Hi all, I am wondering if anyone can help with my results, please?

[PinkLizzie]

I am wondering whether I am converting enough T4 to T3. I was diagnosed in January as may be hypothyroid. I have been medicated since April my TSH was 5.5 then.

Symptoms: I am retaining water (legs ankles and feet), migraines are progressively worse (lasting up to 5 days), sporadic irregular periods (I have had a hormone test which came back normal), I have a puffy face, tingly hands, swollen fingers, feel sluggish and worn out - due to broken sleep (I wake with my heart racing several times a night).

I have recently changed the brand of Levothyroxine from Teva 25 mcg (since April) to Wockhardt 25 mcg ( last weekend), and I find myself feeling less jittery during the day.

Ps: I don't drink, smoke or have caffeine. Apologies for the long post, any help is much appreciated.

[SlowDragon Administrator]

Standard starter dose is 50mcgs unless over 60 years old

Bloods should be retested 6-8 weeks after each dose change

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

Your results show you are under medicated and need 25mcg dose increase in Levothyroxine

See GP and request dose increase in Levothyroxine plus ask for thyroid antibodies to be tested and vitamin D, folate, B12 and ferritin too

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.

nhs.uk/medicines/levothyrox...

NICE guidelines

cks.nice.org.uk/hypothyroid...

The initial recommended dose is:

For most people: 50–100 micrograms once daily, preferably taken at least 30 minutes before breakfast, caffeine-containing liquids (such as coffee or tea), or other drugs.

This should be adjusted in increments of 25–50 micrograms every 3–4 weeks according to response. The usual maintenance dose is 100–200 micrograms once daily.

[PinkLizzie in reply to SlowDragon]

Wow, thank you, for your reply very informative I really appreciate it. I have made an appointment with my GP.

[Lalatoot]

PinkLizzie As SlowDragon says you need more thyroxine. I would not concern yourself with T4 to T3 conversion this early on in your journey. You need to wait until your TSH is 1 or under before looking at conversion figures.

Most people do well on levo alone. Assume that you are going to be one of them! Keep getting tested and increasing your dose as well as making sure your vitamins are optimal.

Getting T3 and monitoring bloods is difficult to get from the NHS so if you can feel well on levo it is much less trouble.

[PinkLizzie in reply to Lalatoot]

Thanks, I will take your advice. I was just intrigued to find out my levels as T3 is not tested on the NHS and have gained a little weight too even though I haven't changed my diet or activities. But this could hopefully change as I seem to be under medicated.

[silverfox7]

Nothing in our thyroid world works quickly and it’s still early days. We can’t really speed it up as it's so easy to miss your sweet spot and have to go back a bit.

This forum is run by Thyroid Uk so if you look at their web site there is more info to help you on your thyroid journey so well worth a read. Shout out if anything you don’t understand and nothing is too trivial, we have all been there!

[HLAB35]

As you say, you're just undermedicated and will hopefully stabilise at a higher dose - somewhere around or above 100mcg. Don't let them fob you off with a 'TSH is now in range - we can stop now' response.

For water retention, insomnia, pms and anxiety I recommend a vitamin mineral combo (that will support your adrenals as well) which has magnesium, zinc and p5p (absorbable b6) in it such as 'Neurobalance' by Igennus. Levels of these are not usually looked at by doctors, so you can only see if they are helpful by giving them a go.

An Epsom Salt bath is a good way to settle before bed - if you put a cupful of Bentonite clay in beforehand it is even more effective as the clay will 'remove' the chlorine and chemicals in the water so the Epsom salts will work to the max. This is a tip from Dr Carolyn Dean who wrote 'Magnesium Miracle' which has helped me tremendously.