Hi all, I have just joined this forum! I am 28 and been on Levothyroxine for a couple of years now as I used to fall asleep at the wheel after commuting to work and working 16hours a day. I've changed my job over a year ago and recently joined the gym and I've started to feel much better. However, I had a blood test yesterday and my dosage has increased from 75 to 100.
Is this something to be worried about?
What can I do to improve this?
I have this issue throughout my family but I want to try and overcome it!
Any help, support or guidelines would be much appreciated.
Many thanks,
Jamie
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j4brett
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That seems a very low dose for someone of your age, for example my elderly Dad is on 100mcg because he is old. Someone else will advise you about what blood tests you need to do to get a better idea of what is going on. I personally think you are undermedicated and need an increase.
You are legally entitled to them so call your gp’s surgery and ask for a copy.
Ideally you have been tested for Tsh, T4,T3, but probably only Tsh/T4. There will be people who are more knowledgeable than myself who will tell you everything you need to know. Good luck. There’s some wonderful people on this site
Important to always obtain copies of all test results with ranges so you can monitor your own progress and check what has been missed !
Surgeries should have on-line access so worth enquiring. ID required. It could be difficult at the moment with the virus issue and surgeries working differently.
Re-test 6/8 weeks after starting new dose. Also check B12 - Folate - Ferritin - VitD as they need to be optimal. Do you have Hashimotos ?
Reading Posts and Replies here will help you to learn more. Keep asking questions too 🤔
Docs are inclined to ignore or not test anti-bodies which confirm Hashimotos. Because it is auto-immune in origin they ignore it as knowledge is limited ! It is the most common thyroid condition globally and there is lots we can do to help ourselves.
Scroll down if you are on a phone to the heading Topics - Hashimotos is featured with over 3,000 posts !
Are you in a position to have Private Testing which will cover all the tests needed and very rarely done in the NHS.
You say thyroid issues run in family.....so it's likely that cause is autoimmune thyroid disease...aka hashimoto's
Make sure that you get blood retested 6-8 weeks after each dose increase ,(or brand change) in levothyroxine
All thyroid tests should be as early as possible in morning before eating or drinking any thing apart from water and last dose levothyroxine 24 hours before test
ALWAYS get actual results and ranges
Easiest way is to register for online access to your medical records.....if blood test results are online
Essential to regularly test vitamin D. Folate, ferritin and B12 too
As young male its astonishing you managed on only 75mcg
Dose should be increased slowly upward in 25mcg steps - retesting each time
Most people need somewhere between 100mcg and 200mcg
Guidelines on dose by weight is 1.6mcg levothyroxine per kilo of your weight
Suggest you read up as much as possible about hypothyroidism and Hashimoto’s in particular...if it turns out you do have hashimoto’s
Basically levothyroxine doesn’t “top up” your own thyroid...it replaces it
Frequently we have to start slowly, especially if been undiagnosed for long time (very common) ....but over time dose needs to be increased, partly because your own thyroid continues to be attacked and output diminishes....but also as TSH drops in response to increased levels of levothyroxine, your own thyroid takes a holiday or shuts down completely
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.
When hypothyroid we frequently have low stomach acid, this then leads to low vitamin levels.....extremely important to regularly test vitamin D, folate, ferritin and B12 .....especially if Hashimoto’s
Far too frequently patients are left on inadequate dose of levothyroxine far too long.....then vitamin levels drop
Low vitamins tend to lower TSH
Frequently medics only test TSH
We ALWAYS recommend getting FULL thyroid and vitamin testing....many patients forced to test thyroid antibodies, Ft4 and Ft3 privately to make progress
Ask GP to test thyroid antibodies and vitamins at 6 week retest ...if not been done yet
However, I had a blood test yesterday and my dosage has increased from 75 to 100.
Is this something to be worried about?
You will have had an increase in dose because your test results indicated this so it's not really anything to worry about, your GP has realised from your test result that you are undermedicated.
For a full picture we should really have the following tests:
TSH
FT4
FT3
Thyroid antibodies will tell us if we have autoimmune thyroid disease but this is rarely done.
