I posted on here a few weeks ago because I was due to have some blood tests through Medichecks. I was diagnosed with subclinical hypothyroidism 5 years ago as my TSH was 5.8. After being bumped up to 50mcg 3 months later - I lost a lot of weight (didn’t actually weigh myself but it was very visible - not sure if it was water retention but I still didn’t change my diet at all).
Over the years I have put the weight and more on. As a 22 year old it’s very difficult for me to understand what’s going on in my body. I went to see an endocrinologist last year In December who requested some tests on the NHS for me (most of them are not done on nhs so DIDNT get tested). It came up that I was vitamin d deficient. Since being prescribed vit d I do not feel as tired at all anymore, my hair has grown back and I feel more alive and happy and positive! HOWEVER. My weight is a real issue. I can’t seem to lose it ... I do not eat terribly but do have a cheat meal every two weeks or so. I am very active. I also still feel very cold at times and last night my heart rate when resting went down to 57 bpm which it has never done before (usually around 68!)
I have attached the private medichecks results I received a month ago. I can’t upload another photo but the rest of my results were as follows :
CRP HS - 0.66 mgL (<5)
Ferritin - 71.3 ug/L (13-150)
Folate serum - 10.6 ug/L (>3.89)
Active b12 - 53.7 pmol/L (>3.89)
Vitamin D 77.3 nmol/L (50-175)
I’m hoping that as I’m still being treated for vitamin that this will go up further (I was at 30 in January). I’ve started supplementing b12, b complex, iron, selenium, magnesium, zinc, and vit E for two weeks.
Can anyone please suggest of what else I can do? I know my T4 is quite low (this was at 22 a few years ago) so now a bit stuck. I’ve sent a letter to my GP requesting I go up to 75mcg.
Thank you!
Clem
Written by
Cepayne98
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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)
Is this how you did this your test?
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)
guidelines by weight might help push for dose increase
Even if frequently 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 eventually 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.
Bloods should be retested 6-8 weeks after each dose increase
If you are taking vitamin B complex, or any supplements containing biotin, remember to stop these 7 days before any blood tests, as biotin can falsely affect test results
Also if you wear a Fitbit or equivalent, take along print out of Weekly summary to show GP ......assuming it shows very low resting heart rate
You shouldn’t supplement iron unless GP has done full iron panel test for anaemia
Your Ferritin level is ok.
Better to just make sure to eat good amount of iron rich foods
Eating iron rich foods like liver or liver pate once a week plus other red meat, pumpkin seeds and dark chocolate, plus daily orange juice or other vitamin C rich drink can help improve iron absorption
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
No other medication or supplements at same as Levothyroxine, leave at least 2 hour gap.
Some like iron, magnesium, omeprazole or vitamin D should be four hours away
(Time gap doesn't apply to Vitamin D mouth spray)
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
Apologies for the delay in replying. I will respond to your points now:
1. That is exactly how I did the test
2. I am still waiting to hear from my GP re increasing to 75mcg. Do all these factors relate to those with subclinical hypothyroidism?
3. I am still supplementing vitamin D through my prescription from the GP - I have about 15 weeks left of this prescription so hopefully my vit D will have increased by a lot.
4. I am slightly confused as to how I would know if a brand does not suit me; do individuals experience nausea etc? I haven't felt anything like that on my medication so far.
Thank you for all your comments - it is really appreciated.
I will wait to see if my GP ups my dosage and then will see how I feel about Teva. Clearly if it doesn’t suit so many people I may have to request what you said previously!
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