Hi all, I was diagnosed with hypo a year ago with TSH 10.7 and my GP prescribed 25mg Levo that was later increased to 50mg.
A month ago I did bloods for TSH and T4 only and the results were TSH 4.2 and T4 17 and they didn't give me any ranges. GP said they were normal and kept me on 50mg.
I was completely clueless until I started reading this forum a couple weeks ago. It has already helped me a lot to understand what's going on with my thyroid. I did new bloods with Medichecks, this time in the morning on an empty stomach 24h after Levo.
TSH 9.65 (0.27 - 4.2) wow what a difference
FT3 4.26 (3.1 - 6.8) 31% through range
FT4 16.6 (12 - 22) 46% through range
TgAb 405 (0-115)
TpoAb 357 (0 - 34)
Apparently I have Hashimoto's and my GP never bothered to check. I'm thinking of going gluten free. Will it make sense at all given that I don't have any obvious digestion issues?
Folate 13.38 (3.89 - 19.45)
B12 active 132 (37.5 - 187.5)
D3 71.2 (50-175)
I take 1000iu D3 + K2 + magnesium glycinate, and a B complex with Folate and B12 methylcobalamin in it.
Ferritin 24.5 (13 - 150)
I'm worried about this one, it looks very low in range. Medichecks doctor commented on it and said I'd better get it up to at least 27. But I don't understand where to start, should I check iron too?
From what I was able to grasp so far, it seems to be a good idea to push the Dr to prescribe a higher dose of Levo first. Or should I try to fix my Ferritin first? I also switched my Levo dose to bedtime, hopefully it will help.
Any advice and comments greatly appreciated.
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Purple_Green
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See/contact GP Monday you need 25mcg dose increase in levothyroxine up to 75mcg daily
Bloods should be retested 6-8 weeks after EACH dose increase
Which brand of levothyroxine are you currently taking?
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
But for some people (usually if lactose intolerant, Teva is by far the best option)
Teva, Aristo and Glenmark are the only lactose free tablets
Most easily available (and often most easily tolerated) are Mercury Pharma or Accord
Note Accord is also boxed as Almus via Boots, and Northstar 50mcg and 100mcg via Lloyds ....but beware 25mcg Northstar is Teva
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
Remember to stop taking vitamin B complex a week before ALL BLOOD TESTS as biotin can falsely affect test results
Also coeliac blood test too BEFORE starting on strictly gluten free diet
If coeliac test is positive you will need to continue eating gluten until endoscopy
Low ferritin
Eating iron rich foods like liver or liver pate once a week plus other red meat, pumpkin seeds and dark chocolate, plus daily orange juice or other vitamin C rich drink can help improve iron absorption
This is interesting because I have noticed that many patients with Hashimoto’s disease and hypothyroidism, start to feel worse when their ferritin drops below 80 and usually there is hair loss when it drops below 50.
Thyroid disease is as much about optimising vitamins as thyroid hormones
Thanks a lot SlowDragon for your reply and links! I found a coeliac home blood test from Lloyds, will check it and fingers crossed I'm not positive.The Levo brand I'm taking is Almus, it seems fine. I'll watch out for Teva.
I'm worried about this one, it looks very low in range. Medichecks doctor commented on it and said I'd better get it up to at least 27. But I don't understand where to start, should I check iron too?
Your ferritin is very low in range. I don't agree with the Medichecks doctor about 27, that is still very low. Low ferritin can suggest iron deficiency or iron deficiency anaemia. To find out you'd need an iron panel (would show iron deficiency) and a full blood count (would show anaemia). You could ask yourGP to do these, no guarantee that he will.
Ferritin is recommended to be half way through range (GP wont agree, they just go by any number that is in range then it's OK!) and according to some articles, the optimal ferritin level for thyroid function is between 90-110 ng/ml.
If you experience any of these it might be useful to list them to discuss with your GP if asking for further testing.
D3 71.2 (50-175)
I take 1000iu D3 + K2 + magnesium glycinate
Your Vit D level could be higher, the Vit D Society and Grassroots Health both recommend a level of 100-150nmol/L and personally I aim for the top end of this range, particularly at the moment with the Covid problem. I would be taking 2,000-3,000iu D3 with that level.
From what I was able to grasp so far, it seems to be a good idea to push the Dr to prescribe a higher dose of Levo first. Or should I try to fix my Ferritin first?
You definitely need an increase in your dose of Levo so I would sort that now, and I would work on ferritin at the same time as it's important to get that up. Recheck everything in 3 months to see how things are going.
I also switched my Levo dose to bedtime,
2-3 hours after evening meal, 4 hours away from magnesium and D3 and 2 hours away from any other supplement? If you are prescribed iron tablets, these also need to be 4 hours away from Levo.
Many thanks SeasideSusie for your advice! Such a massive help. Hopefully I convince my GP to do the iron panel because these symptoms are so me! Yes, I try to keep track of the time gaps before my bedtime Levo, seems to work well so far.
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