Hi everyone, I have just been privately tested for thyroid and would really appreciate some help. While all the results fall within the acceptable ranges they do appear to be on the low side. Could this be responsible for my extreme fatigue. I literally can't get out of bed some days and am desperate for some answers.
Thanks in advance
Mark
Hello MarkP777
Sorry you’re feeling so bad. And I see from your posts of 9 years ago that this isn’t new.
Are you still on thyroid medication? If so, what and how much?
Have you had thyroid antibodies tested?
What about things like Vit B12, Vit D, Ferritin, Folate?
Looking at previous posts…..how much levothyroxine are you currently taking
50mcg is only a STARTER dose
Dose levothyroxine should be increased slowly upwards in 25mcg steps until on, or near full replacement dose
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...
How much do you weigh in kilo
Likely to have very low vitamin levels having been left under medicated for so long
ESSENTIAL to test vitamin D, folate, ferritin and B12
Have you had thyroid antibodies tested?
Request/insist GP test vitamin levels and thyroid antibodies
On levothyroxine most people when adequately treated will have Ft4 at least 60-70% through range
Ft3 at least 50% through range
Being under medicated results in LOW stomach acid, this leads to poor nutrient absorption and low vitamins
Low vitamin levels tend to lower TSH
Which brand of levothyroxine are you currently taking
Do you always get same brand levothyroxine at each prescription
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
Bloods should be retested 6-8 weeks after each dose change or brand change in levothyroxine
For full Thyroid evaluation you need TSH, FT4 and FT3 plus both TPO and TG thyroid antibodies tested.
Very 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)
About 90% of primary hypothyroidism is autoimmune thyroid disease
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 .
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...
Medichecks Thyroid plus antibodies and vitamins
medichecks.com/products/adv...
Blue Horizon Thyroid Premium Gold includes antibodies, cortisol and vitamins by DIY fingerprick test
Levothyroxine does NOT top up failing thyroid
Due to feedback mechanism…….Levothyroxine replaces your own thyroid output
That’s why almost everyone will need to be on full replacement dose eventually
How much do you weigh in kilo
If GP won’t increase dose, you will need to go over their head and see recommended thyroid specialist
Roughly where in U.K. are you?
Can see from previous post 9 years ago you say you have Hashimoto’s
So essential to regularly retest vitamin D, folate, ferritin and B12
Have you had coeliac blood test done
Or are you already on strictly gluten free diet
If GP refuses to increase dose levothyroxine
Email Thyroid UK for list of recommend thyroid specialist endocrinologists...NHS and Private
tukadmin@thyroiduk.org
So are you still only on 50mcgs Levothyroxine
test results 
Latest test results 
Test results 
Blood test results 
Test results 
