I would like to thank you all in advance for your help! This forum is amazing and I feel this is a great way of supporting each other.
I’m a 34 year old women who just been diagnosed with hypothyroidism. But my blood results are not “typical”. And I would like some advice.
I have started recently Levothyroxine (50), after the blood test. And I had an app with and endo this week, which was highly disappointing. He asked me a lot of questions and just requested more blood test.
Please give me your opinion on what should I do now (do a private blood test, ask for other tests, etc) based on these infos.
Thank you!
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Prilver
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Igennus Super B is good quality and cheap vitamin B complex. Contains folate. Full dose is two tablets per day. Many/most people may only need one tablet per day. Certainly only start on one per day (or even half tablet per day for first couple of weeks)
Or Thorne Basic B or jarrow B-right are other options that contain folate, but both are large capsules
If you are taking vitamin B complex, or any supplements containing biotin, remember to stop these 7 days before any blood tests, as biotin can falsely affect test results
Thyroid levels should be retested 6-8 weeks after each dose increase in levothyroxine
Dose levothyroxine is stepped up slowly in 25mcg steps. Most people need to increase until on something around full replacement dose of 1.6mcg per kilo of your weight
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.
Important to test Ft4 and Ft3 at each test. NHS rarely tests Ft3, so thousands of U.K. patients forced to get full thyroid testing privately
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)
Thriva Thyroid plus antibodies and vitamins By DIY fingerpick test
With such a low FT4, one would expect a much higher TSH. Pity they didn't test your FT3, but still, these results look rather like Central Hypo, where the problem lies with the pituitery (Secondary Hypo) or the hypothalamus (Tertiary Hypo) rather than the thyroid itself.
To diagnos that, a lot more tests are necessary. Without knowing which tests your endo has suggested, it's impossible to say if that's the line he's following. But, at this point, there's not a lot more he can do except give you levo.
Welcome to our forum. If you'd like to become a member of Thyroiduk.org.uk this is the organisation behind this forum. It was started by Lyn Mynott when she had difficulties and the office is in her garden and she and her two staff work hard doing all of the background work necessary to try to change attitudes of the medical professionals.
The more members TUK have, the stronger our voices. A short time ago she had a meeting at the House of Lords about the withdrawal of T3 from hypo patients which was done without any notice at all which caused immense worry and stress.
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