Levels within range, still feeling awful! Being impatient??

[Amyhh39]

Hi all, I was diagnosed with UAT 9 weeks ago and my tsh was 67 at diagnosis. Been on 75mg of thyroxine and now my levels are all within normal ranges for tsh, t3 and t4. I'm feeling so weak, lethargic and literally like an old woman... Will this get better? I feel really miserable and worried this is how I'm going to feel forever now...

[knitwitty]

Hi Amy welcome to the forum.Do you have the actual results of your recent blood tests, being in range doesn't mean anything you might be only just in range which might be completely inadequate for you.

Also sometimes it can take a while for us to feel well after we have had an under active thyroid problem for some time.

Could you post all your blood test results ( ideally TSH, free T4 , free T3, folate , ferritin, vitamin D3 and vitamin B12 also an y antibody results they might be TPO and Tg )

Lots of people will come along to help you when we can see your results.

[Amyhh39 in reply to knitwitty]

Hiya thanks for replying! My results are tsh 4.5, t3 was 4.3 and t4 18... didn't get any other results as this was just given to me over the phone

[FancyPants54 in reply to Amyhh39]

OK, tomorrow ring the receptionist and ask for the results of your test (including the ref ranges) to be emailed to you. They are obliged to do it these days. I always get them emailed. No chance of a mistake and you know the ranges, without which not much can be said.

However, unless the range of that lab is way different to most, you are barely inside the upper band, ie you are still hypo. Most of us on medication need our TSH to be 1 or below.

[SeasideSusie Remembering]

Amyhh39

As knitwitty says, we need to see your results, with their reference ranges (these vary from lab to lab).

You wont be optimally medicated yet, it's only been 9 weeks since you started Levo and things move very slowly. It can take months for you to feel properly well.

We should be retested 6 weeks after starting Levo, increase dose, retest 6-8 weeks later, increase dose, retest again 6-8 weeks later, repeat until levels are where they need to be for you to feel well. You can't hurry this, it just takes time.

The aim of a treated Hypo patient on Levo only, generally, is for TSH to be 1 or lower with FT4 and FT3 in the upper part of their reference ranges, if that is where you feel well.

Optimal nutrient levels are important for thyroid hormone to work properly so all the tests that knitwitty has mentioned should be done, post results and ranges here for comment. If GP wont test then consider doing them privately.

[Amyhh39 in reply to SeasideSusie]

Thanks this is really helpful, my gp is lovely but very much "you have uat, here's your medication, see you in 3 months' there's no explanations of the results or anything more really hence why I'm trying to get support here

[shaws Administrator in reply to Amyhh39]

Many members on this forum seem to be far more educated in dysfunctional thyroid glands than some of the medical professionals.

In my case no doctor could diagnose me and if you click on my name it takes you to my hstory to finally be diagnosed.

In a few months, following the advice given, you should feel so much better and at the same time be able to bring our GP up-to-date on how to restore hypothyroid patients to good health and symptom-free.

[SlowDragon Administrator]

Was test done as early as possible in morning before eating or drinking anything other than water and last dose levothyroxine 24 hours before test

Which brand of levothyroxine are you currently taking

What vitamin supplements are you currently taking

Essential to test vitamin D, folate, ferritin and B12

Have you had thyroid antibodies tested

About 90% of primary hypothyroidism is autoimmune thyroid disease also called Hashimoto’s diagnosed by high thyroid antibodies

[Amyhh39 in reply to SlowDragon]

Wow lol I've not been made aware of any results other than the above... I'm not taking any vitamins or additional meds... my.bloods were done at 10am and doctor didn't tell me I should eat or drink or not take my levo

[SlowDragon Administrator in reply to Amyhh39]

Because most GP’s are unaware of relevance TSH is highest early morning

Aim of levothyroxine is to increase the dose slowly upwards in 25mcg steps until TSH is ALWAYS under 2

Most people when adequately treated will have TSH around or under one

Ft4 is false high if you took levothyroxine in morning before test

Aiming for Ft3 at least 50-60% through range minimum

Ft4 is usually slightly higher

Important to have good vitamin levels

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 with autoimmune thyroid disease (Hashimoto’s or Ord’s thyroiditis)

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)

Private tests are available as NHS currently rarely tests Ft3 or all relevant vitamins

List of private testing options

thyroiduk.org/getting-a-dia...

If you can get GP to test vitamins and antibodies then cheapest option for just TSH, FT4 and FT3

£29 (via NHS private service ) and 10% off down to £26.10 if go on thyroid uk for code

thyroiduk.org/getting-a-dia...

monitormyhealth.org.uk/

NHS easy postal kit vitamin D test £29 via

vitamindtest.org.uk

Medichecks Thyroid plus antibodies and vitamins

medichecks.com/products/adv...

Blue Horizon Thyroid Premium Gold includes antibodies, cortisol and vitamins by DIY fingerprick test

bluehorizonbloodtests.co.uk...

Thriva Thyroid plus antibodies and vitamins By DIY fingerpick test

thriva.co/tests/thyroid-test

Thriva also offer just vitamin testing

If TPO or TG thyroid antibodies are high this is usually due to Hashimoto’s (commonly known in UK as autoimmune thyroid disease).

About 90% of all primary hypothyroidism in Uk is due to Hashimoto’s. Low vitamin levels are particularly common with Hashimoto’s. Gluten intolerance is often a hidden issue to.

Link about thyroid blood tests

thyroiduk.org/getting-a-dia...

Link about Hashimoto’s

thyroiduk.org/hypothyroid-b...

List of hypothyroid symptoms

thyroiduk.org/if-you-are-un...

[SlowDragon Administrator in reply to Amyhh39]

With TSH over 2 you need next 25mcg dose increase in levothyroxine

Which brand of levothyroxine are you currently taking

Is it Teva?

Teva brand upsets many people …..but is lactose free. Are you lactose intolerant?

Perhaps trying Accord or Mercury Pharma brand when dose is increased to 100mcg

[SlowDragon Administrator]

TSH should be under 2 as an absolute maximum when on levothyroxine

gponline.com/endocrinology-...

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

Also to test vitamin D, folate, B12 and ferritin

sps.nhs.uk/wp-content/uploa...

[JAmanda]

The idea is to dose Levo till symptoms are alleviated but t4 and T3 remain in range - sounds like you need a dose increase. But it can take months to feel better I think