What is TSH?

[Chaz87]

What is TSH? I asked for my blood results over the phone and they have asked me to come back after month and get my TSH checked, i asked what the reading was and she said 5.26 for TSH

[Lora7again]

TSH is pituitary gland hormone which stimulates your thyroid to make thyroxine. Yours is too high and you have Hypothyroid disease. How do you feel?

[Chaz87 in reply to Lora7again]

Yeah sorry I should have said I have an under active thyroid and I am medicated at 50 levo

[Lora7again in reply to Chaz87]

That is a starter dose most thyroid patients are on a much higher dose than that.

[Chaz87 in reply to Lora7again]

Yeah I’ve always been between 50 and 75. I feel my doctors are clueless when it comes to my results. Maybe you would know if Low iron and thyroid disease have a link!?

[Lora7again in reply to Chaz87]

Yes iron and ferritin are lower in some thyroid disease sufferers as is vitamin D, B12 and folate. We cannot absorb vitamins as well as people who do not have the disease. You should ask your Doctor to check those and you must increase your Levothyroxine by 25mcg and keep increasing it until you feel well and your T4 & T3 is in the upper 3rd of the range. My TSH is 0.70 and I feel well but everyone is different.

[Chaz87 in reply to Lora7again]

Thank you very much for all of your answers Lora7. Xoxo

[Angel_of_the_North in reply to Chaz87]

In that case you need an immediate increase in levo. The aim is for TSH is to be under 2 according to NHS guidelines, most people need it under 1

[SlowDragon Administrator]

So you need to see GP and request 25mcg dose increase in Levothyroxine

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

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.

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)

For full Thyroid evaluation you need TSH, FT4 and FT3 plus both TPO and TG thyroid antibodies tested. Also EXTREMELY important to test vitamin D, folate, ferritin and B12

Low vitamin levels are extremely common, especially if you have autoimmune thyroid disease (Hashimoto's) diagnosed by raised Thyroid antibodies

Ask GP to test vitamin levels NOW and thyroid antibodies if antibodies have never been tested

Low ferritin and iron is extremely common when hypothyroid

You may need to get full Thyroid testing privately as NHS refuses to test TG antibodies if TPO antibodies are negative

Bloods should be retested 6-8 weeks after each dose increase in Levothyroxine

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)

If/when also on T3, make sure to take last dose 8-12 hours prior to test, even if this means adjusting time or splitting of dose day before test

Is this how you do your tests?

Private tests are available. Thousands on here forced to do this as NHS often refuses to test FT3 or antibodies or all vitamins

Cheapest option for just TSH, FT4 and FT3 £29 (via NHS private service )

monitormyhealth.org.uk/thyr...

thyroiduk.org.uk/tuk/testin...

For thyroid including antibodies and vitamins

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

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

Levothyroxine should always be taken on empty stomach and then nothing apart from water for at least an hour after

Many people take Levothyroxine soon after waking, but it may be more convenient and more effective taken at bedtime

verywellhealth.com/best-tim...

Do you always get same brand of Levothyroxine?

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.

To avoid Teva get prescribed 50mcg plus 25mcg (or 3 x 25mcg if on wockhart) or 50mcg plus half 50mcg tablet

No other medication at same as Levothyroxine, leave at least 2 hour gap. Some like calcium, magnesium, HRT, omeprazole or vitamin D should be four hours away

(Time gap doesn't apply to Vitamin D mouth spray)

Come back with new post once you get vitamin and antibodies results

Most people need to supplement to improve low vitamin levels especially if you have autoimmune thyroid disease diagnosed by high thyroid antibodies. About 80-90% of primary hypothyroidism is due to autoimmune thyroid disease

[SlowDragon Administrator]

You are legally entitled to printed copies of your blood test results and ranges.

The best way to get access to current and historic blood test results is to register for online access to your medical record and blood test results

UK GP practices are supposed to offer everyone online access for blood test results. Ring and ask if this is available and apply to do so if possible, if it is you may need "enhanced access" to see blood results.

In reality many GP surgeries do not have blood test results online yet

Alternatively ring receptionist and request printed copies of results. Allow couple of days and then go and pick up.

Important to see exactly what has been tested and equally important what hasn't been tested yet

[Treepie]

Thyroid Stimulating Hormone produced by the pituitary gland.