What is my next step and what will happen. Is this the beginning of cancer???
Goodness me, don't go worrying about cancer, where did you get that idea from?
You are simply undermedicated to have such a high TSH. The aim of a treated Hypo patient on Levo only, generally, is for TSH to be 1 or below with FT4 and FT3 in the upper part of their reference ranges.
As those results were from January, what did your GP do about them? He should have increased your Levo by 25mcg immediately and retested in 6-8 weeks. If nothing was done then I'd go back to your GP to bring this up now and ask why this over range TSH was ignored.
As you've just had another test, did you ask for all those mentioned in reply to your previous post here:
If GP can't get them all done then do them with a private test as suggested. You will then get a full picture and we can guide you on how to move forward. And please stop worrying about cancer.
Post whatever results, with reference ranges, come back from your new test for members to comment.
I’m not surprised you are feeling unwell Carol, as you are under medicated. When my medication is not optimal, my anxiety increase and I worry my symptoms may be more sinister than they are... please don’t over worry. Focus on get your thyroid medication and key vitamins (ferritin, folate, vit D) optimal.
The aim of levothyroxine is to increase dose upwards in 25mcg steps until TSH is ALWAYS under 2
When adequately treated, TSH will often be well under one.
Most important results are ALWAYS Ft3 followed by Ft4. When adequately treated Ft4 is usually in top third of range and Ft3 at least 60% through range (regardless of how low TSH is)
Extremely important to have optimal vitamin levels too as this helps reduce symptoms and improve how levothyroxine works
Ask GP to test vitamin D, folate, ferritin and B12
As you are currently under medicated your vitamin levels may be low
Dose levothyroxine is increased slowly upwards in 25mcg steps. Retesting bloods 6-8 weeks after each dose increase
75mcg is only one step up from starter dose
Unless extremely petite most people are on at least 100mcg levothyroxine per day, or often higher doses
Approx how much do you weigh in kilo?
guidelines on dose levothyroxine by weight
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.
Which brand of levothyroxine are you currently taking
Many people find different brands are not interchangeable
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
Ask GP to test vitamin levels (and thyroid antibodies if not been tested)
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)
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Results, very low TSH
TSH, FT3 & FT4 results
Differing TSH results
TSH results and medication problems
Latest tsh results 36.52
