I’ve recently been starting to feel unwell, I take 50 levothyroxine daily, however I went to the doctors this week, with heart palpitations and anxiety and she said my levels were abit high and I was getting too much now. She said take one tablet every other day. I’ve managed to get hold of some results, not sure if it’s that’s all there is until my next appt please help me with results.
In Jan 2019 results where:
TSH - 6.73 (0.34-5.6)
Serum free T4 level - 11.6 (7.5- 21.1)
Thyroid peroxidase antibod lev. - <1 (0 -9)
Fast forward to May 2019 new results:
TSH - 0.27 (0.34-5.6)
T4 level - 14.6 (7.5-21.1)
Please if anyone could give me any advice based on the results I have I’d be so grateful x
Written by
ChloeL934
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Exactly what "levels" was she referring to that were "a bit high"?
TSH is slightly below range, which is about where most of us have TSH when on replacement hormone (Levo) so that's not high.
FT4 is 52% through it's range so that's not high.
If she is worried that your TSH is below range, then she is erroneously dosing by TSH alone. If your thyroid hormones - and these are FT4 and FT3 (TSH is not a thyroid hormone, it's a signal from the pituitary to make more hormone if it detects there's not enough) are within range then you are not overmedicated. With your FT4 only half way through range then it's very likely that your FT3 isn't high either. But your GP should test this before reducing your Levo.
Dr Toft, past president of the British Thyroid Association and leading endocrinologist, states in Pulse Magazine (the magazine for doctors):
"The appropriate dose of levothyroxine is that which restores euthyroidism and serum TSH to the lower part of the reference range - 0.2-0.5mU/l. In this case, free thyroxine is likely to be in the upper part of its reference range or even slightly elevated – 18-22pmol/l. Most patients will feel well in that circumstance. But some need a higher dose of levothyroxine to suppress serum TSH and then the serum-free T4 concentration will be elevated at around 24-28pmol/l. This 'exogenous subclinical hyperthyroidism' is not dangerous as long as serum T3 is unequivocally normal – that is, serum total around T3 1.7nmol/l (reference range 1.0-2.2nmol/l).*"
*He recently confirmed, during a public meeting, that this applies to Free T3 as well as Total T3. You can obtain a copy of the article by emailing Dionne at
tukadmin@thyroiduk.org
print it and highlight question 6 to show your doctor.
Palps and anxiety can be symptoms of under-medication, rather than over-medication. And those results certainly do not show over-medication. Reducing your levo could make things worse.
Presumably January results were BEFORE starting on Levothyroxine?
Just testing TSH and FT4 is completely inadequate
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 did your tests?
Ask GP to test vitamin levels
NHS refuses to test TG antibodies if TPO antibodies are negative. So you will need to test these and FT3 privately
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
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 in 25mcg steps upwards until TSH is under 2 (many need TSH under one) and most importantly FT4 in top third of range and FT3 at least half way in range
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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