TSH way down after 6 weeks on 25mg levo - Thyroid UK

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TSH way down after 6 weeks on 25mg levo

Fluffysheep profile image
7 Replies

6 weeks ago my TSH was 6.2 (range 0.27 - 4.2). I was put on a starter dose of 25mg of thyroxine. I don't feel as if this has made any difference at all, still highly symptomatic (brain fog and exhaustion are the biggest problems).

Just got results of my latest test, as am due to see the Dr on Friday, and TSH has gone down to 2.07. I did the right things before the blood test, last dose of levo was day before, was fasting etc. I am so worried that the Dr is going to keep my dose the same because my TSH has gone down, even though I still feel awful, or even worse, take me off it. Should I be worried? Only other thing that has changed is I've been taking a once a week dose of invita D3 50000IU as my vitamin D was shown to be low.

Only other thing that was tested was serum free T4 level, this apparently came back as 18 (range 12-22). Last time it was 13.7. Is this a good thing?

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Fluffysheep
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shaws profile image
shawsAdministrator

25mcg of levo is an incremental dose. A starting dose is 50mcg with blood tests every six weeks and, if necessary, an increase of 25mcg until TSH is 1 or lower. As well as doing FT4 why didn't they test FT3. After all it is T3 which is the active hormone and T4 the inactive one. Both FT4 and FT3 should be in the upper part of the ranges.

You can tell the doctor that although your TSH has come down it is from the pituitary gland - not thyroid gland and could you please have a FT3 as well as a FT4. Both should be in the upper part of the ranges. GP should also test B12, Vit D, iron, ferritin and folate. Everything has to be optimal. Tick off your symptoms on the following link:-

thyroiduk.org.uk/tuk/about_...

If you've not had the thyroid antibodies tested ask for these due to the fact that antibodies would inform you that you have an Autoimmune Thyroid Disease also called Hashimitos (the commonest form of hypo). Treatment is the same as hypothyroidism i.e. levo.

Fluffysheep profile image
Fluffysheep in reply to shaws

Thanks shaws. Could you explain a little bit more about the pituitary gland please, just so I have a bit more ammo for the Dr?

The only time I had my FT3 tested was when I did my own medichecks test in May, which is what kicked this all off in the first place. My FT3 was 4.7 (range of 31.-6.8). I did also have my antibodies checked, my TGO antibodies were 230 (range <115), TPO were 17.1 (range <34). Dr wasn't interested in this result whatsoever.

My serum ferritin level in July was 50ng/mL (range 11-307), doesn't sound great but was obviously marked as normal by GP. Total 250H vitamin D was 28.7. it says that 25-50 is consistent with insufficiency, I was prescribed the tablets I mentioned above which are 1 a week, take my last one this Thursday. Dr's appointment is Friday,

Treepie profile image
Treepie in reply to Fluffysheep

TSH stands for Thyroid Stimulating Hormone , it is produced by the pituitary gland and stimulates the thyroid gland to produce the thyroid hormones . It is an indirect way of checking thyroid health and all most doctors are interested in to the detriment of suffererers.

The high antibodies show you have auto immune

thyroiditis ( Hashimotos) .

shaws profile image
shawsAdministrator in reply to Fluffysheep

I am not medically qualified but I doubt there are more than a few medical professionals capable of dealing with those who are hypothyroid. It seems so easy i.e. test TSH and if high the person has hypothyroidism. If very low they think we're now hyperthyroid. The mistake most doctors make is when TSH becomes very low, ie. under 1, they'll reduce our dose so that the TSH will rise into a range.

SlowDragon has given good advice as well as interpreting your results.

SlowDragon profile image
SlowDragonAdministrator

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

Also important to test folate, ferritin and B12

Especially as vitamin D was very low

Low vitamin levels are extremely common, especially if Thyroid antibodies are raised

Have you had thyroid antibodies tested?

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

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.

If vitamin D is low, B vitamins may be too. As explained by Dr Gominack

healthunlocked.com/thyroidu...

GP will only prescribe to bring vitamin D up to 50nmol. Aiming to improve by self supplementing to at least 80nmol and around 100nmol may be better .

Once you Improve level, very likely you will need on going maintenance dose to keep it there.

Retesting twice yearly via vitamindtest.org.uk

Vitamin D mouth spray by Better You is good as avoids poor gut function.

It's trial and error what dose each person needs

SlowDragon profile image
SlowDragonAdministrator

Sorry should have read previous posts

healthunlocked.com/thyroidu...

Your low ferritin is likely an issue, especially if vegetarian

GP should run full iron panel testing for Anaemia. Especially if still having heavy periods

High TG antibodies can cause significant symptoms

ncbi.nlm.nih.gov/pubmed/303...

Fluffysheep profile image
Fluffysheep

Saw the Dr today, and she agreed to up my thyroxine to 50mg. Will see if that has any effect. Have got endocrinologist appointment on 19th, so not too much longer to wait. It's part of a diabetes clinic though, so who knows whether they'll actually know much about the thyroid!!

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