What do my new levels mean? Been taking levo fo... - Thyroid UK

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What do my new levels mean? Been taking levo for six weeks. Many thanks.

Flashgirl profile image
8 Replies

Good evening! Please can I have some advice on my levels? Have included previous blood levels below.

Many thanks!!!!!

FYI

Have been taking Levo 50mcg since 4 feb 2020

Have had a ferritin deficiency for a long time and have been taking ferrous sulphate for seven months. 2x200 a day. Indeed my ferritin level started on 8 in aug 2019, peaked at 50 in jan 2020 and is down to 32 now!

March 2020 blood test shows a problem with transferrin? What does this mean?! Can’t speak to doctor for a week as no appointments.

(Latest blood test 16 March at the bottom).

August 2019:m blood test

Ferritin 8 (range 10.00-200.00)

Serum TSH 1.62mu/L (0.35-5.00mu/L) "Normal"

Serum free T4 11.7 pmol/L (9.00-22.0pmol/L) "Normal"

Prescribed 2 x 200g ferrous sulphates a day. Taking as directed.

Nov 2019 blood test

Vit D was "Normal" (don't have number)

Ferritin 28 (range 10.00-200.00) "Normal"

B12 840 ng/L (range 200-910) I take a B12 supplement "Normal"

Continue to take 2 x 200g ferrous sulphates a day as directed.

Jan 2020

Went back to docs as still feeling tired and very run down, achey, brain fog etc... Whilst waiting for my appt I developed thyroiditis (very sore throat)

Jan 2020 blood test

Se thyroid peroxidase Ab conc (SM) 150.8 ku/L (0.00-5.60ku/L) "Positive"

Serum TSH 1.75mu/L (0.35-5.00mu/L) "Normal" (increased from Aug 2019)

Serum free T4 9.7 pmol/L (9.00-22.0pmol/L) "Normal" (decreased from Aug 2019)

Ferritin 50 (range 10.00-200.00) Normal

4 Feb 2020

Went to see endocrinologist. Prescribed Levo 50mcg

End feb to March - predisone steroids for Thyroiditis. One week at 15mcg. Week at 10mcg. Week at 5mcg. Still have thyroid pain to this day.

16 March 2020 blood test

Serum TSH. 1.51. (Range 0.35/5.00mu/l)

Serum free t4 11.1 (range 9-22.00pmol/l) ”adequate thyroxine replacement”

Serum ferritin 32 (range 10/200. Drop from 50 in jan)

Serum transferrin 2.7 g/l (Range 2.20/3.40g/l)

!!Transferrin saturation index 69% (17.00/57.00%)

Serum iron level 46.7umol/l (range 10.00/30.00umol/l).

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Flashgirl
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SlowDragon profile image
SlowDragonAdministrator

Your Ft4 is very low ...only 16% through range

You need 25mcg dose increase in levothyroxine

The fact your TSH has never risen suggests central hypothyroidism

Very important to test vitamin D and folate ....or getting access to actual results of previous tests

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 as you have Hashimoto’s diagnosed by high thyroid antibodies

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)

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

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

If you can get GP to test vitamins and antibodies then cheapest option for just TSH, FT4 and FT3 £29 (via NHS private service )

monitormyhealth.org.uk/thyr...

Just testing vitamin D here

vitamindtest.org.uk

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 taken at bedtime

verywellhealth.com/best-tim...

markvanderpump.co.uk/blog/p...

healio.com/endocrinology/th...

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 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)

Flashgirl profile image
Flashgirl in reply to SlowDragon

Thanks. My ferritin levels (I’ve been taking ferrous sulphate 2x200 a day since aug 2019).

Aug 2019. 8 (range 10/200)

Nov 2019. 28

Jan 2020. 50

March 2020. 32 (why lower?!)

I also wonder why my serum iron level is so high?

March 2020

vit b12. 705 (range 200/910).

Thank you for the links to the blood tests. I am seeing my consultant next week so hopefully everything will be a bit clearer.

I think I need to get the additional blood tests. I did ask for the T3 test and it was on my blood request form, but for some reason this was not done! Frustrating

SlowDragon profile image
SlowDragonAdministrator in reply to Flashgirl

NHS laboratory’s refuse to test Ft3 is TSH is within range

GP needs to write “Central hypothyroidism “ on blood test and insist Ft3 is tested

Frequently we have to get tested privately

Vitamin D test £29

vitamindtest.org.uk

Flashgirl profile image
Flashgirl in reply to SlowDragon

This makes sense and isn’t an horrendous price! It’s been virtually impossible trying to get my doctor to test for different things ...she’s been very reluctant to say the least!

SlowDragon profile image
SlowDragonAdministrator in reply to Flashgirl

This is most popular option for thyroid and vitamin testing....often on offer at £79

medichecks.com/products/thy...

SlowDragon profile image
SlowDragonAdministrator in reply to Flashgirl

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.

SlowDragon profile image
SlowDragonAdministrator in reply to Flashgirl

humanbean and SeasideSusie are more knowledgeable on iron and ferritin. They may pop along and take a look at your iron and ferritin

Flashgirl profile image
Flashgirl in reply to SlowDragon

That would be great!

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