I am currently on 100mcg levothyroxine and have been for 13 weeks. Just got my 12 week blood test results back and would like some advice as to how they compare from my results in March when I was on 75mcg. Blood test taken in the morning, over 24 hours from last dose on empty stomach.
June results (100)
Serum TSH level 3.78miu/L (0.27-4.20)
Serum free T4 level 18.6pmol/L (12.0-22.0)
March results (75)
Serum TSH level 5.65miu/L (0.27-4.20)
Serum free T4 level 16.7pmol/L (12.0-22.0)
I'm just confused as to how the T4 has increased as to whether its good or bad, and should I be pushing for another increase in levo.
I'm having more good days than bad days atm (yay), but still very tired and fatigued a couple of times a week.
Any advice is appreciated!
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DisneyLoverJ
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Hey DisneyloverJ. Good to hear that things are going in the right direction for you but it looks like you’re still under medicated with a high TSH. What is worrying though is that you’re moving towards the the top end of FT4 but still have a high TSH. So how are you going to respond to another increase in T4? Will it push your FT4 over the edge but still not lower you’re TSH and still not make you feel optimal ie no symptoms which is the idea of thyroid replacement.
What would give you a better picture of how your treatment is going would be to get a FT3 blood test. I suspect from your FT4 score and still such a high TSH score that your FT3 might be low.
In the meantime I’d get a Levo increase and see how it goes for 6wks but then get a full thyroid function test TSH FT4 and FT3
Most of the forum members get private blood tests because our GP’s don’t understand the importance of the FT3 score.
Me personally? I’d get a blood test done now as you’re established on 100mcg then get another done 6wks after an increase. This will give you a better history to work on.
I cannot fathom out why the doctors test FT4 but never FT3! It is the FT3 and T3 which are the most important ones,
Levothyroxine is T4 alone. It has to convert to T3 and it is T3 whic is the active thyroid hormone needed in our millions of T3 receptor cells for us to feel well and function normally.
The aim is for our TSH to be 1 or lower (the professionals seem to think that somewhere in the range is o.k.).
This is your June result:-
Serum TSH level 3.78miu/L (0.27-4.20)
The aim is 1 or lower.
Do you get the earliest appointment for blood draw? Do you allow a gap of 24 hours between last dose of levo and test and take it afterwards? This helps to keep the TSH at its highest as it drops throughout the day.
Looking at previous posts can not see any vitamin results or thyroid antibodies tested
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
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 Primary 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 significantly under one) and most important is that 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.
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. Teva is the only brand that makes 75mcg tablet.
Looking at your results I feel as though your T3 definitely needs checking. If T4 is high in the range and your TSH is still high within the range (anything over 2.5 is hypo) then your T3 is suspect. My GP would only check T4 and TSH. It took a while and becoming very unwell to get T3 medication. Now I have it I feel so much better. There is also a gene test you can get done which will indicate if you can convert well T4 to T3. Its Di02. This may help you understand if it is your T3 levels are low. Low doesn’t mean outside of the range, it means also low within the range. Drs will try to fob you off saying it’s in range. Always remember the ranges set by the NHS are too wide.
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