At last they listened

[NetteAnn24]

18.3 FSH 13.2 T4

Now increased thyroxine to 75g day into my 3rd week of the increase still not feeling 100 %...

[SlowDragon Administrator]

Bloods should be retested 6-8 weeks after each dose increase

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. 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 do your tests?

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

If antibodies are high this is Hashimoto's, (also known by medics here in UK more commonly as autoimmune thyroid disease).

About 90% of all hypothyroidism in Uk is due to Hashimoto's.

Low vitamins are especially common with Hashimoto's. Food intolerances are very common too, especially gluten.

So it's important to get TPO and TG thyroid antibodies tested at least once .

Link about thyroid blood tests

thyroiduk.org/tuk/testing/t...

Link about antibodies and Hashimoto's

thyroiduk.org.uk/tuk/about_...

thyroiduk.org.uk/tuk/about_...

List of hypothyroid symptoms

thyroiduk.org.uk/tuk/about_...

NHS guidelines on Levothyroxine including what foods to avoid (note recommended to avoid calcium rich foods at least four hours away from Levo)

nhs.uk/medicines/levothyrox...

NICE guidelines

cks.nice.org.uk/hypothyroid...

The initial recommended dose is:

For most people: 50–100 micrograms once daily, preferably taken at least 30 minutes before breakfast, caffeine-containing liquids (such as coffee or tea), or other drugs.

This should be adjusted in increments of 25–50 micrograms every 3–4 weeks according to response.

The usual maintenance dose is 100–200 micrograms once daily.

[SlowDragon Administrator]

Always take Levo on empty stomach and then nothing apart from water for at least an hour after.

Many take Levothyroxine early morning, on waking, but it may be more convenient and possibly more effective taken at bedtime.

verywell.com/should-i-take-...

Other medication at least 2 hours away, some like HRT, iron, calcium, vitamin D or magnesium at least four hours away from Levothyroxine

Many people find Levothyroxine brands are not interchangeable.

Once you find a brand that suits you, best to make sure to only get that one at each prescription. Watch out for brand change when dose is increased or at repeat prescription.

Many patients do NOT get on well with Teva brand of Levothyroxine.

Though it is the only one for lactose intolerant patients

[NetteAnn24 in reply to SlowDragon]

I have always taken my meds a hour before food...

And have my bloods done with out food in the morning.

All vitamins and D were OK

[SlowDragon Administrator in reply to NetteAnn24]

Vitamin D at least around 80nmol and around 100nmol can be better

B12 and folate towards top of range

Ferritin at least half way in range

[SeasideSusie Remembering]

Now increased thyroxine to 75g day into my 3rd week of the increase still not feeling 100 %...

It takes 6-8 weeks for levels to stabilise after a dose change, it may be too soon to notice any improvement yet.

I have always taken my meds a hour before food...

Then the test is measuring the dose of Levo just taken and will show a false high FT4 result. If you leave the advised 24 hours between last dose of Levo and the blood test then your FT4 result will show the normal circulating level. If your tests are always showing a false high FT4.

13.2 T4

Presumably this is FT4 (Free T4) test. What is the reference range, they vary from lab to lab, mine is 7-17, we also see 9-19, 11-23, 12-22. So depending on your range you could already be low in range and the fact that you took your Levo one hour before the test is giving a higher than normal result anyway so you could possibly be very close to the bottom of the range. If you let us know the range we can comment further.

Always ask for a print out of your test results and when posting them say exactly what the test is (there is Total T4 [TT4 or just T4] and Free T4 [FT4]. There is also TT3 and FT3. We need to know what's tested.

You said in your first post on the forum "My level FSH was 0.21" and now you're saying "18.3 FSH". That is a massive difference. Which test are you actually talking about here - TSH - Thyroid Stimulating Hormone or FSH - Follicle-Stimulating Hormone?

[NetteAnn24 in reply to SeasideSusie]

Both should read TSH level is now 18.3 was 0.21..

[SeasideSusie Remembering in reply to NetteAnn24]

NetteAnn24

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.

To have a TSH currently of 18.3 means that you are very undermedicated.

There must be a reason why your TSH has gone so much over range, it could be that you have autoimmune thyroid disease as mentioned in SlowDragon's reply above.

I suggest you follow her advice to get a full thyroid/vitamin panel carried out with one of our recommended labs, you wont get all of the tests done with your GP.

Either of the following tests will do exactly what is needed and can be done by fingerprick or for extra cost you can arrange a venous blood draw:

Medichecks Thyroid Check ULTRAVIT medichecks.com/thyroid-func... You can use code THYROIDUK for a 10% discount on any test not on special offer.

or

Blue Horizon Thyroid Check PLUS ELEVEN bluehorizonmedicals.co.uk/t...

Both tests include the full thyroid and vitamin panel. They are basically the same test but with the following small differences:

For the fingerprick test, Blue Horizon requires 1 x microtainer of blood (0.8ml), Medichecks requires 2 x microtainers (total 1.6ml)

Blue Horizon includes Total T4 (can be useful but not essential). Medichecks doesn't include this test.

B12 - Blue Horizon does Serum B12. Medichecks does Active B12.

Serum B12 shows the total B12 in the blood. Active B12 shows what's available to be taken up by the cells. You can have a reasonable level of Serum B12 but a poor level of Active B12. (Personally, I would go for the Active B12 test.)

Come back with the results and reference ranges and we will be able to help you further.

Remember not to take your Levo in the 24 hours prior to doing the test and fast overnight, water is allowed but no tea, coffee, milk, etc.

Make sure that the test is done 6 weeks after this last dose increase, don't do it any sooner than that.

[NetteAnn24]

Also I had my bloods done 3 hours after I took the low dose that day of 50g...

[NetteAnn24]

Well 9 months later, they upped my thyroxine which caused me to go overactive 3 months ago, so reduced it and now I'm back to underactive 4.92 TSH..

Can't see my doctor untill next week and I feel awful can't get out of bed... Lacking energy bones aching