New results after 25mcg of Levothyroxine

[SummerJessica]

So approximately 6 weeks on 25mcg of Levothyroxine and my results of my TSH and T4 have came through from my GP.

On 14th January my TSH was 6.01

My T4 was 118n/mol

Unfortunately they didn't test anything else.

I haven't spoken to my GP yet, but not sure what this all means. I also took high doseage Vitamin D for 6 weeks and am now on daily Vitamin D.

Does this mean I need Levothyroxine or will they stop it? He was reluctant to prescribe it as my bloods didn't show stereotypical hypothyroidism.

Thanks

[greygoose]

Well, your TSH is still too high, saying that you are still hypo. Which isn't surprising given the miserable small dose your doctor put you on! 25 mcg is for the very young, the very old or those that have a heart condition. 50 mcg is a normal starter dose.

Your FT4 is 51.25% through the range, which is probably too low. But it's very likely that the TSH is still too high because your FT3 is still low. But, they rarely test that because they don't understand, and don't want to know, the results.

When you see your doctor - or speak to him - fight tooth and nail to hang on to your levo - because you are hypo, no doubt about that! And, you do need levo. What's more, you need an increase to bring that TSH down to 1 or under - which is what a euthyroid TSH would be. A TSH over 3 is hypo.

[SummerJessica in reply to greygoose]

To be honest I haven't noticed a huge change in my symptoms either. I'm still tired all the time, back to getting raynauds symptoms, hair constantly breaking, my periods have became even more irregular (although do suffer PCOS), constipated, my nails are still weak too, and my skin is so dry! I had hoped some of these symptoms would improve

[greygoose in reply to SummerJessica]

Well, of course, you wouldn't notice a huge change in your symptoms. Not on 25 mcg levo. It's not enough. And they will improve when you get on a high enough dose.

Wait for a bit and see what he says - IF he says anything. If he doesn't, by all means insist on an increase in dose! He shouldn't have started you on such a small dose in the first place. It's his fault if you feel no improvement.

[SummerJessica in reply to greygoose]

Would it be worthwhile asking him to increase the dose? It seems such a small amount and although my TSH has lowered, symptom wise I haven't noticed much difference.

[lisabax in reply to SummerJessica]

Grey goose is right, you need a higher dose and unless you are in one of those at risk categories, you should have been started at 50. Since your doctor has pronounced these as normal, you may have to fight for an increase or see another doctor.

[Venicefan]

The current NHS guidelines say that patients should be started on a full therapeutic dose of levothyroxine which equates to 100mcg of levothyroxine for a 60kg woman (this should be adjusted for weight) unless over 60 or suffering from heart disease.

Here’s the link to the guidelines. ( you may need to paste it into your browser to get the full article)

gp-update.co.uk/Latest-Upda...

If you show this to your GP, you may be able to convince him to increase your dose.

[Hashihouseman]

You need to know your ft3 together with tsh and ft4 .... the time of day you do the blood test affects tsh in particular. While it seems you are under-medicated, adding ft3 and repeat testing over a few months is what’s needed; a snapshot here or there isn’t good diagnostic practice. And it’s worth noting that euthyroid tsh can swing between 0.75 and 3 depending on the time of day and the individual’s personal thyroid characteristics. TSH of about 1 is a kind of healthy average but a test showing anything between 0.75 and 3 doesn’t tell you what your average is! In other words we may bandy around the aim for 1 or less TSH approach on here but that doesn’t account for the variables of testing even in a healthy body. You need a consistently timed spread of ft4 ft3 and tsh tests plus symptoms diary to diagnosis better. That said the snapshots you’ve described do suggest ongoing hypothyroidism and the doctors should respect your symptoms and not slavishly or blindly follow the doctrinaire attitude of it’s ok if you’re in the lab range - that’s utter cobblers!

[SummerJessica]

Thanks everyone. My bloods were taken at 9.15am and I fasted from 10pm the night before. I haven't spoken to the GP yet but have renewed my prescription at 25mcg anyway as I've ran out and hopefully when I speak to him I can ask for an increase in dose. I may have to go private to get my FT3 tested again. I had hoped that they would do a full panel after trialing me on Levothyroxine, but clearly not. You would have thought they had wanted a complete picture. My FT3 on 14th Jan was 4.7 pmol/L

[Jollypolly]

Definitely get onto 50 Levo ASAP ... give it a few weeks on that and then see how you feel