Got a bit of a shock today with my TSH level being 16!, I had a TT in Nov and have been putting on lots of weight. I have started WW walk 15,000 steps and knew something wasn’t right so requested a blood test. I’m on 125 Levo but going up to 150 then having another blood test next month to check levels and then possibly raise it again.
TSH 16.0: Got a bit of a shock today with my TSH... - Thyroid UK
TSH 16.0
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Lissaok
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Hey there again Lissaok
Yes, my TSH went up to around 15/16 at some point in time when I was being medicated with Levothyroxine after RAI thyroid ablation for Graves Disease.
It is vital that you are monitored and dosed on T3 and T4 blood test results and would suggest that you also ask for your ferritin, folate, and vitamins D and B12 to be measured as these need to be at optimal levels for any thyroid hormone to work effectively.
Just increasing T4 - Levothyroxine on a TSH blood test result is futile, as T4 is a prohormone and your body needs to be able to convert the T4 into T3 which is the active hormone that the body runs on.
As detailed in my previous post to you some months ago, a fully functioning working thyroid would be supporting you on a daily basis with approximately 100 T4 + 10 T3 and I read the average persons uses about 50 T3 daily, just to function.
So, having lost your own thyroid, you have lost about 20% of your overall level of T3 and been down regulated in your overall well being, hence the weight increase, as your metabolism is now running too slow for you.
The logical step is to replace like with like, and just think it makes common sense that when there has been a medical intervention and the thyroid surgically removed or ablated with RAI that both vital hormones, both T3 and T4 be on the patients prescription, for if, and probably when they will both be needed to return a balance and a level of well being acceptable to the patient.
There is also Natural Desiccated Thyroid hormone replacement but it seems this is extremely difficult to get on the NHS, though I have to say even getting T3 prescribed on the NHS has become a bit of postcode lottery.
Initially you need to have a full thyroid panel run to include T3, T4, and the vitamins and minerals as detailed so we can see what's going on and what you may now need to do in the way of thyroid hormone replacement.
Thank you so much. I’ve requested a copy of my bloods, T3 wasn’t & wont be checked she said. Bit D, B12, blood count, folate was good apparently but Ferritin was 14 when min in range from 15-400 so I’m going to go on double iron for a month and then single iron there after.
What were the ACTUAL results of vitamin D, B12 and folate?
Just being within range...we need OPTIMAL levels
Clearly ferritin is terrible
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
Links about iron and ferritin
irondisorders.org/Websites/...
Helpful post about iron supplements and testing
healthunlocked.com/thyroidu...
drhedberg.com/ferritin-hypo...
This is interesting because I have noticed that many patients with Hashimoto’s disease and hypothyroidism, start to feel worse when their ferritin drops below 80 and usually there is hair loss when it drops below 50.
Good morning to you :
We really do need to see the actual ranges and numbers of your vitamin and mineral results and of course with a ferritin level that low, your body will not able to convert the Levothyroxine into the T3 which is the active hormone that the body runs on.
My levels came back at 23 which was when I started looking at the ferritin/thyroid connection, and read in several different places that thyroxine doesn't work if ferritin is below 70.
That was my turning point, and by accident I found this amazing site, and started my own way back up as I was unable to tolerate the iron tablets prescribed as I was, unbeknown to me then, dealing with gastric mucosa caused by the RAI treatment I had been given to ablate my thyroid a few years earlier.
It took me over a year to build myself back up, and it is essential that you have a full thyroid panel to include a T3 reading as it seems obvious to me you are not converting your Levothyroxine and it is not a simple fix, or just an increase in your T4 medication.
I would think your T3 will be very low in the range, and it is T3 that the body runs on and fires your metabolism to work effectively, metabolises your food and gives you back nutrients from your food and builds your body back up to wellness.
My doctor refused to test my T3 or T4 as my TSH was always managed to be ' in range ' .
I paid privately and my results showed a T3 at 25% with a T4 at 80% through the range. These hormones, T3 and T4, need to be balanced for wellness, and it's pointless increasing this build up of unconverted T4, Levothyroxine, before knowing your level of T3.
SlowDragonAdministrator
NICE guidelines on full replacement dose
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.
gp-update.co.uk/Latest-Upda...
BMJ also clear on dose required
bestpractice.bmj.com/topics...
