Hi everyone last year just at the beginning of covid i had an accident and smashed my shoulder it's still not right at first didn't feel too bad but over the last 5 months i have felt rotten no energy, hair falling out, weight gain, got no eyebrows now,dry skin swollen with water retention and worst of all no motivation, shave spoken to GP 4 times but all he says is my last bloods were fine and it takes time to recover then he blames my age so have had bloods done with Blue Horizon here are results
TSH 6 would explain how you feel. Contact your Doctor and tell him about this result, if he doesn't feel he can accept a private blood test, then at the very least he should arrange an NHS blood test to check your TSH. if it is that high then you probably need a small dose increase .
make sure the test is early as possible in the morning and take that day's dose afterwards. (that should give highest TSH level, and lowest fT4.)
be firm ...." i have found that my TSH is now over range at 6, and i have symptoms of undermedication so i'd like to try an increased dose of 25mcg (or at least 12.5 mcg) to see if it improves my symptoms. I understand you may not be able to accept a private test result , but if that is the case, please run your own to confirm my current TSH level"
it's not reasonable to say "it was OK last time he looked" as you have given him a good reason for him to look again.
when he said 'your last blood were fine' do you know the actual TSH result ? 'fine' is a matter of opinion "
Ask him what you previous TSH actually was (and range)
Hopefully someone else can comment on the high AM cortisol. as i don't know much abut that ., except it's higher than it should normally be in the morning.
If GP has difficulty accepting your TSH should be kept lower than 6 .. point him to this article in 'GPonline' written by a specialist registrar in endocrinology , and a specialist registrar in cardiology in 2010
Sorry for late reply have not been at all well and we are moving house thank you for your reply have spoken to doctor and had new blood tests so will find out this week
Replacement therapy with levothyroxine should be initiated in all patients to achieve a TSH level of 0.5-2.0pmol/L.
New NHS England Liothyronine guidelines July 2019 clearly state on page 13 that TSH should be between 0.4-1.5 when OPTIMALLY treated with just Levothyroxine
Note that it says test should be in morning BEFORE taking levothyroxine
Dr Toft, past president of the British Thyroid Association and leading endocrinologist, states in Pulse Magazine,
"The appropriate dose of levothyroxine is that which restores euthyroidism and serum TSH to the lower part of the reference range - 0.2-0.5mU/l.
In this case, free thyroxine is likely to be in the upper part of its reference range or even slightly elevated – 18-22pmol/l.
Most patients will feel well in that circumstance.
But some need a higher dose of levothyroxine to suppress serum TSH and then the serum-free T4 concentration will be elevated at around 24-28pmol/l.
This 'exogenous subclinical hyperthyroidism' is not dangerous as long as serum T3 is unequivocally normal – that is, serum total around T3 1.7nmol/l (reference range 1.0-2.2nmol/l)."
(That’s Ft3 at 58% minimum through range)
You can obtain a copy of the articles from Thyroid UK email print it and highlight question 6 to show your doctor
Sorry for late reply have not been well and we are moving house as well i do take the same levothyroxine they have tried to change it but stuck to my guns i take a powder called Green Vibrance it has got all i need,i did the test at 7.am on empty stomach i spoke to my GP and he said to have another blood test will have results this week thank you for your reply
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).
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apologies not needed .x we know what it's like. ...really glad i'm not moving house .you have my sympathy . 
Newbie - latest blood results 
Latest thyroid blood results
Continued latest Blood Results
