I recently went to the doctors with fatigue, brain fog, and other symptoms. They tested my bloods and discovered my levels as: TSH 5.23 and T4 13.8... they explained this is borderline hypothyroidism and put me on 100 mcg of levothyroxine.
Seven weeks later I went back and my second blood results show as: TSH 0.21 and T4 20.2. I told the doctor I’ve been feeling really anxious and they’ve lowered me to 70 mcg.
Few questions, is this change in blood test results normal? Are my second results considered as slightly hyper rather than hypo? And is it normal for me to be feeling really anxious or could this just be a separate issue of general anxiety? Is it likely to be Hashimoto’s? Any reassurance or anything with this would be amazing please I don’t really understand it all and worry that the doctors don’t seem to either.
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Because refrence ranges vary from lab to lab, we always need the ranges that come with your results.
TSH 5.23 and T4 13.8
Presumably your TSH was over range but we can't interpret your FT4 result as the ranges vary so much. If your FT4 is in range, it's very unusual for a GP to prescribe Levo.
put me on 100 mcg of levothyroxine.
That is a high starter dose, normal starting dose is 50mcg and increases of 25mcg every 6 weeks until our levels are where they need to be for us to feel well.
I told the doctor I’ve been feeling really anxious and they’ve lowered me to 70 mcg.
That could be because your starte dose was so high.
is this change in blood test results normal?
Yes, taking Levo will lower your TSH and increase your FT4. High TSH and low FT4 are hypothyroid levels, taking Levo to lower TSH and increase FT4 is what we want.
Are my second results considered as slightly hyper rather than hypo?
You can't be hyper if you are hypothyroid. You can be overmedicated. Your TSH doesn't indicate overmedication but we can't interpret your FT4 without the range.
And is it normal for me to be feeling really anxious or could this just be a separate issue of general anxiety?
It's possible it's due to the high starting dose of Levo, it would have been better to start lower and increase gradually to the amount you need.
Is it likely to be Hashimoto’s?
Impossible to say without testing thyroid antibodies - Thyroid Peroxidase (TPO) and Thyroglobulin (Tg).
Check out ThyroidUK's main website for further information (this is their forum)
I posted today and was concerned that my FT4 hadn’t increased now that I’m on NDT. Is it normal to have an increase of your FT4 on Levo but it to remain low on NDT?
Yes. I replied on your thread that taking NDT tends to lower or even suppress TSH and can lower FT4. This is because of the T3 that NDT contains. Levo is T4 only so increasing Levo will increase FT4.
Oh thank you, that makes it a little clearer now. I thought my NDT would raise my FT4 and was concerned that it hadn’t. Thank you again. Sorry to be so needy!!
You are legally entitled to printed copies of your blood test results and ranges.
UK GP practices are supposed to offer online access for blood test results. Ring and ask if this is available and apply to do so if possible, if it is you may need "enhanced access" to see blood results.
In reality many GP surgeries do not have blood test results online yet
Alternatively ring receptionist and request printed copies of results. Allow couple of days and then go and pick up.
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. This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip, best not mentioned to GP or phlebotomist)
Last Levothyroxine dose should be 24 hours prior to test, (taking delayed dose immediately after blood draw).
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
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
Medichecks currently have an offer on until end of May - 20% off
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 .
The aim of Levothyroxine is to increase the dose slowly up from standard starter dose of 50mcg in 25mcg steps upwards. Bloods need retesting 6-8 weeks after each dose increase. This continues until TSH is under 2 (many need TSH under one) and FT4 in top third of range and FT3 at least half way in range
More recent thinking is to start some patients straight on to 100mcg.....but many people seem to find that too much too soon
All four vitamins need to be regularly tested and frequently need supplementing to maintain optimal levels
NHS guidelines on Levothyroxine including that most patients eventually need somewhere between 100mcg and 200mcg Levothyroxine.
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