Most doctors only do TSH. If this is over range it tells the GP that you are undermedicated and he will increase the dose of Levo. Sometimes if it's high in range a GP will increase the dose, others will say that it's fine because it's in range. In fact, 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, if that is where you feel well.
TSH is only part of the picture, and it's not a thyroid hormone, it's a signal from the pituitary to tell the thyroid to make hormone if it detects there's not enough. The actual thyroid hormones are T4 and T3, and by measuring FT4 and FT3 we can see the levels of our thyroid hormones, that's what tells us if we need an increase in our dose of Levo, FT3 being the most important one as it's low T3 that causes symptoms but unfortunately it's very rare to get FT3 tested with our GP.
So first thing to do is obtain a print out of your results, or if your surgery offers online access you should be able to see the result and range there. Post the actual results/reference ranges for further comment.
You should be retested 6-8 weeks after this dose increase to check your levels.
When doing thyroid tests, we advise:
* Book the first appointment of the morning, or with private tests at home no later than 9am. This is because TSH is highest early morning and lowers throughout the day. If we are looking for a diagnosis of hypothyroidism, or looking for an increase in dose or to avoid a reduction then we need TSH to be as high as possible.
* Fast overnight - have your evening meal/supper as normal the night before but delay breakfast on the day of the test and drink water only until after the blood draw. Eating may lower TSH, coffee affects TSH so it's possible that other caffeine containing drinks may also affect TSH.
* If taking thyroid hormone replacement, last dose of Levo should be 24 hours before blood draw, if taking NDT or T3 then last dose should be 8-12 hours before blood draw. Adjust timing the day before if necessary. This avoids measuring hormone levels at their peak after ingestion of hormone replacement. Take your thyroid meds after the blood draw. Taking your dose too close to the blood draw will give false high results, leaving any longer gap will give false low results.
* If you take Biotin or a B Complex containing Biotin (B7), leave this off for 7 days before any blood test. This is because if Biotin is used in the testing procedure it can give false results (most labs use Biotin in the assay).
These are patient to patient tips which we don't discuss with doctors or phlebotomists.
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What can I do to improve this?
Improve what? Do you have any symptoms at the moment? If so what are they? Being undermedicated may cause symptoms but we can also have low nutrient levels which bring their own problems. We Hypos often have low nutrient levels so it's import that we test:
Vit D
B12
Folate
Ferritin
We need optimal levels for thyroid hormone to work properly. See if your GP will test these for you, if not we have recommended private labs who offer all the tests we need either by fingerprick or venous blood draw (extra cost for that).
**
I have this issue throughout my family but I want to try and overcome it!
Is this close family? Do they all have hypothyroidism? Maybe ask if anyone knows if theirs is caused by autoimmune thyroid disease - Hashimoto's for underactive and Graves for overactive. If they do it's possible that this is also the cause of your hypothyroidism and testing antibodies would be helpful so that you'd know for definite. It doesn't change the treatment but there are some things you can do to help yourself.
**
You might find it interesting to have a look at ThyroidUK's main website, this is their forum, there's lots of information there:
Thanks for such a detailed response. I really appreciate it all. I'm just reading through and digesting what you have said as I've never really looked into this, so some of the stuff you have said I need to study! Thank you again
I have this issue throughout my family but I want to try and overcome it!
I get the impression that no-one has explained to you that hypothyroidism is for life. You cannot 'overcome' it, nor cure it. You need thyroid hormones to live. So, if your thyroid is incapable of producing enough to make you well, you have to take the hormone exogenously. And, that's what levo is: thyroid hormone T4. And, you will be taking it for the rest of your life, and you will doubtless need other increases as time goes by for various reasons, such as decreased absorption levels, either in the gut or at a cellular level. So, increasing your dose was not something to be worried about, it's just all part of the process, and you should really be grateful that your doctor recognised the need to increase - because not all of them do!
You need to be aware that not everyone can tolerate different brands of levothyroxine
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.
As been on 75mcg....Are you currently taking Teva?
Hi, no I take 50 and a 25 to make up the 75. I have my blood test results. Is it worth me posting them in here because I really dont understand what any of it means!?
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