Do I need more levo?

[Tiff35]

Hi all

I have a GP apt tomorrow afternoon to discuss results of thyroid test and was hoping for some advice.

Results

TSH 6.83 (range 0.35-4.94)

T4 17.5 (range 9-19)

I am currently on 50 mcg levothyroxine as started checking every 6 weeks from being on nothing going up 25mcg.

I am wandering if I should suggest another 25mcg if my T4 is near the upper end already? What if the GP says to continue on 50mcg? I’m still feeling symptoms so hoping something can be done but have a feeling he might not increase.

Sorry another question, Previously when being treated last year after a pregnancy my TSH was similar but my T4 much lower at 11.8. Why this time Would my T4 be higher? Any ideas?

Thanks for my support!

I might also add I have been up and down on and off with medication over last 18 months and previous tests have shown high antibodies so I was originally told it was thyroiditis but now when off medication my T4 has been boarderline lower level and TSH around 14.

Thanks

[SeasideSusie Remembering]

Tiff35

Previously when being treated last year after a pregnancy my TSH was similar but my T4 much lower at 11.8. Why this time Would my T4 be higher? Any ideas?

TSH 6.83 (range 0.35-4.94)

T4 17.5 (range 9-19)

When did you take your last dose of Levo before this test?

When booking thyroid tests, we advise:

* Book the first appointment of the morning. This is because TSH is highest early morning and lowers throughout the day. If we are looking for a diagnosis of hypothyroidism, or looking for an increase in dose or to avoid a reduction then we need TSH to be as high as possible.

* Fast overnight - have your evening meal/supper as normal the night before but delay breakfast on the day of the test and drink water only until after the blood draw. Eating may lower TSH, caffeine containing drinks affect TSH.

* Leave off Levo for 24 hours before blood draw, if taking NDT or T3 then leave that off for 8-12 hours. Take after the blood draw. Taking your dose too close to the blood draw will give false high results, leaving any longer gap will give false low results.

These are patient to patient tips which we don't discuss with doctors or phlebotomists.

So if you took your last dose of Levo close to the blood draw this would have given you this high FT4.

When on Levo only, the aim of a treated hypo patient generally is for TSH to be 1 or lower with FT4 and FT3 in the upper part of their ranges if that is where you feel well. So obviously your TSH has a long way to go. You need an increase in your Levo of 25mcg, retesting in 6-8 weeks time but remember to do the test under the conditions advised above.

If your GP doesn't want to increase your dose, tell him that you took your Levo just before the test (if that is the case) so it would be measuring the dose you took and hope he understands that. If he doesn't, then ask if you can have a trial of an extra 25mcg and say you will go back immediately if you feel overmedicated.

I might also add I have been up and down on and off with medication over last 18 months and previous tests have shown high antibodies so I was originally told it was thyroiditis but now when off medication my T4 has been boarderline lower level and TSH around 14.

You have Hashimoto's as explained in reply to a previous post of yours

healthunlocked.com/thyroidu...

Are you addressing the Hashi's with a gluten free diet and selenium as suggested?

And what has happened about your poor nutrient levels also discussed in that post? Have you optimised them?

[Tiff35 in reply to SeasideSusie]

Thank you so much for your fast reply SeasideSusie you are very informative.

You are correct I did take my medication this time (completely forgot to withhold it for the blood test when previously I had always done it the way you suggested) So I will certainly discuss this with the GP and ask for 75 mcg.

My vitamin levels did increase from when I last posted although admittedly I haven’t checked for a while and I continue to take a combination of b vits and b12 and selenium. As for gluten free I have been off and on with this (it’s a struggle) but have felt much better when stopping especially as my bowels are sensitive too. (I am currently awaiting a colonoscopy as my stool inflammation markers have been very high so wandering if this is all connected in some way- autoimmune resppnse )

Thanks again for your help.