Hi please can anyone advise on latest blood results. Gp states all ok!

[lt1806]

I am still having symptoms of tiredness, weight gain and severe heavy achy legs, so much so Im having severe pain when trying to walk after sitting for any period of time? I am currently on 75 mcg of levo.

Thyroid function test(TAR)- satisfactory

Serum TSH level 1.68 ( 0.27-4.20 miu/L

Serum free T4 14.5pmol/L 12.00-22.00

Any advice greatly appreciated thank you x

[SeasideSusie Remembering]

lt1806

There's not much more to add to what was said in reply to your previous thread 3 months ago when I said you were undermedicated on 75mcg then and needed an increase

healthunlocked.com/thyroidu...

You appear to be on the same dose of Levo now, you still need that increase, your FT4 is only 25% through it's range.

Both thyroid antibodies and all the recommended vitamins mentioned before still need testing. If GP wont do them, you may want to consider doing what hundreds of us here do and that is a private test with one of our recommended labs - Medichecks Thyroid Check ULTRAVIT or Blue Horizon Thyroid PLUS ELEVEN.

[lt1806 in reply to SeasideSusie]

Thank you for your reply, the gps would not up the dose 3 months ago as stated it was too big a jump from the December and made me wait another 8 weeks. I am trying to understand how this all works! Will more levo increase the Ft4 levels? I will make an appointment this week and discuss other tests (I doubt they will do them so will then resort to private) will gps except these results?

[SeasideSusie Remembering in reply to lt1806]

I am trying to understand how this all works!

Here is the protocol for initiation and titration of Levo which your GP should be following

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

You may need to click on "Initiation and Titration" in the left hand menu

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.

◦For people aged over 50 years and people with cardiac disease or severe hypothyroidism: 25 micrograms once daily, adjusted in increments of 25 micrograms every 4 weeks according to response.

•Once a stable thyroid-stimulating hormone (TSH) level is achieved and an adequate dose determined, arrange follow up to check thyroid function tests (TFTs) at 4–6 months and then annually.

As mentioned in the other thread, 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.

**

Will more levo increase the Ft4 levels?

Yes. FT4 and FT3 are the thyroid hormones. Taking Levo is giving you T4 because your body isn't producing enough naturally.

TSH is a pituitary hormone, it signals the thyroid when it detects there's not enough thyroid hormone. The signal is TSH and it is high when the pituitary detects there is not enough hormone and it is low when the pituitary sees there is enough thyroid hormone.

So as you increase the dose of Levo your TSH will fall and your FT4 will rise. T4 has to convert to T3 and if you convert well your FT3 will rise and keep in balance with your FT4.

Unfortunately, many doctors are ignorant about treating thyroid disease and don't understand that it's the actual hormone levels - FT4 and FT3 - that are important and need to be at a level where we feel well, usually in the upper part of the range. TSH becomes irrelevant after we have become diagnosed but doctors don't understand this.

[lt1806 in reply to SeasideSusie]

Thank you so much will have a good read and go discuss further with gp.

[Hidden in reply to lt1806]

May be it's time to ask your GP to refer you to see an Endocrinologist.

Gps don't seem to be very knowledgeable about thyroid problems.

It's hard to understand why, when the thyroid is such an important gland,controlling our metabolism.

An Endo is more likely to prescribe you some T3 if needed.

[Hashihouseman in reply to SeasideSusie]

TSH is not irrelevant it is a vital Ingredient and consideration for thyroid hormone metabolism. However, it could be seen as irrelevant as a diagnostic tool if it is used on its own or with just t4 blood levels. You absolutely have to know all three free hormone levels allied to symptoms to titrate replacement hormones and then TSH matters just as much as the other two, they are inextricably linked and only together can each of them reliably describe the state of play at any point. In healthy euthyroid cohorts TSH values less than 1 and more than 2 are outside the modal range. Free T4 levels beyond 18 are also unusual except in cases of levothyroxine only replacement therapy. That doesn’t mean they are optimal even for those people.

[Dingoatemybaby]

Can you ask your doctor to test Your CK enzyme levels?

I described to my Endo similar pains from exercising (something I love) but it was making me feel very ill later in the day. My CK Enzyme levels were through the roof, I was told to immediately stop any form of punishing exercise until my levels calmed down. So I stopped the cardio workouts for a month, went back got tested, all was better (my thyroxine was being increased) and got the ok to exercise again. Then everything was tested again a month later to check I was sustaining and managing - and I was.

I no longer get terrible pains after exercises and am back in full swing again.

It might be worth looking in to. It is only a pointer for your Endo that your thyroid levels are too low, and the ck enzyme level will correct itself when you are healthy again.

May not be your issue but it’s not uncommon either. Good luck!