If you are already taking correct dose by weight, then need to be looking at poor gut function, malabsorption and low vitamins
Do you always get same brand of levothyroxine?
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
verywellhealth.com/best-tim...
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
Teva and Aristo are the only lactose free tablets
healthunlocked.com/thyroidu...
Teva poll
healthunlocked.com/thyroidu...
No other medication or supplements at same as Levothyroxine, leave at least 2 hour gap.
Some like iron, calcium, magnesium, HRT, omeprazole or vitamin D should be four hours away
(Time gap doesn't apply to Vitamin D mouth spray)
Thank you, I’ve check my weight so I should be on 140 mg and I’m starting 150 mg tomorrow. I take the meds at the right time before anything in the morning when I wake, I’m rather strict about it. I’m on the brand Teva but I have not had any issues...other than this. I’ve requested copy of my bloods
It’s likely to take some while to improve that ferritin level
Presumably GP did full iron panel test for anaemia?
humanbean is our iron expert
I don’t they did, I am going to post my blood test. Just trying to work out how to!
Bone profile (44Z2.)
Specimen: BloodCollected: 27 May 2020 10:30
Provider Specimen Comments: On thyroxine
InvestigationNormalityResult
Bone profile (44Z2.)
Serum alkaline phosphatase level (XE2px)72 IU/L [30.0 - 100.0]
Serum albumin level (XE2eA)46 g/L [35.0 - 48.0]
Serum calcium level (XE2q3)2.38 mmol/L [2.2 - 2.6]
Serum adjusted calcium concentration (Xabpk)2.36 mmol/L [2.2 - 2.6]
Calcium corrected for Albumin
Liver function tests (X77WP)
Specimen: BloodCollected: 27 May 2020 10:30
Provider Specimen Comments: On thyroxine
InvestigationNormalityResult
Liver function tests (X77WP)Bilirubin not analysed as icteric index normal
Serum alanine aminotransferase level (XaLJx)26 IU/L [0.0 - 35.0]
Serum total bilirubin level (XaERu)NA
Renal profile (44J5.)
Specimen: BloodCollected: 27 May 2020 10:30
Provider Specimen Comments: On thyroxine
InvestigationNormalityResult
Renal profile (44J5.)Either Serum Creatinine has not significantly risen or there is
no previous result to compare from the last year.
Multiply GFR by 1.21 if Afro-Caribbean race.
Serum sodium level (XE2q0)137 mmol/L [132.0 - 146.0]
Serum potassium level (XE2pz)4.1 mmol/L [3.5 - 5.0]
Serum urea level (XM0lt)4.1 mmol/L [2.5 - 6.7]
Serum creatinine level (XE2q5)72 umol/L [45.0 - 84.0]
GFR calculated abbreviated MDRD (XaK8y)79 ml/min/1.73m*2
Acute kidney injury warning stage (XabmE)0 [< 1.0]
Full blood count (424..)
Specimen: BloodCollected: 27 May 2020 10:28
InvestigationNormalityResult
Full blood count (424..)
Total white blood count (XaIdY)4.8 10*9/L [4.0 - 10.0]
Red blood cell count (426..)4.29 10*12/L [3.8 - 4.8]
Haemoglobin concentration (Xa96v)125 g/L [120.0 - 150.0]
Haematocrit (X76tb)0.39 [0.36 - 0.46]
Mean cell volume (42A..)91 fL [83.0 - 101.0]
Mean cell haemoglobin level (XE2pb)29.2 pg [27.0 - 32.0]
Mean cell haemoglobin concentration (429..)321 g/L [315.0 - 345.0]
Platelet count - observation (42P..)247 10*9/L [150.0 - 410.0]
Neutrophil count (42J..)2.1 10*9/L [2.0 - 7.0]
Lymphocyte count (42M..)2.1 10*9/L [1.0 - 3.0]
Monocyte count - observation (42N..)0.3 10*9/L [0.2 - 1.0]
Eosinophil count - observation (42K..)0.1 10*9/L [0.0 - 0.5]
Basophil count (42L..)0.0 10*9/L [0.0 - 0.1]
Bone profile (44Z2.)
InvestigationNormalityResult
Bone profile (44Z2.)
