Since I posted last time the Endocrinologist has changed my meds to 75 (Teva) for 5 days & 100(accord) Levothyroxine a week.My results are nowTSH 0.62 & T4 21.8I am, however ,feeling tired & my irregular heartbeat seems worse & having lots of
times ,especially at night - when I am sweating heavily.
I wasn’t sure what the following meant ,either on my previous blood test in July,
which stated Serum thyroglobulin 0.6ng/mL , Antithyroglobulin. 20.0iu/mL
& Thyroglobulin recovery 118%. Should any of these results be looked at again ?
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Etch43
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Teva contains mannitol as a filler, which seems to be possible cause of problems, as it changes gut flora .
Teva is the only brand that makes 75mcg tablet. So if avoiding Teva for 75mcg dose ask for 25mcg to add to 50mcg or just extra 50mcg tablets to cut in half
But for some people (usually if lactose intolerant, Teva is by far the best option)
Teva, or Aristo (100mcg only) are the only lactose free tablets
Most easily available (and often most easily tolerated) are Mercury Pharma or Accord
Mercury Pharma make 25mcg, 50mcg and 100mcg tablets
Accord is also boxed as Almus via Boots, and Northstar 50mcg and 100mcg via Lloyds ....but Accord doesn’t make 25mcg tablets
Physicians should: 1) alert patients that preparations may be switched at the pharmacy; 2) encourage patients to ask to remain on the same preparation at every pharmacy refill; and 3) make sure patients understand the need to have their TSH retested and the potential for dosing readjusted every time their LT4 preparation is switched (18).
TSH looks fine, I presume that T4 result is actally ‘FT4’ & is looking high (although you haven't provided the range). Having high in range FT4 isn't always benefical if it isn't being well utilised, and can end up counter productive. Do you have an FT3 result? This will allow you to see how well you are converting.
As thyroid cells are the only source of thyroglobulin (Tg), they serve as a biochemical marker of persistent or recurrent disease. However, TGAb’s can interfer with the test so to get a correct result, TG recovery is worked out using some equation.
You need FULL thyroid and vitamin testing 6-8 weeks after any dose change or brand change in levothyroxine
Just testing TSH and Ft4 is completely inadequate
What’s the range on antibodies results
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)
Is this how you do your tests?
Private tests are available as NHS currently rarely tests Ft3 or all relevant vitamins
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.
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