For full Thyroid evaluation you need TSH, FT4 and FT3 tested. Also EXTREMELY important to test vitamin D, folate, ferritin and B12
Low vitamin levels are extremely common, especially as you have autoimmune thyroid disease (Hashimoto's) diagnosed by raised Thyroid antibodies
Ask GP to test vitamin levels or test privately
Good you did test as Recommended on here...... 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.
Private tests are available as NHS currently rarely tests Ft3 or all relevant vitamins
These are GP results have done Medichecks well woman and will do again but want to continue to get NHS to test as well as and they as you know don't usually test T3 or vitamins unless absolutely necessary in their opinion.
Yes taking good quality B complex as advised and stopped prior to blood draw by GP
Yes taking oral Vitamin D K.
Haven't done Coeliac test next on list.
Not strictly but trying to eliminate Gluten.
I was trying to ascertain whether the lowered GP results TSH and increased every so slightly T4 were adequate or whether I should be pushing to have another increase?
If not eating high level of gluten there’s not much point testing for coeliac
Highly likely you need to increase dose levothyroxine up to 75mcg
Might need to get TSH, Ft4 and Ft3 tested privately first
See GP and request 25mcg dose increase ....see if you can get dose increase
Print out these guidelines to take along ...perhaps only produce them if GP refuses
guidelines on dose levothyroxine by weight
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 or near 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.
I've already purchased Medi check Thyroid panel. How do we know when we are near full replacement dose? I know the guidelines say dosing for weight but they are guidelines I'm a bit confused as to how I know when I have reached optimal. I felt awful when I was first put on 25mcg so after the 8 weeks I argued that it should be increased. I do feel better than I did now that I am on the 50mcg.
On weight calculation I should be on 118 so rounded up 120 so I think I will take the medicheck to see what my T3 is and then come back and post the result to ask for more advice which is always greatly received and appreciated.
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Thyroid results and B12 improvement, but could I still have anaemia?
Low TSH on no meds - should I be concerned or not?
Shouldn't my TSH have lowered?
Still have symptoms but TSH is supposedly normal
Fluctuating TSH should I increase meds
