Confused!

[Chotty]

Good morning

I have recently moved to Spain and after routine bloods taken have found out that I have an under active thyroid.

I have been put on 75mg of thyroxine but still feel dreadful.

I suffer with pins and needles , terrible fatigue and weakness and constantly feeling cold.

I have spoken to my for this week and she wants me to have my bloods taken again.

My original results were as below and I’m not sure what they mean!

TSH 15.2. (0.27-6.33)

T4. 0.8. (0.85-1.86)

I’m so worried and would appreciate some feedback.

Thanks 😊

[SlowDragon Administrator]

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

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

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

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)

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

Pins and needles is frequently low B12

[Chotty in reply to SlowDragon]

Thank you for this.

It’s a bit tricky with the language barrier in Spain to fully understand what the dr is saying and for me to explain to her how awful I am feeling.

I will ask her about the vitamin testing but I do already take a high dose vitamin b complex.

I am having my bloods taken again soon (after 12 week rest)so hopefully will get more info.

[Marz in reply to Chotty]

I lived in Greece for 15 years and found most Doctors spoke excellent English. Blood tests are international in most cases.

Write the tests down that you need/want so they can do their own pronunciation !

[SlowDragon Administrator in reply to Chotty]

If you take high dose vitamin B this is likely to contain high level of biotin

If you are taking vitamin B complex, or any supplements containing biotin, remember to stop these 7 days before any blood tests, as biotin can falsely affect test results

endo.confex.com/endo/2016en...

endocrinenews.endocrine.org...

Do you normally stop thanking vitamin B complex before previous tests?

If not, the results may be unreliable

[Chotty in reply to SlowDragon]

Hi

No I haven’t stopped the vitamins before a test. I will do that this time.

Thank you for all your information.

I might have a private consultation when I go back to uk if I carry on feeling this un well.

I’ve only been on the meds for a few months and I know how complex thyroid issues can be.

[SlowDragon Administrator in reply to Chotty]

First step is to get full testing (making sure to stop vitamin B complex a week before any blood tests)

Always get tested as early as possible in morning before eating or drinking anything other than water and last dose levothyroxine 24 hours before test

Come back with new post once you get results

75mcg is only one step up from starter dose levothyroxine. You are likely to need further increases

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

[SlowDragon Administrator in reply to Chotty]

If you comeback visiting this country?

You can get full testing privately

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

[Chotty]

Thank you 😊

[Treepie]

Look at Thyroid UK web site for information.