Understanding results

[17-26-11]

Hi all. Hope you're all bearing up at this scary time.

I've had my medicheck results and wonder what you think?

The reply I had with them said my results were excellent and my symptoms must be from something else?

TSH 2.54

T3 3.91

Free Thyroxine 15

Thanks

[SeasideSusie Remembering]

17-26-11

Previous post says you are diagnosed hypo and on 50mcg Levo.

These results show that you are undermedicated (although we always need reference ranges to interpret results, these differ from lab to lab and not everyone knows Medichecks ranges).

The aim of a hypo patient on Levo, generally, is for TSH to be 1 or below with FT4 and FT3 in the upper part of their ranges.

Your TSH is far too high for someone on Levo, and your FT4 is 15 (12-22) which is just 30% through range and your FT3 at 3.9 (3.1-6.8) is just 28.9% through range.

You should ask your GP for an increase in Levo, 25mcg now and retest in 6-8 weeks. Repeat if necessary until your levels are where they need to be for you to feel well.

In support of your request for an increase, use the following information:

Dr Toft, past president of the British Thyroid Association and leading endocrinologist, states in Pulse Magazine (the magazine for doctors):

"The appropriate dose of levothyroxine is that which restores euthyroidism and serum TSH to the lower part of the reference range - 0.2-0.5mU/l. In this case, free thyroxine is likely to be in the upper part of its reference range or even slightly elevated – 18-22pmol/l. Most patients will feel well in that circumstance. But some need a higher dose of levothyroxine to suppress serum TSH and then the serum-free T4 concentration will be elevated at around 24-28pmol/l. This 'exogenous subclinical hyperthyroidism' is not dangerous as long as serum T3 is unequivocally normal – that is, serum total around T3 1.7nmol/l (reference range 1.0-2.2nmol/l).*"

*He recently confirmed, during a public meeting, that this applies to Free T3 as well as Total T3.

You can obtain a copy of the article by emailing Dionne at

[e-mail]

print it and highlight question 6 to show your doctor.

You can also refer to NHS Leeds Teaching Hospitals who say

pathology.leedsth.nhs.uk/pa...

Scroll down to the box

Thyroxine Replacement Therapy in Primary Hypothyroidism

TSH Level .................. This Indicates

0.2 - 2.0 miu/L .......... Sufficient Replacement

> 2.0 miu/L ............ Likely under Replacement

[SlowDragon Administrator]

Speak to GP on phone and request 25mcg dose increase in levothyroxine

Also you still need vitamin D, folate, ferritin and B12 tested

Ask GP to do so

Or test privately

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)

Vitamin D test

vitamindtest.org.uk