So i have Hashimoto’s, was diagnosed at the start of the year. I am currently on 50mcg of levothyroxine, however i still have issues such as joint pain, fatigue and freezing cold hands that turn blue/white and skin rashes. Also heavy hair loss so now embracing wig life 😅😋Now I don’t want to attribute every little bump or bruise, to my thyroid condition. However surely I should feel better on medication? Should I ask for an increase in my levothyroxine? I was thinking my body might not be great at converting t4 to t3 as my t3 is maybe a tad low🤷♀️ Also my doctor ran an ANA panel? and it was positive, not sure if that’s related to thyroid issues or not.
Any help appreciated thanks 😊
Here are my ranges:
TSH 2.5 (0.35-5)
T4 10 (9-21)
T3 1.2 (3.1-6.8)
B12 800 (200-883)
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Was test done as early as possible in morning before eating or drinking anything apart from water and last dose Levothyroxine 24 hours before test?
When adequately treated Ft4 should be in top 1/4 of range - around 18-20
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 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).
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.
Thank you for the reply, thanks for all the info. On my last blood test my ferritin was in normal range (according to my doctor) However I did have a b12 deficiency but I supplemented with 10,000 mcg sublingually. Now my b12 is 800 so it came up quite nicely. Oh and yes I tested high for both tpo and tgab antibodies.
Yeah you’re right, it is pretty low. However I’m not sure if my doctor thinks there’s something else going on, because of the Ana positive antibodies. So I’m not sure if my thyroid is 100% to blame for me feeling lousy. However I will definitely get on to my doctor about a dose increase.
Sure to be! Hope you get a dose increase ASAP. Ideally TSH between 0.2 and 0.5 and free T3 and free t4 in the top third of their ranges and that’s according to DrToft the eminent endocrinologist. Thyroid U.K. admin have a copy of his reply qn 6 in Pulse magazine where he states this. You could get a copy to show your GP, he might learn something! Toft is surgeon to the Queen when she’s in Scotland so highly regarded.
Great! Thanks for the info, I’ll be sure to check it out. Yes got a phone consultation however it’s not for a week yet, I will just ride it out till I can speak to my gp🤷🏼♀️
Eek have you seen your t4 and T3 levels..? Yes you need an increase. And likely another and another if they give you25mcg each time. I’d be stressing your symptoms and asking for a decent increase perhaps at 1.6mcg x you body weight in kilos as per NICE guidelines. You must be poorly with those levels.
Thanks for the reply, yeah they are quite low, I’ll definitely get onto my gp about a dosage increase. Yeah I feel fairly rough, i guess it must be because of my low thyroid hormones.
As everyone has said your thyroid results are appalling don’t be diverted by something else. Your Gp is not thyroid educated once on meds most feel best with TSH of 1 or below and T3 and T4 well into top quarter of range. You are seriously under medicated. I had T3 of 1.3 and high T4 I have a conversion issue. You may be fine if only you had enough T4 to convert. You need a different Gp or educate this one.
Yeah they are not great, i don’t know why my gp didn’t mention that my t4 and t3 were very low, she looked over the results with me🤷♀️ In hindsight I should have questioned the numbers😐 oh right I thought I had a conversion issue, but you might be right in that I don’t have enough t4 to convert anyway😅 definitely be getting onto my gp about a dose increase.
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