Hi All
I was diagnosed with hypothyroidism one month ago and been taking 50 levothyroxine. After reading posts I here I went to my Drs to get a print out of my levels
Free T4 7.2 pmol/L (7.7 - 20.6)
TSH 12.55 mIU/L (0.30 - 4.80)
Can someone tell me what this means please
Lucy60
The figures in brackets are the reference ranges. If your result lies between those two figures (within range) you are classed as "euthyroid" (normal).
If your result lies outside of the range (higher or lower) then your result is abnormal and abnormal results indicate a thyroid problem.
Your TSH is over range. In the UK it needs to reach 10 before a diagnosis of hypothyroidism, despite the top of the range being 4.8 in your case.
Your FT4 is below range.
Your results indicate hypothyroidism, which has been diagnosed and now you have Levo prescribed.
50mcg is a starter dose. You need to be retested 6 weeks after starting Levo, you should be given an increase of 25mcg Levo then you will need retesting again 6-8 weeks later. This continues until your levels are where they need to be for you to feel well.
The aim of a treated hypo patient, generally, is for TSH to be 1 or lower with FT4 and FT3 in the upper part of their reference ranges, if that is where you feel well.
Follow the advice on how to do thyroid blood tests given in reply to your previous post here:
As you were diagnosed one month ago, it will take a while (through small increments of levo) for your TSH (thyroid stimulating hormone) to reduce and it is TSH that slowly rises until we're diagnosed as being hypothyroid.
In UK we're only diagnosed when TSH rises to 10. In other countries, we'd be diagnosed when TSH is much lower when symptoms are also taken notice of by the doctor/endocrinologist.
The aim is a TSH of 1 or lower and a Free T4 and Free T3 to be in the upper part of the ranges. The main point is that all clinical symptoms are relieved.
Free T4 7.2 pmol/L (7.7 - 20.6)
TSH 12.55 mIU/L (0.30 - 4.80)
This is the procedure to get the best out of blood tests:-
The earliest possible blood draw. Fasting (you can drink water) and allow a gap of 24 hours between last dose of levo and test and take it afterwards. This helps keep the TSH at its highest as it drops throughout the day and may prevent the doctor adjusting our dose of hormones.
Ask also for B12, Vit D, iron, ferritin and folate. Everything has to be optimal and many of us can be low on these.
It is beneficial to get a Free T4 and Free T3 (I note you've only had a FT4 tested). FT4 is very low as you're just newly diagnosed and should slowly increase.
T4 is an inactive hormone and has to convert to Liothyronine (T3) the active hormone and it is T3 that's needed in our millions of T3 receptor cells. Heart and brain have the most receptor cells.
Always get a print-out of your results with the ranges for your own records.
p.s. It is helpful if you can put a little of your history in your profile (you've just put your name) so that in future members can read it (if they wish) without you having to repeat answers.
GP should have given you a blood test form to get bloods retest after 6-8 weeks on 50mcg levothyroxine
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 and thyroid antibodies at this next test
You may need to get full Thyroid testing privately as NHS refuses to test TG antibodies if TPO antibodies are negative
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 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.
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
Levothyroxine should always be taken 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 effective and more convenient taken at bedtime
verywellhealth.com/best-tim...
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. So if avoiding Teva for 75mcg dose ask for 25mcg to add to 50mcg or just extra 50mcg tablets to cut in half
healthunlocked.com/thyroidu...
Teva poll
healthunlocked.com/thyroidu...
No other medication or supplements at same time 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)
Thank you I have the blood test form and have booked an appointment for 2 weeks time. I did mention vitamin testing but Dr didn't seem too concerned about this. I am taking in all the information on here which I must say has been of great help to me as it's made me realise what's been wrong with me as I put most symptoms down to age or work related stress/ tiredness
You could test vitamin D here (very easy test)
£29 postal NHS kit
Come back with new post once you get results
Very important to know if cause of hypothyroidism is due to autoimmune thyroid disease. So you need thyroid antibodies tested
Thank you. I shall look into this
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