New to this!

[ChelleBaugh]

Hi all, diagnosed as subclinical hypothyroid in February, started on 50mgs Levothyroxine, had blood test in April all back normal. Starting feeling tired again and slight weight and missed period. Had blood test 2 days ago and TSH is elevated, but only slightly to 5.3. T4 T3 normal. Gp has increased dose to 75mgs. Does this usually happen so quickly in terms of months and is missing a period normal?

Many thanks

[SlowDragon Administrator]

Welcome to the forum

Yes 50mcg levo is only a standard starter dose

Blood should be retested 6-8 weeks after each dose increase

Thyroid test should always be done as early as possible in morning before eating or drinking any thing apart from water and last dose levothyroxine 24 hours before

This gives highest TSH and lowest Ft4

Important to get thyroid antibodies tested and vitamin D folate ferritin and B12 tested too

Most people need levothyroxine increased slowly upwards until on full replacement dose

Full replacement dose is typically 1.6mcg per kilo of your weight

Add vitamin results and ranges if you have any

[ChelleBaugh in reply to SlowDragon]

Thanks for the reply. I will get the full results tomorrow, but as far as I am aware T4 and T3 were normal at every test, just TSH raised.

[fuchsia-pink in reply to ChelleBaugh]

Please don't allow your doctor to use words like "normal" or "in range" - get the actual results and reference ranges (which vary from lab to lab).

The point here is that - for example - a free T4 range might be say 12 - 22. If your result is 12.1 you will feel dreadful. If it's 20 you will feel fine. But both are "in range" and hence "normal". The reality is that once you are on thyroid meds, you are likely to need your TSH at the lower end (or even below) the reference range - certainly no more than 2, and your free T4 and free T3 in the top third, possibly the top quartile of the range.

Your current TSH - out of range AND while you're on meds - is much much too high. An increase in meds should make you feel better.

Good luck x

[ChelleBaugh in reply to fuchsia-pink]

Thank you so much for replying. I will get the lab results x

[SlowDragon Administrator in reply to ChelleBaugh]

Come back with new post once you get results and ranges

[SlowDragon Administrator in reply to ChelleBaugh]

Essential to test Ft4 and Ft3..

Frequently GP will only test TSH .

Find out if ever had thyroid antibodies tested

About 90% of primary hypothyroidism is due to autoimmune thyroid disease..

Diagnosed by high thyroid antibodies...also called hashimoto's

Low vitamin levels are especially common with hashimoto's

Once you find a brand of levothyroxine you prefer try to always get same brand of levothyroxine at each prescription

[HashiFedUp]

I need my TsH below 0.6 to feel well so would suggest you will have to continue with increases until you are down this way.

T4 and T3 ought to be 75% up through the range too.

Hope this helps!

Ps I would suggest you have full underactive thyroid not subclinical.

Welcome to this lovely forum 😊

[vocalEK in reply to HashiFedUp]

I agree. "Subclinical" is a misnomer. "Clinical" refers to observable clinical symptoms. Doctors these days are calling anyone with a TSH slightly raised, but not up to the top of the range, subclinical. In the UK, they have arbitrarily set 10 as the magic number, whereas in the US and other countries, they begin treating hypothyroidism when the TSH gets up to 3 or 4. As you can imagine, anyone with a TSH of 10 is likely to have a LOAD of hypo symptoms.