Memory loss

[bellsjet]

I am having my thyroid blood test this morn . I have not had one for twelve months. I am on Levothyroxine 50mg. For the last few months my memory has got awful ( never been great) . I am now forgetting how to do things I have always done. I am only 58 years old and both my parents had dementia. Please help can my thyroid levels affect my memory this much.

[shaws Administrator]

I am sorry you are on 50mcg of levothyroxine alone. Your doctor should have increased your dose about every six weeks until your TSH was 1 or lower. I doubt many doctors are aware of this very important fact. It seems that the majority of the medical professionals are so unknowledgeable about this very, very common condition - which - for the sufferers - they may not feel improvements on levo, especially for you - on 50mcg of levo for 12 months. This is ridiculous as you should have had increases of 25mcg every six weeks until your TSH was 1 or lower and your Free T4 and Free T3 in the upper part of the ranges. Unfortunately for us the 'Frees' are rarely tested.

In fact many on this forum do not get the expertise from doctors which you'd expect they should have.

Are you aware that all blood drawn for thyroid hormones has to be at the very earliest possible, fasting (you can drink water) and allow a gap of 24 hours between your last dose of levothyroxine and the test and take afterwards.

Levothyroxine is an inactive hormone and it has to convert to T3. Ask doctor if you can get both Free T4 and Free T3 tested (probably wont agree but ask anyway).

We have to read, ask questions and be helped along our rocky road until we feel well again and are on the correct dose plus all vitamins/minerals have to be checked.

You should request B12, Vit D, iron, ferritin and folate. We have to take of our own body/health into our own hands as it seems we are failed by many medical professionals who don't look further than a TSH result.

[fuchsia-pink]

You are probably under-medicated - and hence suffering form "brain fog". Please ask your GP (or receptionist) for the actual blood results, and post them here - as a new post. Don't be fobbed off by "normal" or "in range" - you are aiming for much better than that - you want "optimal" - and for that you need the actual results, and reference ranges [which vary from lab to lab].

As shaws says, you are only on a "starter" dose of levo at the moment ...

It's quite likely that your GP is doing the minimum of testing - TSH and if you're lucky free T4. Can you treat yourself to a full set of blood tests - TSH, free T4, free T3, thyroid antibodies, ferritin, folate, vit D and B12? Then you will get the full picture.

Good luck x

[Marz]

If you click onto bellsjet you will find your post of two years ago. Lots of helpful Replies which still apply - saves me typing it all again 🌻

So important to have B12 tested along with Folate - Ferritin and VitD. Low B12 can cause memory issues as well as low T3 ..

[SlowDragon Administrator]

50mcg levothyroxine is only a starter dose

Bloods should be retested 6-8 weeks after each dose increase

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

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)

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 vitamins including folate (private blood draw required)

medichecks.com/products/thy...

Thriva Thyroid plus antibodies and vitamins By DIY fingerpick test

thriva.co/tests/thyroid-test

Blue Horizon Thyroid Premium Gold includes antibodies, cortisol and vitamins by DIY fingerprick test

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

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...