Shambavi/Penny: I've just read that not taking... - Thyroid UK

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Shambavi/Penny

shambavi18 profile image
5 Replies

I've just read that not taking enough thyroxin may be the reason I have PAD (periferal arterial disease.) So be aware. I take 75mg a day.

I would like to get tests and things, whatever it takes to get the address of safe T3 supplyer.

Please advise how I start.

Thanks

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shambavi18
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5 Replies
Marz profile image
Marz

I think most people here would suggest you have the correct testing of your thyroid - also vitamins and minerals too. If the latter are poor - adding T3 will not be beneficial.

I have read your previous posts. Are you able to have Private Home Testing ? A good way of discovering more about your thyroid and nutrient status ..

Do you have Hashimotos ?

shambavi18 profile image
shambavi18 in reply to Marz

Yes Hashimotos. I take vitamins and minerals and had B12 injections in February. I can do Home testing, I think, do you mean can I get blood drawn?

Marz profile image
Marz in reply to shambavi18

No I just asked if you are able to have Private Testing. Lots of people find it too costly.

SlowDragon profile image
SlowDragonAdministrator

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 as you have Hashimoto’s

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)

Is this how you do your tests?

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...

Thyroid plus vitamins including folate (private blood draw required)

medichecks.com/products/thy...

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 then cheapest option for TSH, Ft3 and Ft4

£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

Come back with new post once you get results

Remember to stop taking any supplements that contain biotin a week before ALL blood tests as biotin can falsely affect test results

SlowDragon profile image
SlowDragonAdministrator

guidelines on dose levothyroxine by weight

Even if we don’t start on full replacement dose, most people need to increase levothyroxine dose slowly upwards in 25mcg steps (retesting 6-8 weeks after each increase) until on full replacement dose

NICE guidelines on full replacement dose

nice.org.uk/guidance/ng145/...

1.3.6

Consider starting levothyroxine at a dosage of 1.6 micrograms per kilogram of body weight per day (rounded to the nearest 25 micrograms) for adults under 65 with primary hypothyroidism and no history of cardiovascular disease.

gp-update.co.uk/Latest-Upda...

Traditionally we have tended to start patients on a low dose of levothyroxine and titrate it up over a period of months.

RCT evidence suggests that for the majority of patients this is not necessary and may waste resources.

For patients aged >60y or with ischaemic heart disease, start levothyroxine at 25–50μg daily and titrate up every 3 to 6 weeks as tolerated.

For ALL other patients start at full replacement dose. For most this will equate to 1.6 μg/kg/day (approximately 100μg for a 60kg woman and 125μg for a 75kg man).

If you are starting treatment for subclinical hypothyroidism, this article advises starting at a dose close to the full treatment dose on the basis that it is difficult to assess symptom response unless a therapeutic dose has been trialled.

A small Dutch double-blind cross-over study (ArchIntMed 2010;170:1996) demonstrated that night time rather than morning dosing improved TSH suppression and free T4 measurements, but made no difference to subjective wellbeing. It is reasonable to take levothyroxine at night rather than in the morning, especially for individuals who do not eat late at night.

BMJ also clear on dose required

bmj.com/content/368/bmj.m41

bestpractice.bmj.com/topics...

We see thousands of people on here left on inadequate dose of levothyroxine and poor quality of life as direct result

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