Should I start the prescribed 25mcg levo for a high-normal TSH?

[Laura221]

Hi everyone,

I"m 22 and for years, my TSH has been between 3,5 and 4,5. My latest test came back at 4,1 (range 0,5-4,5). My T4 came back at 11,5 (range 10-22). I went to see an endo and she told me she could give me 25mcg if I wanted to. So I went ahead and asked for the prescription, since my TSH has been like this for at least 5 years and doesn't seem to get better with supplements, and I experience some mental health and hormonal issues that I thought could be related to my thyroid.

Should I do it? Or is it not possible to experience symptoms at this level?

[Lalatoot]

In some countries you would be treated with a TSH of 3. However 25mcg might not be enough. Be aware that your symptoms may worsen on a low dose which just indicates that you need it increased by 25mcg.

What happens is that the struggling thyroid takes a rest when the body senses the new hormones. Unfortunately the 25mcg dose is sometimes not enough to make up for what the resting thyroid was making.

[SlowDragon Administrator]

Looking at previous posts

You tested negative for high TPO thyroid antibodies

Have you had TG antibodies tested

About 90% of all primary hypothyroidism in Uk is due to Hashimoto’s.

Low vitamin levels are particularly common with Hashimoto’s.

Gluten intolerance is often a hidden issue to.

Are you on strictly gluten free diet

Link about thyroid blood tests

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

Link about Hashimoto’s

thyroiduk.org/hypothyroid-b...

20% of Hashimoto's patients never have raised antibodies

Have you had ultrasound scan of thyroid

healthunlocked.com/thyroidu...

Paul Robson on atrophied thyroid - especially if no TPO antibodies

paulrobinsonthyroid.com/cou...

Had vitamin D, folate, B12 and ferritin tested?

Standard starter dose of levothyroxine is 50mcg (unless over 65 years old).

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...

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

[greygoose]

Your TSH may be in the so-called 'normal' range, but that doesn't make it 'normal'. You are technically hypo when your TSH reaches 3. And, yes, that is more than high enough for you to experience symptoms - although I have to say, it's not the TSH itself that is causing the symptoms, it will be low T3 - which, of course, they haven't tested! But your FT4 is much too low, so your FT3 is probably going to be, too.

The TSH of a euthyroid (normal) person is around 1, and that's where you need yours to come down to - or even lower.

[Catseyes235]

Yes! Can’t do any harm and if you start to feel benefits (after 6 weeks or so) then you can have amount increased if necessary.