I have had my test results back today and my doctor has suggested that I take 50 mg tablets one day and 75 mg the next please can you help me with the results below.
TSH serum 6.68 MUL range 0.35 to 4.9 4MLUL
Serum free T4. 10.2 pmol/L. 9.01 - 19.05pmol/L
Serum free T3 2.7pmol/L. 2.63 - 5.70pmol/L
Serum Vit 12. 398 pg/mL. 187.00 - 883.00pg/ml
I am aware that my Vit D is under and I am now taking
Serum ferritin. 85. Ng/mL. 20.00 - 204.00ng/mL
Serum folate. 5.6ng/mL. 3.10 - 20.50ng/mL
Thank you
You're FT4 is only 11% through range
FT3 only 3% through range
Helpful calculator for working out % through range
So you are currently very under medicated
You are likely to need 25mcg dose increase in Levothyroxine to 75mcg everyday (not just alternate days)
Bloods should be retested 6-8 weeks later
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.
B12 and folate are also likely too low and may benefit from supplementing
Presumably you have Hashimoto's?
Are you on strictly gluten free diet?
Hi Slow Dragon,
Thank you for your help. I am not gluten free and have not been diagnosed with Hashimoto’s.
I have several brands of tablets I have 25 mg that are Wockhardt and Teva also 50mg I’m Actsvis. A bit of a mixed bag I think.Should I not be mixing these tablets?
Well different brands often affects people. Teva especially frequently causes adverse reactions. Teva is the only lactose free Levothyroxine, it contains mannitol instead which may be why it upsets quite so many
List of different brands available in the Uk
Some are only available in certain sizes. Eg Wockhart is only 25mcg
thyroiduk.org.uk/tuk/treatm...
Link to other posts mentioning Teva. It's a Marmite brand, most people hate it, but a few love it
healthunlocked.com/search/p...
The fact your dose is changing up and down (incorrectly) strongly suggests that the cause of your hypothyroidism is due to autoimmune thyroid disease also called Hashimoto's
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.
Do you have online access to your medical record and blood test results?
Look through past test results for thyroid antibodies test results. Ask GP to test thyroid antibodies if not been done
So you need to test both TPO And TG thyroid antibodies
You may need to get full Thyroid testing privately as NHS refuses to test TG antibodies if TPO antibodies are negative
Low vitamins are especially common with Hashimoto's. Food intolerances are very common too, especially gluten.
So it's important to get TPO and TG thyroid antibodies tested at least once .
20% of Hashimoto's patients never have raised antibodies, an ultrasound scan of thyroid helpful
healthunlocked.com/thyroidu...
approx 5% with Hashimoto's are coeliac, but over 80% find gluten free diet helps, sometimes significantly. Either due to direct gluten intolerance (no test available) or due to leaky gut and gluten causing molecular mimicry (see Amy Myers link)
Changing to a strictly gluten free diet may help reduce symptoms, help gut heal and slowly lower TPO antibodies
While still eating high gluten diet ask GP for coeliac blood test first or buy test online for under £20, just to rule it out first
Assuming test is negative you can immediately go on strictly gluten free diet
(If test is positive you will need to remain on high gluten diet until endoscopy, maximum 6 weeks wait officially)
Trying gluten free diet for 3-6 months. If no noticeable improvement then reintroduce gluten and see if symptoms get worse
chriskresser.com/the-gluten...
amymyersmd.com/2018/04/3-re...
thyroidpharmacist.com/artic...
I think I would change the doctor, if you can. Like many in UK few really know how to treat hypothyroid patients so that symptoms are relieved. Your TSH is too high.
The aim - once diagnosed, is to gradually increase dose until TSH is 1 or lower and FT4 and FT3 towards the upper part of the ranges. The latter two are rarely tested.
We have to read and ask questions in order to recover our health and SlowDragon has given her usual excellent advice.
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
Not a fan of mixing brands as potency may be slightly different. I only have experience with what is now Mercury Pharma. I was put on that a long time ago but pharmacist insisted giving it all in 25 mcg’s I worked up to 125/100 but then thought I would I Roxy W 100 mcg but same brand as that would help the NHS cost wise. It didn’t work out for me. Each tablet has to be within a potency and that never changes so a good point to always sticking to one brand as one could be on the plus side and the next be on the negative and depending on the dose needed it could well make a noticeable difference. By this time I had a load of 100’s and loads of 25’s so I experimented a bit more and found that 4x 25 was not the same as 1x100! So I used up the 100’s as quickly as I could and stuck with the 25’s. Then I remembered about my initial pharmacist insisting I took the doses all in 25’s!
So that’s how one brand worked for me, I have t tried different brands since I started out and got a different brand every time and that’s when the pharmacist stepped in. So I’m never forgotten he wise words though she didn’t explain at the time. Neither do I have any experiences with other brands but just something to think about.
Initially the pharmacist did ask which brand I would prefer but I thought, given time, I could get stable on any so instead I asked which brand she could easily get so she told me and to get it put on prescription and then I was tested after 6 weeks and my stability improved. I’ve seen fairly recently that if brand changes to retest after 6 weeks so it appears that the potency can be different and not just me feeling like that. It does concern me though reading posts where any medication can arrive at the pharmacy.
My pharmacists did suggest though that I gradually increased my stock in case the pharmacy couldn’t source it every month so I did that and got eventually a month in hand. Useful when the weather turns nasty as well as a bit of a cushion to say going out if conditions not good.
Best to stick to one brand but not always available as global supply chains for many meds seem to be precarious . Had various brands with no apparent ill effect so been lucky in that respect.
I am due for a repeat blood test I know I have to take the last tablet 23 hours beforehand but do I have to stop taking vitimin D as well
Help with blood results
Blood test results??
Please help with blood test results
Test results - GP vs Blue Horizon with ranges
