroid

GP should prescribe 1600iu daily for 6 months

Local CCG guidelines

clinox.info/clinical-suppor...

Aiming to improve vitamin D to at least 80nmol and around 100nmol may be better .

Vitamin D mouth spray by Better You is good as avoids poor gut function.

It's trial and error what dose each person needs.

Once you Improve level, you may need on going maintenance dose to keep it there, certainly in winter

Retesting twice yearly if supplementing via vitamindtest.org.uk

Government recommends everyone supplement October to April

gov.uk/government/news/phe-...

Is this B12 test a standard NHS test? Or an active B12 test via Medichecks or Blue Horizon?

You need folate tested too

Many, many patients do not get on with Teva brand of Levothyroxine.

Unless lactose intolerant, you might be better trying a different brand

healthunlocked.com/search/p...

Different brand options

thyroiduk.org.uk/tuk/treatm...

Cholesterol will naturally drop as hypothyroidism improves

nhs.uk/conditions/statins/c...

[Peacefull in reply to SlowDragon]

Hi,

The B12 was active from Medichecks. I will ask for the folate tests. and have started on the D, but will change to Spray as i'm low on pills.

Thank you.