Tsh 7 waiting for levo dose increase to work anyone feel very bad morning and better as day goes on

[Katy14]

Tsh 7 waiting for levo dose increase to work anyone feel very bad morning and better as day goes on. On week 4 of increase still fatigue anxiety ?

Thanks kate

[tattybogle]

You do need to give it longer than 4 weeks , i find 8 is more reasonable to get a true idea of how a new dose will actually feel. Having said that . since your TSH was still at 7 and dose was only increased form 75 to 75/100 alternate.... i strongly suspect that the 12.5mcg increase might not be enough anyway.

So if you don't feel much different at 6 weeks i'd be going and asking for repeat blood asap with a view to getting another increase.

[Katy14 in reply to tattybogle]

Thank you think maybe the lower dose increase is my age 71

Regards kate

[tattybogle in reply to Katy14]

might explain their caution , yes they seen to think either a)you'll explode or b)it's not worth bothering treating hypothyroidism properly in 'old' people . and yes, there is reason to increase dose gradually in some people who might struggle to cope with a large increase all at once, regardless of age.

However TSH of 7 has nothing at all to do with being 71, and everything to do with hypothyroidism.

healthunlocked.com/thyroidu... tsh-levels-in-healthy-people-with-no-known-thyroid-disease

as this graph and the table below it show;

TSH does rise in age .. but only by a very little bit .. it's not expected to go anywhere near 7 even if you're ancient, and the risks of bone and heart issues associated with TSH over 4 are a consideration too. They are constantly trying to frighten us about risks of TSH below 0.04 , but the risks for TSH over 4 are (mostly) greater then those of TSH below 0.04

academic.oup.com/jcem/artic... Serum Thyroid-Stimulating Hormone Concentration and Morbidity from Cardiovascular Disease and Fractures in Patients on Long-Term Thyroxine Therapy

"Design: We conducted an observational cohort study, using data linkage from regional datasets between 1993 and 2001.

Setting: A population-based study of all patients in Tayside, Scotland, was performed.

Patients: All patients taking T4 replacement therapy (n = 17,684) were included.

Main Outcome Measures: Fatal and nonfatal endpoints were considered for cardiovascular disease, dysrhythmias, and fractures. Patients were categorized as having a suppressed TSH (≤0.03 mU/liter), low TSH (0.04–0.4 mU/liter), normal TSH (0.4–4.0 mU/liter), or raised TSH (>4.0 mU/liter).

Results: Cardiovascular disease, dysrhythmias, and fractures were increased in patients with a high TSH: adjusted hazards ratio, 1.95 (1.73–2.21), 1.80 (1.33–2.44), and 1.83 (1.41–2.37), respectively; and patients with a suppressed TSH: 1.37 (1.17–1.60), 1.6 (1.10–2.33), and 2.02 (1.55–2.62), respectively, when compared to patients with a TSH in the laboratory reference range. Patients with a low TSH did not have an increased risk of any of these outcomes [hazards ratio: 1.1 (0.99–1.123), 1.13 (0.88–1.47), and 1.13 (0.92–1.39), respectively].

Conclusions: Patients with a high or suppressed TSH had an increased risk of cardiovascular disease, dysrhythmias, and fractures, but patients with a low but unsuppressed TSH did not. It may be safe for patients treated with T4 to have a low but not suppressed serum TSH concentration."

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Also this;

healthunlocked.com/thyroidu.... gps-told-keep-tsh-0.5-2pmol-l-hypothyroidism-causes-raised-cholesterol-thyroid-disease-effects-on-heart-and-cardiovascular-system.

[Katy14 in reply to tattybogle]

Thank you lots of info there

[tattybogle in reply to Katy14]

realised after i'd written it that this info may not help with the anxiety . sorry x... don't worry, they are all 'long term' risks.. just wanted to make sure you don' get fobbed off about a further increase if you need it, and get re tested after 6 week's rather than getting left for months and months on this dose.

[Buddy195 Administrator]

Hi Katy14, it took ages for my anxiety to lessen and I only really started to feel ‘well’ and ‘like the old me’ when TSH was significantly below 1. I react badly to large increases in Levo (palpitations/ tremor etc) so have had to do this very slowly in x 12.5mcg. Are your key vitamins (ferritin/ folate/ B12 and Vit D) optimal? Getting these higher in range, in addition to being gluten free really helped. I also followed forum advice to supplement with magnesium, which does help me relax. Best wishes to you.

[Katy14 in reply to Buddy195]

Thank you what type of magnesium do you recommend ?

[Buddy195 Administrator in reply to Katy14]

There are lots to choose from, but I take magnesium glycinate as I find this is most gentle on the stomach. I take it early evening as it helps me relax/ sleep.

[Doris11]

Hi, Katy14 I'm on 75mcgs of Thyroxine (diagnosed march 2021) and I'm awful in the mornings! I sometimes go back to bed (retired nurse) but feel better later in the evenings! give yourself some time 4-6 weeks is about time then make an appointment with your GP for a discussion and blood tests as your TSH is high at moment.. but hopefully will reduce. Mines been 5 months and seeing GP tomorrow still got lots of symptoms on 75mcgs of Thyroxine.

[Katy14 in reply to Doris11]

Thank you think I been undermedicated for a while tsh been 4.1 last 18 months then this one 7 hope feel better soon Kate x