Blood levels

[Loula86]

My levels were TSH- 16 and T4- 9. I’ve started on 50mcg Levo. I can’t go for my blood test to see what effect it’s having due to risk of Covid-19. I’m just curious what dose others ended up on with similar levels to mine. Dr said she wouldn’t be surprised if my dose needed increasing but to continue on 50mcg for another month (and then see if I can go for a blood test after that). Thanks all x

[greygoose]

And, your doctor is right. I don't think there's much doubt that you're going to need at least two increases of 25 mcg to get your TSH down to 1 or under. But, how much you will eventually need, to feel well, is anybody's guess. And, even if people have the exact same results on starting out, they will probably have different needs as to how much levo they eventually end up on.

The protocol is to work up slowly - 25 mcg every six to eight weeks - until you feel well, and your TSH is wherever it needs to be to have your FT4 and FT3 in the right place for you.

Of course, it's not going to go smoothly with all these other problems going on, so you will have to stay as you are until things calm down. But, if you start feeling really bad, ring your doctor and insist on an increase in dose even without the blood test, because 25 mcg is just a starter dose, never intended to be anyone's final dose.

[mistydog in reply to greygoose]

Her starting dose is 50mcg

[greygoose in reply to mistydog]

Oh yes! sorry, got confused.

[SlowDragon Administrator]

As per reply in previous post

healthunlocked.com/thyroidu...

You need FULL thyroid and vitamin testing

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)

Even if we start slowly, most need to increase slowly upwards until on full replacement dose

NICE guidelines on dose by weight

nice.org.uk/guidance/ng145/...

1.3.6

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.

BMJ also clear on dose required

bmj.com/content/368/bmj.m41

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