Increase Levo or not? : Hi all, Further to my... - Thyroid UK

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Increase Levo or not?

Chris1802p profile image
9 Replies

Hi all,

Further to my recent posts, following on from hemi-thyroidectomy, I’ve now been on 75mg Levo for 7 weeks. These are my results today.

I think I’m feeling a bit better, although I have psoriatic arthritis so it’s a bit difficult to tell in terms of fatigue etc- I do still have symptoms.

I think I would have a battle on my hands to get my dose increased to 100mcg- would it be ok to just stay on this dose and see how things go?

I would like my thyroid levels to be really optimal, but my GPs just don’t get that at all and would probably refuse an increase.

I am supplementing Vit d, K2, magnesium and B12 at levels recommended here, and will recheck those in a few months.

Any advice welcome and thanks in advance.

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9 Replies
SlowDragon profile image
SlowDragonAdministrator

Just testing TSH and Ft4 is completely inadequate

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

Presumably you have Hashimoto’s?

Ask GP to test vitamin levels (And 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...

Come back with new post once you get full results

If currently taking any supplements that contain biotin (eg vitamin B complex) remember to stop these a week before ALL BLOOD TESTING

SlowDragon profile image
SlowDragonAdministrator

Are you on strictly gluten free diet?

Chris1802p profile image
Chris1802p in reply toSlowDragon

No I’m afraid not, I am wrestling with my diet somewhat lately.

My GP surgery will not do the full range of blood tests, they say it’s not necessary as my thyroid results are ‘normal’.

I cant’t afford to get the full range done privately very often. I had to get this one privately as my surgery just tested TSH despite asking for TSH, FT3 and FT4.

I’ve had Thyroid antibodies tested several times in the past and they have never been raised.

SlowDragon profile image
SlowDragonAdministrator in reply toChris1802p

So very unlikely to have had both TPO and TG antibodies tested....as NHS only tests TG antibodies if TPO antibodies are high

Significant minority of Hashimoto’s patients only have high TG antibodies

20% of Hashimoto's patients never have raised antibodies at all

healthunlocked.com/thyroidu...

Paul Robson on atrophied thyroid - especially if no TPO antibodies

paulrobinsonthyroid.com/cou...

Chris1802p profile image
Chris1802p in reply toSlowDragon

This was my antibody result 9 months ago-

Thyroglob ABs: 85.4 (<115)

Thyr Peroxidase ABs: 9.86 (<34)

I have had them both tested on at least two other occasions as well and they’ve been negative.

After my partial thyroidectomy the remainder stubbornly refused to start working again. I had no levo at all. Took nearly 3 months but it then worked wonderfully for 15 years. Towards the end of 3 months doc was about to give me levo and suggested first I should take some Orovite tablets, concentrated B and C vitamins. These used to be only available on prescription, they are genuinely great IF you need them. They should work within a week.

They worked excellent and gave me the best health I had had for many years previous.

Suggest you try some but not normally stocked by a pharmacy, OK from Amazon.

Chris1802p profile image
Chris1802p in reply to

Thanks for replying.

I’m happy to be on Levo, my thyroid was struggling even before the op, I’m just having trouble trying to get to the correct dose.

jrbarnes profile image
jrbarnes

I had the same procedure thirteen years ago and prior to it the only symptom I had was fatigue and hypoglycemia. I functioned normally for a few years without meds after the procedure before the fatigue returned and my TSH was 5. It wasn't doing a great job. I found my perfect dose was between 75 and 100mcg (75+12.5). I'm in the US so I'm not sure if you have an 88mcg dose available. I took Levothyroxine successfully for several years but I had to be at the very very top of FT4 to feel normal. My FT4 levels were always flagged high yet my actual thyroxine levels were well within safe limits. I've had a lot of problems over the past three years because a small decrease in my T4 brought my T3 levels way down below optimal. I'm currently trying a lesser potent name brand T4 and a little T3, after searching for a Dr that would prescribe it.

Is it possible you can stress to your GP that not feeling well is affecting your ability to work and take care of basic needs? You may have to remind these people that the purpose of thyroid medication is to feel normal and functional again. I've had to get a little pushy with Doctors. Perhaps, your GP would be open to an increase of 12.5 mcg of Levo? I lost about four years of my life being kept undermedicated. My advice is that you're going to have to take charge of your thyroid management because a lot of Doctors in any system are just going through the motions but this is your life! You cannot be passive with them.

Chris1802p profile image
Chris1802p in reply tojrbarnes

Many thanks for this... you’re right and this is a really helpful reply. Glad you’re ok now 👍

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