Serum alkaline phosphatase level (XE2px)72 IU/L [30.0 - 100.0]
Serum albumin level (XE2eA)46 g/L [35.0 - 48.0]
Serum calcium level (XE2q3)2.38 mmol/L [2.2 - 2.6]
Serum adjusted calcium concentration (Xabpk)2.36 mmol/L [2.2 - 2.6]
Calcium corrected for Albumin
Liver function tests (X77WP)
Specimen: BloodCollected: 27 May 2020 10:30
Provider Specimen Comments: On thyroxine
InvestigationNormalityResult
Liver function tests (X77WP)Bilirubin not analysed as icteric index normal
Serum alanine aminotransferase level (XaLJx)26 IU/L [0.0 - 35.0]
Serum total bilirubin level (XaERu)NA
Renal profile (44J5.)
Specimen: BloodCollected: 27 May 2020 10:30
Provider Specimen Comments: On thyroxine
InvestigationNormalityResult
Renal profile (44J5.)Either Serum Creatinine has not significantly risen or there is
no previous result to compare from the last year.
Multiply GFR by 1.21 if Afro-Caribbean race.
Serum sodium level (XE2q0)137 mmol/L [132.0 - 146.0]
Serum potassium level (XE2pz)4.1 mmol/L [3.5 - 5.0]
Serum urea level (XM0lt)4.1 mmol/L [2.5 - 6.7]
Serum creatinine level (XE2q5)72 umol/L [45.0 - 84.0]
GFR calculated abbreviated MDRD (XaK8y)79 ml/min/1.73m*2
Acute kidney injury warning stage (XabmE)0 [< 1.0]
27 May 2020 16:23Plasma glucose levelReport ID: 5393089/18
Request Receipt: Request Comments:
Issued: 27 May 2020 16:23Provider Comments:
Arrived: 27 May 2020 17:14Service Type: NewFinancial Details:
Follow-up action: No Further Action
Clinical Information: on t4 wt gain
Plasma glucose level (XM0ly)
Specimen: BloodCollected: 27 May 2020 10:29
InvestigationNormalityResult
Plasma glucose level (XM0ly)4.4 mmol/L [4.0 - 7.7]
Lower limit applies only to diabetics on insulin.
Bone profile (44Z2.)
Specimen: BloodCollected: 27 May 2020 10:30
Provider Specimen Comments: On thyroxine
InvestigationNormalityResult
Bone profile (44Z2.)
Serum alkaline phosphatase level (XE2px)72 IU/L [30.0 - 100.0]
Serum albumin level (XE2eA)46 g/L [35.0 - 48.0]
Serum calcium level (XE2q3)2.38 mmol/L [2.2 - 2.6]
Serum adjusted calcium concentration (Xabpk)2.36 mmol/L [2.2 - 2.6]
Calcium corrected for Albumin
Liver function tests (X77WP)
Specimen: BloodCollected: 27 May 2020 10:30
Provider Specimen Comments: On thyroxine
InvestigationNormalityResult
Liver function tests (X77WP)Bilirubin not analysed as icteric index normal
Serum alanine aminotransferase level (XaLJx)26 IU/L [0.0 - 35.0]
Serum total bilirubin level (XaERu)NA
Renal profile (44J5.)
Specimen: BloodCollected: 27 May 2020 10:30
Provider Specimen Comments: On thyroxine
InvestigationNormalityResult
Renal profile (44J5.)Either Serum Creatinine has not significantly risen or there is
no previous result to compare from the last year.
Multiply GFR by 1.21 if Afro-Caribbean race.
Serum sodium level (XE2q0)137 mmol/L [132.0 - 146.0]
Serum potassium level (XE2pz)4.1 mmol/L [3.5 - 5.0]
Serum urea level (XM0lt)4.1 mmol/L [2.5 - 6.7]
Serum creatinine level (XE2q5)72 umol/L [45.0 - 84.0]
GFR calculated abbreviated MDRD (XaK8y)79 ml/min/1.73m*2
Acute kidney injury warning stage (XabmE)0 [< 1.0]
Serum vitamin B12 level (XE2pf)
Specimen: BloodCollected: 27 May 2020 10:28
Provider Specimen Comments: Override of request intervention
InvestigationNormalityResult
Serum vitamin B12 level (XE2pf)309 ng/L [211.0 - 900.0]
If high clinical suspicion of PA or neuropathy,
with a normal B12 level, further investigate
with autoantibody testing.
