Results from 2011 When I was diagnosed Hypothyroid

[Thyb]

Hi All, In one of my previous posts I was asked what my blood results were when I was First diagnosed Hypo.

I have looked back at all results online and here they are with date I was diagnosed:-

02/06/2011 age 56 (well 5 days off being 56)....

Serum FT4 10.7 pmol/L (12-22)

Serum TSH 7.22 miu/L (0.35-5.5)

16/07/2013

Serum Free T4 13.7pmol/L *(12-22)

Serum TSH 9.9miu/L (0.35-5.5)

03/09/2013

Serum Ft4 12.7 pmol/L (12-22)

Serum TSH 7.45 miu/L (0.35-5.5)

O4/03/14

Serum TSH 3.72 miu/L (0.35-5.5)

13/03/2014

tTg negative

12/06/2014

Postmenopausal positive

Serum TSH 3.88 (0.35-5.5)

31/10/2014

Serum TSH 4.10 (miu/L 0.35-5.5)

SERUM B12 331 ng/L (180-914)

Serum folate 6.7ng/mL (4.6-18.7)

07/08/2015

Serum Free T4 12 pmol/L (12-22)

Serum TSH 6.69 miu/L (0.35-5.5)

As I've been taking 50mcg levothyroxine daily for almost 2 weeks, I don't think it could do much harm to start taking either an extra 12.5mcg or 25mcg daily??

Sounds like I'm asking for some reassurance here...yes

Unfortunately, My levo is only available in 50mcg (meaning not 25, probably would be in 100mcg, I wouldn't know) as I've never had more than 50 and when alternating on 25mcg dose I cut the tablet (used to be Actavis, now Accord) pharmacy tells me Accord own Actavis.

I sure remember Teva and Eltroxin made me feel worse than Accord....

Ironically, all bloods in past 9 years have really not changed much at all....well definitely not significantly....Think you might agree

I did put more frequent results than those shown above but, screen on phone went blank and they 'disappeared'

[SlowDragon Ambassador]

TSH 5.7

FT4 9.7

Folate 9.7

Ft3 3.2 (3.1-6.8 pmol/L)

He did not 'have time' apparently to give me rest of reference ranges. Hence, I don't have them.

Vit B12 432 (no doubt because I'm taking sublingual drops) so this has substantially risen

I received a text from GP At 10:30 this Morning saying 'your thyroid is untreated' up dose to 100mcg..daily.

In "Theory" that is probably What I need. In practice would no doubt be far too much!!

I 'upped my dose of levothyroxine a few days ago from 50mcg x 4 times a week, 25mcg x3 times a week to 50mcg daily.

You don’t want to increase too fast

Perhaps increase to 75mcg /50mcg alternate days and hold that for 6-8 weeks

You can cut 50mcg tablets in half ....using pill cutter or a craft scalpel

[Thyb in reply to SlowDragon]

Thank you, I don't have pill cutter or craft scalpel but they do have a line in middle so I use a sharp knife or break with hand...Pharmacy has no pill cutters left but 75 alternate days should hopefully be ok...I'll know about an hour after taking

[SlowDragon Ambassador in reply to Thyb]

Local art shop usually has craft knife ...if needed

[Thyb in reply to SlowDragon]

Thank you but no Local Art Shops around here unfortunately.....I live in a quiet place. Art shops about 60 mile round trip

[Thyb in reply to SlowDragon]

SD

That was 6 days ago when GP text me, a GP I'm not familiar with either.

Hence, 1st time ever a GP has mentioned upping dose to a ridiculous titration. Endo asked me to up dose a while ago from 50mcg every other day to 50mcg 1 day and 25mcg the next and so forth which I did and then about 2 weeks ago 50mcg daily which I'm doing.

But my post was re somebody asking me to post results when I was 1st diagnosed which I have. That was my post 18 days ago

[Nanaedake in reply to Thyb]

2011

Serum FT4 10.7 pmol/L (12-22)

Serum TSH 7.22 miu/L (0.35-5.5)

So, when you were first diagnosed your TSH was slightly elevated and FT4 was below lab range. I presume you were prescribed levothyroxine? How much were you started on? 2 years later your TSH was 9.9. So were you taking levothyroxine then? And if so, how much?

I can't quite work out was Tg negative stands for. It could be thyroglobulin but NHS usually tests TPO. You need to find out whether you have been tested for TPO and TgAb antibodies. They are the Thyroid antibodies. Also, have you ever had a thyroid ultrasound?

There is no vitamin D test. Can you check? If vitamin D hasn't been tested then you need it doing. If vitamin D is low, it could be causing problems.

