TSH increasing despite levothyroxine

[Scottifi]

Hi had my 8 weekly blood test and my TSH is 8.08, last test was 5.0. My free T4 is 11.8. The biochemist has commented about poor compliance, malabsorption or other medicines. I take 150mcgs of levothyroxine every morning at least an hour before food and don’t take any other medications. The only time is missed was the morning of my blood test. So do I need more levothyroxine am on 1.5 mcgs/kg. Or is the levothyroxine not working anymore. Vitamins FBC all normal

Thanks again for the support.

[fuchsia-pink]

Yes, you need more meds. There is reference here to a starting dose of 1.6 mcg per kg - but (a) you're on less than that and (b) it's a starting dose ...

If your key nutrients are good, you are unlikely to feel well until TSH is less than 2 and probably less than 1 and both free T4 and free T3 are nice and high. So I'd add an extra 25 mcg a day of levo if it were me x

[Scottifi in reply to fuchsia-pink]

Thank you I have gone to 175mcg from today and will just tell the GP what I have done, just saw my blood results on my NHS app and they have labelled the result borderline.

[Buddy195 Administrator]

I definitely think you need an increase in Levo. Have the symptoms you posted about a few months ago subsided at all? How are you feeling now?

[Scottifi in reply to Buddy195]

I am not really any different, bit less tired! But thanks for asking.

[shaws Administrator]

You need an inrease in dose. The aim being a TSH of 1 or lower with both FT4 and FT3 in the upper part of the ranges. The latter two are rarely tested and we need regular increases - not kept somewhere within the ranges.

I think the majority of GPs think that 'anywhere' in the range is fine and as they know no clinical symptoms.

I doubt they are aware that symptoms are not relieved we're underdosed.

[Vw68 in reply to shaws]

I have just spoken to my GP about my latest results. My TSH is 2.41 and T4 17.1, no T3 tested. I am on 50mcgs of levothyroxine after a 3 month trial of 25mcgs which shot my TSH up to 17. He says my levels are fine. My hypothyroidism is post RAI some 6 years ago. I think I should increase my levothyroxine to 75mcgs and maybe I will feel better? Feel brain fog and heavy.

[shaws Administrator]

You take your dose one hour before food but do you wait an hour after the dose before eating?

[Scottifi in reply to shaws]

Yes try too.

[shaws Administrator in reply to Scottifi]

Food can interfere with the uptake of your thyroid hormones. You can take your dose early a.m. when you awake and wait an hour before eating. or

take dose at bedtime - as long as stomach is empty (about 2 or 3 hours after eating).

[SlowDragon Administrator]

Are you always getting same brand levothyroxine?

Your low Ft4 shows dose is inadequate

Could be poor absorption.

Think you already had coeliac blood test done?

Have you tried absolutely strictly gluten free diet

[Scottifi in reply to SlowDragon]

Yes now on accord alums as have moved pharmacies. No never had a coeliac test done but will ask. Thanks

[Scottifi in reply to Scottifi]

Almus