Test results advice: Hi all I take 75mcg... - Thyroid UK

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Test results advice

Mogget
Mogget
6 Replies

Hi all

I take 75mcg Levothyroxine along with starting to take all the recommended supplements (but the supplements only since the last 4 weeks). I still have lots of hypo symptoms. Do I need an increase in my Levo based on these results?

TSH 2.9 (0.35-4.94)

FT4 17 (9-20)

FT3 5.1 (2.4-5.7)

Thank you 😊

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SeasideSusie
SeasideSusieAdministrator

Mogget

Do I need an increase in my Levo based on these results?

Yes. The aim of a treated hypo patient generally, when on Levo, is for TSH to be 1 or below or wherever it needs to be for FT4 and FT3 to be in the upper part of their reference ranges, if that is where you feel well. Increase by 25mcg Levo now, retest in 6-8 weeks, repeat until your levels are where they need to be for you to feel well.

take all the recommended supplements (but the supplements only since the last 4 weeks)

What supplements are you taking? Based on what nutrient tests and their results?

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Mogget
Mogget
in reply to SeasideSusie

Thank you, that’s helpful - I’ll just need to persuade the GP to increase as I was told everything is fine and no action required. Got another appt scheduled next week.

I’m taking the following based on test results from last year that showed low levels:

- Vit D

- B complex (due to low folate)

- Eating liver once per week for iron

I’m also taking the following (but not based on any test results):

- Vit K2 Mk7

- Magnesium

- NAC

- Omega 3

- Selenium

- Vit A

- Vit E

- Vit C

- Zinc

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Mogget
Mogget
in reply to SeasideSusie

Hi Susie, my GP is refusing to increase my levo by 25mcg because my levels are ‘fine’. Do you have any advice - can I purchase it privately? And if so, where?

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SeasideSusie
SeasideSusieAdministrator
in reply to Mogget

Mogget

Your GP is saying that your levels are fine purely because they are within their ranges. The following information may be useful in supporting your request for an increase:

NHS Leeds Teaching Hospitals say

pathology.leedsth.nhs.uk/pa...

Scroll down to the box

Thyroxine Replacement Therapy in Primary Hypothyroidism

TSH Level .................. This Indicates

0.2 - 2.0 miu/L .......... Sufficient Replacement

> 2.0 miu/L ............ Likely under Replacement

and

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.

What I would say is that your FT4/FT3 are higher than I would expect to see with your TSH level. When did you take your last dose of Levo before the blood test? To get the normal circulating level we need to take last dose 24 hours before blood draw - did you leave that long?

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Mogget
Mogget
in reply to SeasideSusie

Thank you so much Susie - I’m going to make an appointment with a different doctor and take that literature with me.

I took my last dose 22 hours before the blood draw.

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