Hello, thanks to your help I went back to the GP and got new blood tests, he has now increased the Levo to 50 from this morning. I got my test results through from the surgery. The inital result in Feb was:
06-Mar-2020Se thyroid peroxidase Ab conc 15 (iu/mL0.00 - 24.00iu/mL)
01-May-2020Serum TSH 7.55 (mU/L
0.27 - 4.20mu/L)
01-May-2020Serum free T4 12.7 (mmol/L
12.00 - 22.00pmol/LT4)
For at least the last year I have felt so tired, down, teary, unable to concentrate and full of aches and pains. I just come back from work and lie on the sofa! I have felt like I perminantly needed a holiday, then even after time off work, felt no better. The 'brain fog' and memory problems have had such a big impact on decision making in my life. I know that I am not as bad as some and so feel that I should just get on with it. But then I also recognise that I have been fighting feeling crappy like this for such a long time and at last perhaps I have a reason. I have been for couclling, had accupunture, tried mindfullness and living a healthy life. And still, I have had to making excuses for myself and my poor performance, its really affected my sence of who I am. So I just want to rest until I start to feel better. Is that feasable, if I rest what if I never get going again...Am I just feeling sorry for myself? I stepped down from a leadership role at work last autumn, I thought it was just the stress at the time, but now I'm thinking it was this thyroid issue. I have also recently found out that both my uncle and grandmother on my dad's side have underactive thyroid. I know its really common, I just need to get my head round it I guess. Are there any good books out there?
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GrowingVeg
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I'm not surprised you are feeling dreadful - you are still very under-medicated. You want your TSH to be 1 or lower and your free T4 to be nice and high - instead, TSH is too high and free T4 is crawling along the bottom of the range, Have you had your free T3 tested? - bet it's rubbish too
I would suggest you ask for an increase in levo - and ideally full blood testing - ie including free T3 and key nutrients - ferritin, folate, vit D and B12. You need the nutrients nice and high to make your levo work best. Ke.ep testing every 6 - 8 weeks after each increase in meds until you get to the right dose for you
I can't recommend any books - other people I'm sure will have suggestions - but reading the questions and replies on this site will teach you a lot.
Thank you for helping me feel slightly sane fuchsia-pink. I'm not very good at talking to the GP, yet. I meant to ask about the nutrient tests yesterday, but I totally forgot!! I've not had free T3 tested yet either. My next appointment with him is in 3-4 weeks time, so I will make notes for then.
You feel rough because you have hypothyroidism and are still very under medicated
This will improve as dose is increased...but we frequently need to increase slowly, especially if been hypothyroid and undiagnosed for some time
Standard starter dose of levothyroxine is 50mcg (unless over 65 years old).
Bloods should be retested 6-8 weeks after each dose increase
The aim of Levothyroxine is to increase the dose slowly in 25mcg steps upwards until TSH is under 2 (many patients 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.
Also note 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 at next test
You will need to get TG Thyroid antibodies testing privately as NHS refuses to test TG antibodies if TPO antibodies are negative
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 as NHS currently rarely tests Ft3 or thyroid antibodies or all relevant vitamins
Even if we don’t start on full replacement dose, most people need to increase dose slowly upwards in 25mcg steps (retesting 6-8 weeks after each increase) until on full replacement dose
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.
Come back with new post once you get next test results and especially vitamin results too for advice on how to improve if too low
Levothyroxine is an extremely fussy hormone and should always be taken on an 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 convenient and perhaps more effective taken at bedtime
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. Teva contains mannitol as a filler, which seems to be possible cause of problems. 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
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