Whether to start medication for TSH 6.0 levels,... - Thyroid UK

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Whether to start medication for TSH 6.0 levels, low energy, and some minor symptoms visible

Seansinh profile image
8 Replies

Thank you everyone for being so helpful and amazing. This is a great community. I am a 35yo male.

Recently my blood test reports indicated mild HypoT. TSH levels were 6.0. T4 and T3 levels are well within range.

A few months ago, from an old report, I checked that the TSH levels were nearly 5. Again T3 and T4 were normal.

The Endocrinologist (who I met for a sore throat actually :)) suggested that I start medication for HypoT and gave a 25mg dose of Levo. I am not sure whether I should take it or not?

I do suffer from mild anxiety, brain fog, and loss of motivation these days (for almost a couple of years now). Everything takes longer to think about and I have started saying a lot of 'Ummm' in between my sentences with long pauses ( I noticed from a webinar, must be irritating for the audience!).

Can the community pl advise?

Thank you in anticipation. It would help me a lot in deciding.

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Seansinh
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8 Replies
shaws profile image
shawsAdministrator

I'd start levothyroxine and it is a small starting dose. I will also state I'm not medically qualified and have hypothyroidism. I had to diagnose myself as no doctor or any medical professional could.

thyroiduk.org.uk/tuk/testin...

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If you're in the UK, the medical professionals have been directed not to prescribe levo until the TSH reaches 10. In other countries we'd be diagnosed upon symptoms alone and given a trial of levo.

In the past we were diagnosed upon clinical symptoms alone and given NDT (natural dessicated thyroid hormones). There were no blood tests or levo at that time. Tick off your symptoms:-

thyroiduk.org.uk/tuk/testin...

thyroiduk.org.uk/tuk/about_...

You should ask for B12, Vit D, iron, ferritin and folate to be tested also. Everything has to be optimal.

Lalatoot profile image
Lalatoot

Sound advice from Shaws.

greygoose profile image
greygoose

Given that you are hypo when your TSH reaches 3 - and in some countries you'd be treated at that level - I wouldn't describe your hypo as 'mild'. And, your symptoms aren't saying 'mild', either. That is just your doctors opinion, and opinions can be wrong. And, he's wrong to be giving you 25 mcg. He should be giving you 50 mcg! 25 mcg is much too low for a man of your age, and it could actually make your symptoms worse rather than better. So, if I were you, I'd tell him you'll start levo when he puts you on the correct dose. But, you do need to start it sooner, rather than later.

T4 and T3 levels are well within range.

That is meaningless because the ranges are too wide. The question is: were they at the right point in the range to make you well? And, the answer to that question is no. Because if they had been, your TSH would have been lower. You have to consider the three readings in relation to each other, not the TSH as a separate entity. And, for that reason, you should always give us all the numbers: results and ranges - rather than just saying 'normal' or 'in-range' (which, incidentally, both mean the same thing). Then we get a better idea of what is going on. :)

SlowDragon profile image
SlowDragonAdministrator

Important to test thyroid antibodies and vitamins too

Has this been done?

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/endo to test vitamin levels

Also being male, get testosterone tested. Low testosterone linked to being hypothyroid

You may need to get full Thyroid 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

List of private testing options

thyroiduk.org.uk/tuk/testin...

Medichecks Thyroid plus ultra vitamin

medichecks.com/products/thy...

Medichecks often have special offers, if order on Thursdays

Thriva Thyroid plus vitamins

thriva.co/tests/thyroid-test

Blue Horizon Thyroid Premium Gold includes vitamins

bluehorizonbloodtests.co.uk...

Important to try to establish WHY you are hypothyroid....the root cause

Do you have family with autoimmune disease?

Glandular fever?

An ultrasound scan of thyroid can be very useful

20% of Hashimoto's patients never have raised antibodies

healthunlocked.com/thyroidu...

SlowDragon profile image
SlowDragonAdministrator

Link specifically about men and thyroid disease

thyroidpharmacist.com/artic...

jimh111 profile image
jimh111

A TSH of 6.0 is marginal, it doesn't tell you much other than your thyroid is a little below par. However, your signs and symptoms are consistent with hypothyroidism. As your endocrinologist has suggested you start levothyroxine I would go along with their advice. I think you really need to start with 50 mcg to notice a substantial difference but the endocrinologist seems unusually helpful so I would go with their approach. If someone is willing to help you it seems churlish to challenge their advice, at least not before you have given them a chance.

It would really help to know your TSH, fT3 and fT4 results along with the reference intervals.

It doesn't sound like you main problem is simply reduced secretion from the thyroid, I would expect a high TSH and low fT4 if this were so. However, I might be wrong so try the simple approach of titrating your levothyroxine until TSH comes down to around 1. If this works then fine but I suspect you may need higher doses of levothyroxine or liothyronine in the future (I've noticed that patients diagnosed with a mildly elevated TSH often fail to respond fully to levothyroxine). So, for now give the endocrinologist a chance and try levothyroxine therapy, it is safe and may be the answer.

Bugbear123 profile image
Bugbear123

You say your T3 is in normal range but don't indicate whether it's a T3 reading of Free T3. There's an important difference

luckylucky profile image
luckylucky

I was started on levothyroxine 25mcg last year and was asked to take only 5 days a week . My tsh was 5.87. Ft3, Ft4 and antibodies all normal. With in 8weeks, my tsh dropped to 1.72. Before starting Thyroxine, I had low energy levels, bad memory. After starting Thyroxine, I started feeling better. starting with the low dose and that too only 5 days a week worked for me.

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