Continued T3 3.8 ( 3.1 - 6.8)
Following on from my last post I can’t seem to ... - Thyroid UK
Following on from my last post I can’t seem to upload the photos but the results are TSH - 0.81 range 0.3 - 5.5 T4 - 17 (10 - 22) T3 3.8 (3.
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Runner25
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SlowDragonAdministrator
Was this test done as early as possible in morning before eating or drinking anything other than water and last dose levothyroxine 24 hours before test
Do you always get same brand of levothyroxine
How much levothyroxine are you currently taking
Have you had thyroid antibodies tested to see if cause of your hypothyroidism is autoimmune thyroid disease also called Hashimoto’s
About 90% of primary hypothyroidism is autoimmune thyroid disease, so it’s likely
When were vitamin D, folate, ferritin and B12 last tested
What vitamin supplements are you currently taking
It was done at 9.30 am but I had had breakfast. Last dose was 24 hours before. Taking 75mcg Levo. Brand is Mercury pharmacy and the other is Accord. I started taking Ingennus Super B complex 2 weeks ago and I have also been taking super strength Vit D3 since January. I haven’t got Hashimotos. My Vitamin levels were tested last November and were in range but the B bits weren’t tested.
Were you taking B complex before blood test?
Important to stop all supplements that contain biotin a week before all blood tests as biotin can falsely affect test results
Please add November vitamin results and ranges
Obviously vitamins need retesting, including ferritin
Have you had BOTH TPO and TG thyroid antibodies tested for Hashimoto’s (NHS only tests TG antibodies if TPO antibodies are positive)
Significant minority of Hashimoto’s patients only have high TG antibodies
20% of Hashimoto's patients never have raised antibodies
Have you had ultrasound scan of thyroid. If not, request one
Cost £125 privately
healthunlocked.com/thyroidu...
Paul Robson on atrophied thyroid - especially if no TPO antibodies
paulrobinsonthyroid.com/cou...
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
NICE guidelines on full replacement dose
nice.org.uk/guidance/ng145/...
1.3.6
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.
Also here
cks.nice.org.uk/topics/hypo...
gp-update.co.uk/Latest-Upda...
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.
BMJ also clear on dose required
bestpractice.bmj.com/topics...
Guidelines are just that ....guidelines.
Some people need more .....some less
Hi There when we last spoke I didn’t know that I had Hashimotos because nobody had bothered to tell me! It was only when I asked my Specialist, as an afterthought really, that he confirmed I have. He then went onto say that he didn’t think the title was useful or relevant anymore because it was named after a POW Dr! He didn’t give me any advice at all. I’m on 75mcg of T4 and that’s it. I do supplement with Vit D and B Complex, both brands recommended on here. My Specialist has done 2 appeals for me to have T3, both turned down. Not available in my area at all. He did say that at just below1 my TSH was suppressed and he didn’t want to suppress it further anyway because that can cause bone and heart problems. Up until he said that I was going to medicate myself, but now I’m too scared to. My ferritin and every other vit, min, blood test all within range. I went gluten free a week ago as I have read that can help. A busy few days can leave me with a terrible headache and wiped out and I’m now getting really stressed as I don’t know when these attacks will happen. I know stress makes it worse. My Dr just wanted to give anti depressants. I can’t upload my test results as when I try to do that from my phone it never works on this site. But they are on an earlier message. I’m in the middle of a flare up and I don’t know what to do.
