thyroxine increase - advice please

[lloydjam]

HI, I am normally well controlled at 150 mg thyroxine - keeping my TSH at around 1.0. Ive just had a blood test as i have been feeling really under the weather with shivers and aches and pains and found my TSH to be 4.0 which is too high for me. Im trying to get hold of my doctor but thinking of going up to 200mg of thyroxine - does any one have any thoughts on this ( i will get this confirmed when i speak to him next where i can !!) - also i have put on 2 stone in the past year, do you think this would be the likely cause of this?

thank you !

[greygoose]

An increase of 50 mcg is too much. Increases should only be 25 mcg every six weeks. It's a big mistake to increase too rapidly. Even though you were probably under-medicated on 150 mcg, if you were still putting on weight.

[shaws Administrator]

I am not medically qualified but would increase by 1/4 tablet at a time.

[pennyannie]

Hello Lloydjam

A fully functioning working thyroid would be supporting you on a daily basis with approximately 100 T4 - brand name Levothyroxine + 10 T3 - brand name Liothyronine .

Personally I just think that when there has been a medical intervention both these essential hormones should be on the patient's prescription for if, and probably when they will both be required to give the patient back better health.

T4 is a storage hormone and needs to be converted into T3 which is the active hormone that the body runs on, and I read T3 is about 4 times more powerful than T4 and most people use about 50 T3 daily just to function.

Your ability to convert the T4 into T3 can be compromised if you do not maintain ferritin, folate, B12 and vitamin D at optimal levels so it would be sensible to have these tested alongside a TSH. T3 and T4.

Some people can get by on T4 alone, some people simply stop converting the T4 into T3 at some point in time and some people simply need both these essential hormones dosed and monitored independently to bring them both into balance and to a level acceptable to the patient, which generally sees both T3 and T4 in the upper quadrants of the ranges.

As you will see from the above, even with excellent health and optimal levels of vitamins and minerals as you have lost your thyroid, you have lost this small % of T3 that it once gave you, and that, in essence is roughly 20% of your overall well being and don't doubt, overtime just this factor will pull you down and reduce your overall quality of life.

The thyroid is a major gland responsible for full body synchronisation including your physical, mental, emotional, psychological and spiritual wellbeing, your inner central heating system and your metabolism.

It would be a good idea to have a full thyroid blood test to include the above vitamins and minerals and if your doctor isn't helpful there are private companies to be found on the Thyroid uk website along with so very much information to enable you to start reading up on all things thyroid.

Please action a full blood test and then start a new post with the results and ranges and you will receive considered opinion and be able to rebuild your health and wellness, much of it through your own efforts, as I did.

[tattybogle]

I agree with others above .... slowly, slowly, catchy monkey.

I only ever change by 12.5mcg at a time now, wait min 8 weeks, test. decide. Or at most 25mcg is OK.

remember that TSH is in effect a window into the recent past, and as the 4 is such a big change from your 'normal' it could be the result of a 'swing' in results and could already be on it's way back down.

The problem with only having access to TSH without the actual FT4/FT3 that go with it , is that it's like trying to steer a car from the back seat of the caravan. Reactions /Responses are a bit delayed and your decisions are a bit of a blind guess.

[SlowDragon Administrator]

Maximum increase of 25mcg and retest in 6-8 weeks

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 been under medicated

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)

Do you always get same brand of levothyroxine at each prescription?

What vitamin supplements are you currently taking?

When were vitamin levels last tested?