Are my Blood Test Results OK?

[Mionaonthehill]

I was diagnosed with Hashimoto’s and have been on Levothyroxine 50mcg for 6 weeks and my TSH has reduced from 5.04 to 1.54miu/L (0.27-4.2) which is good. However I don’t feel any better I still have all the hypo symptoms dry skin, constipation, Fatigue, weight gain, hair loss etc. in fact I feel worse than I did a few weeks ago.

My other results are;

T3 4.74 pmol/L (3.1-6.8) up from 4.43 last test

T4 15.4 pmol/L (12-22) up from 12.5 last test

Thyroglobulin antibodies 510 kiu/L (<115) up from 482 before

Thyroid peroxidase antibodies <9 kiu/L (<34) same as before

Iron 109 ug/L (13-150) previously 128

Folate serum 7.3 ug/L (>3.89) up from 4.20

B12 Active 80.3 pmol/L (>37.5) up from 73.5

CRPHS 4.45 mg/L (<5) up from 2.36

I am seeing my GP next week and am not sure what to say. If I tell her I don’t feel any better she may take the medication away (I had to fight to get treatment in the first place) but I am not back to my old self and need to get well. Any comments/advice most welcome.

[Sarahlouise1980]

I’m hypothyroid and I’d say you need another increase in Levothyroxine. Your free T4 and free T3 should be nearer the top of the range and TSH lower. This is generally where I feel most well xx

[Mionaonthehill in reply to Sarahlouise1980]

Hi Sarahlouise thanks for your reply. I will see what the GP says and fight for it if they don’t.

[Sarahlouise1980 in reply to Mionaonthehill]

You’re welcome 😊. For reference I’m on 125mcg so the 50mcg you’re on is a very low dose. I think when I was first diagnosed (Over twenty years ago) I was started on 25mcg and then tested and raised by 25mcg every six weeks until I was well. Good luck xx

[Angel_of_the_North in reply to Mionaonthehill]

You could say you feel a little bit better but not right and ask for an increase

[greygoose]

Don't say you don't feel any better, say that you feel a bit better, but you're sure you could feel a lot better with an increase in dose.

[Mionaonthehill in reply to greygoose]

Thanks Greygoose - a very good way to put it

[greygoose in reply to Mionaonthehill]

You're welcome.

[SlowDragon Administrator]

Recommended on here that all thyroid blood tests should ideally be done as early as possible in morning and before eating or drinking anything other than water .

Last dose of Levothyroxine 24 hours prior to blood test. (taking delayed dose immediately after blood draw).

This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip, best not mentioned to GP or phlebotomist)

Is this how you did the test?

FT4 is only 34% through range

Helpful calculator for working out % through range

chorobytarczycy.eu/kalkulator

This suggests you need dose increase in Levothyroxine

You may gave a battle with GP, if they are only looking at TSH

Which brand of Levothyroxine are you currently taking?

Have you had vitamin D tested?

If not ask GP or use NHS postal kit £29

vitamindtest.org.uk

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

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)

All four vitamins need to be regularly tested and frequently need supplementing to maintain optimal levels

[Mionaonthehill]

Hi Slowdragon. I fasted and did all that you recommend. It was a medichecks test as I know NHS only does TSH. What I’ve been doing is taking the medicheck results to the GP and that was how I got my 50 Levo in the first place. I will bring this up about F4 still in lower range when I go next week. If she doesn’t want to increase I will try self medicating up to 75 myself and see how it goes and if I feel better. Thanks too for link to the vitamin D test. I was looking for one as I don’t know my levels.