I am wondering if anyone has had experience in their TSH levels being all over the place?
I fell pregnant in August, and when my bloods were done at 6 weeks it showed a TSH of over 10, despite me being on Thyroxine at 100mcg.
My Thyroxine was increased to 125mcg, then produced the following results in October -
Serum TSH level
0.36 miu/L (0.55 - 4.78)
Serum free T4 level
22.2 pmol/L (10 - 20)
Was told to reduce to 100MCG each day
November
Serum TSH level
2.41 miu/L 0.35 - 4.78
NO T4 LEVEL GIVEN
No Change in Medication
January
Serum TSH level
4.56 miu/L (0.35 - 4.78)
Advised should be under 2.5 for trying to conceive
So medication increased to 125mcg one day, 100mcg another
February
Serum TSH level
6.68 miu/L (0.35 - 4.78)
T4 16.6 pmol/L
10 - 20
Now it has swung the other way, I have been increased back up to 125mcg every day.... just not sure what the answer is, last time I was on that dose my T4 increased!
Can anyone help?
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Ceebee26
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No I haven't tested Vitamins, although think I will order this from Medichecks - what Vits do you recommend testing?
I have changed to a strictly Gluten Free diet since Jan 5th, although I did not have a coeliac blood test prior to doing this...what is the relation between coeliac and my levels? Would being diagnosed Coeliac make a difference etc.
It is always the same brand, and I always take on an empty stomach first thing in the morning before anything else.
Hashimoto’s is as much a disease of the gut as the thyroid
Vitamin levels are frequently too low
What vitamin supplements are you currently taking?
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
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 do your tests?
Private tests are available. Thousands on here forced to do this as NHS often refuses to test FT3 or antibodies or 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
If you can get GP to test vitamins and antibodies then cheapest option for just TSH, FT4 and FT3 £29 (via NHS private service )
Vitamin D deficiency is frequent in Hashimoto's thyroiditis and treatment of patients with this condition with Vitamin D may slow down the course of development of hypothyroidism and also decrease cardiovascular risks in these patients. Vitamin D measurement and replacement may be critical in these patients.
Evidence of a link between increased level of antithyroid antibodies in hypothyroid patients with HT and 25OHD3 deficiency may suggest that this group is particularly prone to the vitamin D deficiency and can benefit from its alignment.
There is a high (approx 40%) prevalence of B12 deficiency in hypothyroid patients. Traditional symptoms are not a good guide to determining presence of B12 deficiency. Screening for vitamin B12 levels should be undertaken in all hypothyroid patients, irrespective of their thyroid antibody status. Replacement of B12 leads to improvement in symptoms,
Levothyroxine can decrease serum homocysteine level partly; still its combination with folic acid empowers the effect. Combination therapy declines serum homocysteine level more successfully.
Your results show you need dose increase in levothyroxine back to 125mcg per day
Bloods should be retested 6-8 weeks after each dose change
Probably never needed dose reduction in October
Never ever agree to dose reduction without getting FULL Thyroid and vitamin testing
All four vitamins need to be optimal
If Ft3 is not over range you are not over medicated
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 is in top third of range and FT3 at least half way through 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.
Have followed strictly gluten free since beginning of January - Thyroglobulin Antibodies have increased since my last test in October, Peroxidase Antibodies have slightly decreased.
Any Thoughts - currently back on 125mcg Thyroxine a day
So this test was done when still on 100mcg .....or how long on 125mcg?
Do you always get same brand of levothyroxine?
Bloods always done as early as possible in morning before eating or drinking anything other than water and last dose levothyroxine 24 hours before test?
No only back on 125mcg for 5 days before that was alternating at 125mcg one day and 100mcg another at doctors request..but they put me back up due to high TSH.
I dont really understand the whole conversion thing I must admit.
I will try and redo the tests in 6 weeks.
Bloods always taken at same time, and I'm not sure about branding as I've never 0aid much attention to it!
I usually take meds before bloods, guess that isn't advisable?
Taking levothyroxine before blood test causes false high Ft4 result
So remember at test in 6 weeks time ....get blood test as early as possible in morning before eating or drinking anything other than water and last dose levothyroxine 24 hours before test
New NHS England Liothyronine guidelines July 2019 clearly state on page 13 that TSH should be between 0.4-1.5 when treated with just Levothyroxine
Note that it says test should be in morning BEFORE taking Levo thyroxine
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