What are ‘normal’ thyroid levels?

[FLAMB]

Hi

I’ve had my results back but have no idea what a normal level should be.

I’ve gone from 100+ to the following

TSH 17.22

TS4 14.2

Can anyone help advise?

TIA

[SeasideSusie Remembering]

FLAMB

We always need reference ranges when posting test results please, ranges vary from lab to lab so we can't interpret your results accurately without your ranges.

The aim for a treated Hypo patient on Levo, generally, is for TSH to be 1 or below with FT4 (not TS4 ) and FT3 in the upper part of their reference ranges.

You are obviously very undermedicated to have such a high TSH.

Maybe re-read replies to your first post on the forum when SlowDragon gave lots of information about the full range of tests required and how Levo shold be started and titrated:

healthunlocked.com/thyroidu....

[FLAMB in reply to SeasideSusie]

Thanks for the response, I feel like I have no idea what is going on at the moment. So I am stabbing in the dark lol.

Do I ask my doctor for the reference range?

I have gone from 3 months on 50mg, then my thyroid levels starting increasing quite dramatically so they increased my Levothyroxine to 75mg.

Im still losing my hair and my sense of taste and smell is shot to pieces. It would be lovely if they could increase my dose now but I suppose these things have to be done slowly

I'll re-read Slowdragon's response below

[SeasideSusie Remembering in reply to FLAMB]

FLAMB

Don't ask the doctor for the ranges, they don't like us to have results, etc. A couple of days after every test always ask the receptionist for a print out, this will include the ranges. As long as a GP has seen them then we are legally entitled to our test results here in the UK.

Testing should be repeated 6-8 weeks after any dose change.

You will need your Levo increased regularly until your TSH is below, as SlowDragon has mentioned.

[humanbean]

For information on the TSH of healthy people with no known thyroid disease see this link :

healthunlocked.com/thyroidu...

[SlowDragon Administrator]

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.

nhs.uk/medicines/levothyrox...

If your TSH is 14

What’s range on Ft4?

Ask GP for 25mcg dose increase in levothyroxine

Also note what foods to avoid (eg recommended to avoid calcium rich foods at least four hours from taking Levo)

All four vitamins need to be regularly tested and frequently need supplementing to maintain optimal levels

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 to test vitamin levels and thyroid antibodies, if not been tested yet

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)

[FLAMB in reply to SlowDragon]

Thanks again for the reply & information. Is it worth getting an independent test, I am not sure what I would do with the information. I don't want to be a know it all and argue with the doctor... mainly because at the moment I am not sure what is going on.

I have started not taking my levo before tests, thanks for this tip.

[SlowDragon Administrator in reply to FLAMB]

See GP, they will definitely increase dose of levothyroxine up by 25mcg

Bloods should be retested 6-8 weeks later

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...

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...

academic.oup.com/jcem/artic...

Physicians should: 1) alert patients that preparations may be switched at the pharmacy; 2) encourage patients to ask to remain on the same preparation at every pharmacy refill; and 3) make sure patients understand the need to have their TSH retested and the potential for dosing readjusted every time their LT4 preparation is switched (18).

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...

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)

You are legally entitled to printed copies of your blood test results and ranges.

The best way to get access to current and historic blood test results is to register for online access to your medical record and blood test results

UK GP practices are supposed to offer everyone online access for blood test results. Ring and ask if this is available and apply to do so if possible, if it is you may need "enhanced access" to see blood results.

In reality many GP surgeries do not have blood test results online yet

Alternatively ring receptionist and request printed copies of results. Allow couple of days and then go and pick up.

Important to see exactly what has been tested and equally important what hasn’t been tested yet

GP should have tested vitamin levels and thyroid antibodies

If not.....Ask that they do so ....or test privately

Private tests are available as NHS currently rarely tests Ft3 or thyroid antibodies or all relevant vitamins

List of private testing options

thyroiduk.org/getting-a-dia...

Medichecks Thyroid plus ultra vitamin (doesn’t include folate)

medichecks.com/products/thy...

Thyroid plus vitamins including folate (private blood draw required)

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...

If you can get GP to test vitamins and antibodies then cheapest option for just TSH, FT4 and FT3

£29 (via NHS private service ) and 10% off if go on thyroid uk for code

thyroiduk.org/getting-a-dia...

monitormyhealth.org.uk/thyr...

Medichecks - JUST vitamin testing including folate - DIY finger prick test

medichecks.com/products/nut...

Medichecks often have special offers, if order on Thursdays

[SlowDragon Administrator]

Examples of private test results

healthunlocked.com/search/p...

healthunlocked.com/search/p...

Frequently vitamins are low, but not low enough for GP to treat

NHS only prescribes to treat deficiencies

Self supplementing often required to bring vitamins to optimal levels