I had a phone consultation with my doctor so had no results to ask about, have just seen them online. My TSH is 17 so high, my free T4 is 12.5 which my doc says is normal. He has prescribed levothyroxine 50mg, Have had very few symptoms and was surprised when he told me i was hypothyroid, and the only difference it has made is that I feel much warmer and i have had a few nights when i could not sleep til after midnight. So i am confused and wondering what to do next. If my T4 is fine why did the doctor prescribe more T4. And I only went to the doctor to see if i had sleep apnea!
thanks Chris
Written by
krisneptune
To view profiles and participate in discussions please or .
When the doctor says FT4 is fine, it means it is within the lab range. Without seeing the actual lab range I can't say how low in the lab range your FT4 is but usually the bottom of the range is around 11 or 12 and top of range around 19 or 20. It's very likely that your FT4 is right at the bottom of the lab range indicating that you do not have enough thyroid hormone in store for your body to use, hence your elevated TSH. Your pituitary gland is signalling for your thyroid to produce more thyroxine and it's working overtime and can't cope. So your doctor is right to prescribe levothyroxine to replace the Thyroid hormone your thyroid can't produce.
You're lucky not to have symptoms but it will impact your organs if left untreated.
Some people don't have symptoms at first and I think it took years before I realised what was going on with my thyroid. My GP showed me a graph of my TSH getting lower and lower until it became suppressed over many years. I of course was unaware of this because I never knew anything about thyroid disease. I think you are lucky this has been treated before you start to feel really ill because I was left untreated for several years and it took me years to regain my health.
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
At next test 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)
Private tests are available as NHS currently rarely tests Ft3 or thyroid antibodies or all relevant vitamins
If TPO or TG thyroid antibodies are high this is usually due to Hashimoto’s (commonly known in UK as autoimmune thyroid disease).
About 90% of all primary hypothyroidism in Uk is due to Hashimoto’s. Low vitamin levels are particularly common with Hashimoto’s. Gluten intolerance is often a hidden issue to.
Hi Slowdragon, very comprehensive reply, thanks. I have another blood test in 2 weeks unfortunately my first test did not have free T3, so cannot campare, but think i need T3 and the both antibodies done to see what is going on. Will see what doc says about testing for other things, the only other was vit d which was at the top of the range. Apnea is one of the symptoms and my snoring has gone from 2.5 hours to 1 hour so far.
You say you went to the doc because you thought you had sleep apnoea, so are you tired, do you feel that you need sleep, even after a ‘good night’s’ sleep? Feeling tired is a symptom of an under active thyroid. And here’s a potentially rude question, are you overweight or have you put on weight recently? The overweight bit is related to sleep apnoea, but that and putting on weight are under active thyroid symptoms also.
The only symptom I noticed at first was tiredness, my TSH wasn’t anywhere as near as high as yours but my T4 was under range, and as the tiredness crept up I didn’t even realise how tired I’d been until I wasn’t allowed to give blood one time.
H Beads, thanks for the reply, yes i am very tired in the afternoons, would fall asleep sitting down on a sofa very easily. I have put on a bit of weight, but not much, started low carb a few years ago and lost a lot of weight, but think i have put all back on. Not being able to give blood must have been a shock.
I didn't think I had any symptoms but now realise I did. Snoring, itchy stomach, puffy face, weight gain, tiredness and anxiety. If you are being treated - your TSH should be under 1.
Most people find that they have hashis which means your levels can go up and down.
You'll need to increase your dose gradually but most people end up higher than 50 which is a starter dose.
You can get a medical exemption certificate from your doctor as your prescriptions will now be free. Also if you haven't already, most GPS now have an app where you can order repeat prescriptions to a named pharmacy and dependent on the access allowed also see test results - just saves time.
I've been fine on Levo. I just take 100 every day, with extra 25 on mon, wed and Friday. Always at least 45 mins before breakfast or coffee etc.
Also, I found it worthwhile having vitamins checked, my vitamin D was very low. Sometimes, you can find that your vitamin absorption isn't very good.
Many people find Levothyroxine brands are not interchangeable.
Many patients do NOT get on well with Teva brand of Levothyroxine. Teva contains mannitol as a filler, which seems to be possible cause of problems. Teva is the only brand that makes 75mcg tablet. So if avoiding Teva for 75mcg dose ask for 25mcg to add to 50mcg or just extra 50mcg tablets to cut in half
Are you currently taking Teva?
Teva, Aristo and Glenmark are the only lactose free tablets
Physicians should: 1) alert patients that preparations may be switched at the pharmacy; 2) encourage patients to ask to remain on the same preparation at every pharmacy refill; and 3) make sure patients understand the need to have their TSH retested and the potential for dosing readjusted every time their LT4 preparation is switched (18).
Levothyroxine is an extremely fussy hormone and should always be taken on an empty stomach and then nothing apart from water for at least an hour after
Many people take Levothyroxine soon after waking, but it may be more convenient and perhaps more effective taken at bedtime
No other medication or supplements at same as Levothyroxine, leave at least 2 hour gap.
Some like iron, calcium, magnesium, HRT, omeprazole or vitamin D should be four hours away
(Time gap doesn't apply to Vitamin D mouth spray)
If you normally take levothyroxine at bedtime/in night ...adjust timings as follows prior to blood test
If testing Monday morning, delay Saturday evening dose levothyroxine until Sunday morning. Delay Sunday evening dose levothyroxine until after blood test on Monday morning. Take Monday evening dose levothyroxine as per normal
Hi SlowDragon, thanks for the reply, i have 2 brands, Murcury and Actavis, but it has Accord on the strip. I retired in March this year, from being a pharmacist, so I have had lots of customers asking for specific brands, sometimes this was easy, sometimes impossible and time consuming, will be interesting from the other side. Am having another blood test soon, so will take into account when to take my last dose. Thanks Chris
Content on HealthUnlocked does not replace the relationship between you and doctors or other healthcare professionals nor the advice you receive from them.
Never delay seeking advice or dialling emergency services because of something that you have read on HealthUnlocked.
First Post on Thyroid
Further to my last post about Levo and joint pain I now need help to understand my blood results.
Hi, This is my first post, what do others think about GP Secretary contacting me with information, GP not seen!
I increased my meds myself.
Following on from my last post….. 
