Your TSH was extremely high at diagnosis and Ft4 extremely low
Male and 6.1 and around 16st 5
You still have several dose increases still to go
Get next 25mcg dose increase in levothyroxine up to 125mcg
Looking at previous posts you are taking Accord levothyroxine. (Also boxed as Almus and Northstar)
Accord don’t make 25mcg tablets. Ask GP for prescription for 50mcg tablets and cut in half to get 25mcg
Thyroid levels should be retested 6-8 weeks after EACH dose increase
guidelines on dose levothyroxine by weight
16 stone 5 pounds = 103.8 kilo
104 x 1.6= 166mcg levothyroxine as the likely daily dose required
Even if we frequently 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 eventually 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.
Have you had vitamin D, folate, ferritin and B12 levels tested yet
Or thyroid antibodies and coeliac blood test?
Low vitamin levels are extremely common when hypothyroid and improving low vitamin levels helps how levothyroxine works and improving low vitamin levels can significantly improve symptoms
Bloods should be retested 6-8 weeks time....and you will be ready for next increase by then
If not done so already, get a weekly pill dispenser so that it’s easy to see if you have forgotten daily tablets (and put the cut half tablet in next days slot)
I've had my tsh shoot up whenever my ferratin goes down and improve when the ferratin increased. As slow dragon suggested try to get ferratin, b12, iron, vit d, folate tested.
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