Feeling Tired...

[Chicadee16]

I have had my first set of blood tests after diagnosed with Hypothyroidism. Really pleased all was normal, but Im still feeling tired after any physical exertion over an hour or so. Is this normal? Does anyone else find their stamina is affected despite taking the medication as prescribed?

[greygoose]

It's not about just taking the medication as prescribed. It's about taking the right amount. When a doctor says 'normal', all he means is 'in-range'. But, 'in-range' isn't always good enough, because the ranges are so wide. You need the actual numbers: results and ranges. Ask at reception for a print-out. If you live in the UK, it's your legal right to have one.

How much levo are you taking? You're more than likely under-medicated if you've just started out.

[Chicadee16 in reply to greygoose]

My TSH level was TSH level 0.56 mu/L

I will ask for a print out although I wont understand it!

Im on 100mg

Another question I have: do the GP's automatically recall you for a yearly test or do you have to ask for it?

[greygoose in reply to Chicadee16]

You don't have to understand it, you've got us! We understand it. lol

If all your doctor is testing is the TSH, then that is totally inadequate. It only tells you about ond fifth of the story.

Your TSH, there, looks fine. But TSH is not a thyroid hormone, it is a chemical messenger between the thyroid and the pituitary. It does not tell you the levels of your thyroid hormones - your T4 and T3 could still be too low.

100 mcg is not a large dose. It's not much more than a starter dose. Were you started on 100 mcg? Or did you work up to it?

I'm afraid I don't know if GPs in the UK recall you automatically, I don't live there. But, from what I've read on here, some do and some don't.

[Chicadee16 in reply to greygoose]

Many thanks for your help. I was started on 100mg. Have been taking it for 3 months only. So I should ask for T4 and T3 and vitamins and antibodies to be tested, is that correct?

[greygoose in reply to Chicadee16]

It should have been retested six weeks after starting on it. That's how long the body takes to process it. So, yes, you do need all those tests done, but if you're in the UK, I doubt you'd get them all done on the NHS.

[Chicadee16 in reply to greygoose]

It was tested after 8 weeks but only blood sugar, cholesterol and TSH.

Ive read before that the NHS wont test routinely but I will ask!

[greygoose in reply to Chicadee16]

Was the cholesterol high? If so, your FT3 is more than likely low.

[Chicadee16 in reply to greygoose]

Heres my cholesterol report:

Serum lipid levels

Serum cholesterol level 6.7 mmol/L [3.1 - 6.5]

Above high reference limit

Serum LDL cholesterol level 4.5 mmol/L

Serum HDL cholesterol level 1.31 mmol/L [1.1 - 1.8]

Serum cholesterol/HDL ratio 5.1

Serum triglyceride levels 2.0 mmol/L [0.2 - 2.0]

Non-HDL Cholesterol 5.39 mmol/L

[greygoose in reply to Chicadee16]

Hardly worth worrying about. I hope your doctor didn't want to put you on statins!

[Chicadee16 in reply to greygoose]

Whats Ft3?

[Chicadee16 in reply to greygoose]

No statins! Sorry I think I know that Ft 3 is T3?

[greygoose in reply to Chicadee16]

T3 is the hormone, FT3 is the blood test.

There are two blood tests for T3: FT3 and TT3. FT3 is the most important.

[Chicadee16 in reply to greygoose]

Many thanks for clarity x

[greygoose in reply to Chicadee16]

You're welcome.

[SlowDragon Administrator]

How much levothyroxine are you currently taking?

Do you always get same brand of levothyroxine

How long have you been on this dose

Standard starter dose of levothyroxine is 50mcg and dose is typically increased slowly upwards in 25mcg steps

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

What vitamin supplements are you currently taking?

Low vitamin levels are extremely common, especially if you have autoimmune thyroid disease (Hashimoto's) diagnosed by raised Thyroid antibodies

Do you have Hashimoto’s?

Ask GP to test vitamin levels and thyroid antibodies if not been tested yet

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)

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...

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

Thriva also offer just vitamin testing

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...

Can you add the actual results and ranges of recent tests

[Chicadee16 in reply to SlowDragon]

Im on 100mg, always the same make. Dont know what Type of thyroidism I have...the Go didn't tell me, or doesn't know.

What will thyroid antibodies test tell me?

Here are the only result figures I have

TSH level 0.56 mu/L

[SlowDragon Administrator in reply to Chicadee16]

How long have you been on 100mcg

When were levels last tested?

About 90% of primary hypothyroidism is due to autoimmune thyroid disease

You are legally entitled to printed copies of your blood test results and ranges.

The best way to get access to current and historic blood test results is to register for online access to your medical record and blood test results

UK GP practices are supposed to offer everyone online access for blood test results. Ring and ask if this is available and apply to do so if possible, if it is you may need "enhanced access" to see blood results.

Link re access

healthunlocked.com/thyroidu...

In reality many GP surgeries do not have blood test results online yet

Alternatively ring receptionist and request printed copies of results. Allow couple of days and then go and pick up.

Important to see exactly what has been tested and equally important what hasn’t been tested yet

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 and thyroid antibodies if these haven’t been tested yet

Come back with new post once you get full thyroid results and vitamin results

[Chicadee16 in reply to SlowDragon]

Ive been on 100gm since July 14/2020 Ive only just been diagnosed.

I didnt realise that 90% of people have Hashimoto's!

I do have online access to my blood tests, and it says:

TSH level 0.56 mu/L....before I started the drugs it was 75

They also tested for cholesterol and blood sugar which are both normal.

No other tests were done.

Will the GP know from these tests if I have Hashimotos?

[SlowDragon Administrator in reply to Chicadee16]

No, not unless they tested

TSH of 75 was high

Ask that they test vitamins and thyroid antibodies

Ask for ultrasound scan of thyroid too

[Chicadee16 in reply to SlowDragon]

Many thanks xx

[SlowDragon Administrator in reply to Chicadee16]

20% of Hashimoto's patients never have raised antibodies

healthunlocked.com/thyroidu...

Paul Robson on atrophied thyroid - especially if no TPO antibodies

paulrobinsonthyroid.com/cou...

On plus side ....seems patients who get diagnosed with high TSH often make good recovery, easier than those who’s TSH doesn’t react so well

[Chicadee16 in reply to SlowDragon]

Can you tell me what the high levels of TSH signify pls, to your understanding?

[SlowDragon Administrator in reply to Chicadee16]

TSH is the message from pituitary telling thyroid to increase output of thyroid hormones

Your TSH response is working well

Link about thyroid blood tests

thyroiduk.org/getting-a-dia...

You need TSH, Ft4 and Ft3 tested together,....testing as early as possible in morning before eating or drinking anything other than water and last dose levothyroxine 24 hours before test

Is this how you did most recent test

Also need both TPO and TG thyroid antibodies and vitamins tested