I had a total thyroidectomy Aug 2018 and blood test results in August 2019 seemed ok....
TSH 1.8815 (normal values Italy 0.28-4.60)
FT3 2.69 (1.40-4.20)
FT4 1.04 (0.80-2.20)
I was, and still am, taking 75mcg levo Mon- Thurs, and 50mcg Fri Sat and Sun.
Blood test result done yesterday, as follows
TSH 6.8650 (same normal range as above)
FT3 2.39
FT4 0.93
Not so good. Bit hypo?? Was thinking of changing levo to 75mcg every day to start with?? Can anyone give me a bit of guidance? Will prob go and see endo, but have never had full trust in endos, more trust in this site and advice given. All you administrators are brilliant and give excellent advice.
Thanks in advance.
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Your TSH is well over range, your FT4 is below range, it's very obvious that you need a dose increase.
You are currently taking 450mcg per week equivalent to 64.28mcg daily.
If you increase to 75mcg daily that's just a little over 10mcg daily increase.
With your current results I think you would do better with a higher increase and my suggestion would be 5 days at 100mcg and 2 days at 75mcg or 4 days at 100mcg and 3 days at 75mcg.
I'm not medically trained and this just my opinion but it's giving you the closest to a normal dose increment when titrating Levo, ie 25mcg daily.
You need to increase dose up slowly 25mcg steps upwards retesting 6-8 weeks after each dose increase
For full Thyroid evaluation you need TSH, FT4 and FT3 tested. Also EXTREMELY important to test vitamin D, folate, ferritin and B12
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)
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.
Consider starting levothyroxine at a dosage of 1.6 micrograms per kilogram of body weight per day (rounded to the nearest 25 micrograms) for adults under 65 with primary hypothyroidism and no history of cardiovascular disease.
Sometimes people without a thyroid need T3 so you could ask your Doctor for some. If he refuses which he might do because the NHS are trying to just give us Levothyroxine because it is probably cheaper and we are at the bottom of the list when it comes to treating us properly. I know that sounds negative but my treatment for the last 12 years has been disgusting. I actually worked for the NHS and my husband used to be a manager at several hospitals until he retrained in the law. The NHS can be wonderful or it can treat patients badly and thyroid patients are treated badly imho. Anyway back to you ... if I was you if the Doctor won't prescribe T3 I would source your own NDT I have taken Thyroid S from Thailand in the past and it worked well for me. I am a strange case and I have Graves' Disease but sometimes I can become underactive and I have taken both Levothyroxine or NDT. At the moment I am in remission from Graves' Disease so I am taking nothing just vitamin D spray and selenium.
Just as a point of reference a fully functioning working thyroid would be supporting you on a daily basis with approximately 100 T4 + 10 T3. and I read, and believe, through trialling T3, that T3 is about 4 times stronger than T4.
T4 is a pro hormone and needs to be converted by your body into T3 which is the active hormone that our bodies run on.
The average person needs about 50 mcg T3 a day in order to function.
Our conversion of the T4 into T3 can be compromised if vitamins and minerals are not optimal., and as previously detailed, ferritin, folate, B12 and vitamin D need to be optimal in the ranges, and not just anywhere.
As you can see by loosing your own natural production of T3 this has meant you have lost about 20% of your overall daily requirement of this active hormone and over time this may effect your overall wellbeing and compound your health issues.
Some people can get by supplementing T4 alone, some people simply stop converting the T4 into T3 at some point in time, and some people simply need both these vital hormones dosed and monitored independently to bring them into balance and to a level of well being acceptable to the patient.
I just think it makes common sense that both these essential thyroid hormones are on the patients prescription for if, and probably when, they may both be needed for optimal health and wellbeing.
Your Thyroid and How To keep It Healthy is a book written by a doctor who has hypothyroidism . Dr Barry Durrant-Peatfield writes in an easy to understand manner and I found this book helpful in my learning curve. The thyroid is a major gland responsible for full body synchronisation, your mental, physical, emotional, psychological and spiritual well being, your inner central heating system and your metabolism.
We need to know all about this amazing little, but very important gland and need to try and compensate as best we can for the loss.
I am with Graves Disease having had my thyroid ablated with RAI back in 2005.
I am now self medicating with Natural Desiccated Thyroid and getting my life back, thanks in the most part, to this supportive and educational website.
Hi I had a thyrodecotomy this year in July after struggling with graves for 5 years. I got so fed up and switched to thyroid s two weeks ago. It is the best decision I have ever made. I had the exact symptoms you are experiencing and was low on both ferritin and vit D . I am on supplements and I feel so well. In fact I have not felt this well since 2014. Good luck
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