If you're getting a reaction to levothyroxine tablets within an hour then it's not the levothyroxine causing problems although some people have problems with the fillers in tablets. Levothyroxine has a 7 day half life so you would not experience any changes from levothyroxine for at least a couple of weeks.

If you're having problems with the fillers then some people suggest taking an antihistamine to test if that prevents the reaction.

In 2015, your TSH is only slightly above the reference range although FT4 is very low in range showing that your thyroid was struggling. Were you taking levothyroxine when you had this test?

You really need to get full thyroid testing, TSH, FT4 and FT3 (as well as thyroid antibodies) as you have no FT3 results. And you need vit D testing.

You've still got a way to go with B12 because the recommendation is to get it above 550.

If you felt unwell on levothyroxine in 2011, 2012 or 2013, it could be because you were taking TEVA levothyroxine. TEVA was not absorbed effectively so you were likely not getting the dose listed on the packet. That alone could have made you feel unwell.

I agree with Slowdragon to raise dose in smaller increments to allow for physical adjustment.

[Thyb in reply to Nanaedake]

Thank you...I've only ever taken a maximum of 50mcg levothyroxine daily. This year my TPO and Tgab are very high.

My vitamin D is 66, I take supplements plus MK7-K2 SPray. Igennus Super B Complex, High dose Sublingual B12 also. I have a Magnesium spray But wherever I spray it I get pains.....strange

Over the 1st 5-7 years of taking levo I could have had any 'make/brand' I wouldn't have taken notice and understood zilch about thyroid. I had no idea not to take levo before a blood test and would have had blood tests at literally any time of day.....

2010-2017 approx had some big stressors

I had thyroid tests on 1st July and posted results 2nd July.

Previously I postedcresults from Blue Horizons

[Nanaedake in reply to Thyb]

As your thyroid antibodies are high, you have autoimmune thyroid disease which can cause fluctuations in thyroid status but it looks like poor quality levothyroxine between 2011 and 2015 is likely to have impacted you as on the same dose of levo you were more hypothyroid than you are now so I suspect the levothyroxine potency was compromised meaning it was not as potent as it should have been. Thereby leaving you very underdosed and probably making you feel ill due to side effects of the poor quality of the tablets.

You have never been on sufficient levothyroxine and long term underdosing can mean lack of vitamins absorption.

Now that quality problems have been corrected in levothyroxine production in the UK, if you stay on the tablets you're taking now and increase to the correct amount it will help. Your vitamin D is still too low if the unit of measurement is nmol/L. It's said to be best around mid-lab range and it's likely to drop in winter.

[SlowDragon Ambassador in reply to Thyb]

Well you likely do need 100mcg per day, but having been left on too low a dose for years, it can be hard to increase

Increasing by 25mcg per day and waiting 6-8 weeks for rest of your body’s endocrine system to catch

Then ideally retest bloods before next increase

[Thyb in reply to SlowDragon]

Can I ask what your thoughts are on this post regarding my TSH FT4 when I was 1st diagnosed in June 2011....

Initially, I put many more results between 2011-2013 but screen went blank andvthey 'disappeared' off here...!!

Wish I could sit at a Computer as being able to cut and paste would be a 1000,000 times easier....

[SlowDragon Ambassador]

On levothyroxine TSH should be under 2.5. Most people, when adequately treated have TSH under one

So you were always under treated

Aim is to bring a TSH under 2.5

gp-update.co.uk/SM4/Mutable...

Official NHS guidelines saying TSH should be between 0.2 and 2.0 when on Levothyroxine

(Many of us need TSH nearer 0.2 than 2.0 to feel well)

See box

Thyroxine replacement in primary hypothyroidism

pathology.leedsth.nhs.uk/pa...

Dr Toft, past president of the British Thyroid Association and leading endocrinologist, states in Pulse Magazine,

"The appropriate dose of levothyroxine is that which restores euthyroidism and serum TSH to the lower part of the reference range - 0.2-0.5mU/l.

In this case, free thyroxine is likely to be in the upper part of its reference range or even slightly elevated – 18-22pmol/l.

Most patients will feel well in that circumstance.

But some need a higher dose of levothyroxine to suppress serum TSH and then the serum-free T4 concentration will be elevated at around 24-28pmol/l.

This 'exogenous subclinical hyperthyroidism' is not dangerous as long as serum T3 is unequivocally normal – that is, serum total around T3 1.7nmol/l (reference range 1.0-2.2nmol/l)."

You can obtain a copy of the articles from Thyroid UK email print it and highlight question 6 to show your doctor



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