Confused no more!

[Mumoffour4]

Without this forum I would never have understood what to expect or look for when I comes to test results! I’ve started keeping a dairy and went back to see a GP armed with information ready to plead my case! Thankfully, I didn’t have to plead!! Before I’d said anything he told me my Tsh levels were way off (5.6)and that I really shouldn’t be waiting the six months for another test. He is increasing my dose in 25mcg steps, I’ve been on 50mcg for two and half years, with blood tests every six weeks until my TSH level is suppressed. He is even treating my ferritin levels(18.3) and was so keen to get me back to health!!

He thinks that by The autumn I should be feeling much better!! He made copious note on my file so that should I see a different doctor;as he is semi retired, they understand the goals. Interestingly he also lectures on abnormal blood results; specifically thyroid issues,how lucky was I!! I only hope there are more doctors like him coming through the ranks. It’s been five long years , two years undiagnosed despite seeking help at various times,of feeling,’less than’ but now that I understand more about this condition, thanks to this site and your responses to my previous post, hopefully I won’t have to go back to the hole I was in! I understand that I am incredibly lucky to have, by chance, seen this doctor and hope that there are so many more like him. As you can probably tell I’m a bit excited about the prospect of feeling, normal again, even had a cheeky glass of wine to celebrate but I know this is a long road. It was so worth seeking a second opinion!!😊

[Lalatoot]

Great to hear.

[SlowDragon Administrator]

At next blood test make sure you get vitamin D, folate, B12 and both TPO and TG thyroid antibodies tested too

Great to hear you didn't have to fight for dose increase

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

Clearly ferritin is terrible

NHS guidelines on Levothyroxine including that most patients eventually need somewhere between 100mcg and 200mcg Levothyroxine.

nhs.uk/medicines/levothyrox...

Also what foods to avoid (eg recommended to avoid calcium rich foods at least four hours from taking Levo)

Make sure to get same brand of Levothyroxine at each prescription

[Mumoffour4 in reply to SlowDragon]

I would never have known what to be looking for if it wasn’t for joining this forum and I would still be waiting for answers!! I’ve even taken photographs of myself, hair loss, bags under my eyes etc... to see if at the time of being on the right dose I can see a physical difference. It feels good to be better informed. I’m getting copies of my blood results for comparison too. I’m not the most confident person in the doctors office but I have decided that from now on I will approach this issue as if it were one of my children who was suffering. Ive been given two brands of levo one for 50 and one for 25 but I will definitely ask for the same brands going forward also get my TPO and TG anti bodies results. I take my levo of a night as it seems to help with the massive anxiety I get during the night, does anyone else find this?

[SlowDragon Administrator in reply to Mumoffour4]

Which two brands of Levothyroxine?

Levothyroxine should always be taken on empty stomach and then nothing apart from water for at least an hour after

Many people take Levothyroxine soon after waking, but it may be more convenient and more effective taken at bedtime

All medication at least two hours away from Levo. Some like HRT, PPI's, magnesium, iron or vitamin D, at least four hours away

verywellhealth.com/best-tim...

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.

For full Thyroid evaluation you need TSH, FT4 and FT3 plus both TPO and TG thyroid antibodies tested. Also very 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).

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