Serum folate level (42U5.)
Specimen: BloodCollected: 27 May 2020 10:28
Provider Specimen Comments: Override of request intervention
InvestigationNormalityResult
Serum folate level (42U5.)6.9 ug/L [4.0 - 20.0]
If high clinical suspicion of PA or neuropathy,
with a normal B12 level, further investigate
with autoantibody testing.
Serum ferritin level (XE24r)
Specimen: BloodCollected: 27 May 2020 10:28
Provider Specimen Comments: Override of request intervention
InvestigationNormalityResult
Serum ferritin level (XE24r)Below range14 ug/L [15.0 - 400.0]
Below low reference limit
If high clinical suspicion of PA or neuropathy,
with a normal B12 level, further investigate
with autoantibody testing.
27 May 2020 16:58Serum vitamin B12 level; Serum folate level; Serum ferritin levelReport ID: 5393162/7
Request Receipt: Request Comments:
Issued: 27 May 2020 16:58Provider Comments:
Arrived: 27 May 2020 18:11Service Type: NewFinancial Details:
Follow-up action: No Further Action
Clinical Information: on t4 wt gain
Serum vitamin B12 level (XE2pf)
Specimen: BloodCollected: 27 May 2020 10:28
Provider Specimen Comments: Override of request intervention
InvestigationNormalityResult
Serum vitamin B12 level (XE2pf)309 ng/L [211.0 - 900.0]
If high clinical suspicion of PA or neuropathy,
with a normal B12 level, further investigate
with autoantibody testing.
Serum folate level (42U5.)
Specimen: BloodCollected: 27 May 2020 10:28
Provider Specimen Comments: Override of request intervention
InvestigationNormalityResult
Serum folate level (42U5.)6.9 ug/L [4.0 - 20.0]
If high clinical suspicion of PA or neuropathy,
with a normal B12 level, further investigate
with autoantibody testing.
Serum ferritin level (XE24r)
Specimen: BloodCollected: 27 May 2020 10:28
Provider Specimen Comments: Override of request intervention
InvestigationNormalityResult
Serum ferritin level (XE24r)Below range14 ug/L [15.0 - 400.0]
Below low reference limit
If high clinical suspicion of PA or neuropathy,
with a normal B12 level, further investigate
with autoantibody testing.
Serum TSH level (XaELV)
Specimen: BloodCollected: 27 May 2020 10:30
Provider Specimen Comments: On thyroxine
InvestigationNormalityResult
Serum TSH level (XaELV)Above range16 mu/L [0.3 - 5.5]
Above high reference limit
Raised TSH ? under replaced
27 May 2020 16:58Serum vitamin B12 level; Serum folate level; Serum ferritin levelReport ID: 5393162/7
Request Receipt: Request Comments:
Issued: 27 May 2020 16:58Provider Comments:
Arrived: 27 May 2020 18:11Service Type: NewFinancial Details:
Follow-up action: No Further Action
Clinical Information: on t4 wt gain
Serum vitamin B12 level (XE2pf)
Specimen: BloodCollected: 27 May 2020 10:28
Provider Specimen Comments: Override of request intervention
InvestigationNormalityResult
Serum vitamin B12 level (XE2pf)309 ng/L [211.0 - 900.0]
If high clinical suspicion of PA or neuropathy,
with a normal B12 level, further investigate
with autoantibody testing.
Serum folate level (42U5.)
Specimen: BloodCollected: 27 May 2020 10:28
Provider Specimen Comments: Override of request intervention
InvestigationNormalityResult
Serum folate level (42U5.)6.9 ug/L [4.0 - 20.0]
If high clinical suspicion of PA or neuropathy,
with a normal B12 level, further investigate
with autoantibody testing.
Serum ferritin level (XE24r)
Specimen: BloodCollected: 27 May 2020 10:28
Provider Specimen Comments: Override of request intervention
InvestigationNormalityResult
Serum ferritin level (XE24r)Below range14 ug/L [15.0 - 400.0]
Below low reference limit
If high clinical suspicion of PA or neuropathy,
with a normal B12 level, further investigate
with autoantibody testing.
Same Results seem to be repeated several times
B11, folate and ferritin low
B12?
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