I am a 30 yr old usually healthy female, you may see in my previous posts that I’ve had an ongoing problem with my thyroid for probably a good 10 years now with my levels going up and then back to normal or borderline over the years, never warranting further investigation by my doctors.
Around a month ago i was tested and my TSH was slightly high at just over the normal range at 4.4 if i remember correctly. I was tested again on 18th August and it was high at 5.93 had another blood test the day after due to breathing problems and it had gone up to 8.77 in 24 hours!!!
Can this happen to thyroid, it seems to go up and down with it fluctuating regularly. But after my ongoing battle of literally years i finally today have been given levothyroxene!
You don’t know how much of a relief that is that they’re listening.
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Coop20
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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 at next test and thyroid antibodies
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
As SlowDragon has said, having only a TSH test is not a lot of good, you need the full range of tests. Also treating using the TSH alone will not get you well nor keep you well.
Thanks, i did have the full tests and have attached the lower result that i have for Tuesday as i don’t have the others from the hospital yet, it included antibodies which were both normal.
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
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.
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.
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