Hello from Seattle WA USA - It's always something new and I keep adapting. Just notified of high TSH level from blood test. Thought It was just age as I was achy and tired all the time even though I take HRT injection weekly and survived another double PE after dealing with Afib for years. Now on anticoagulants for life time even as I am a muscular and look 10+ years younger than I am thankfully. :^) Still exercising with weights and bicycling. I feel like I am dancing as fast as I can but this year alone this diagnosed with asymptomatic brain tumor and now this hormone thyroid deficiency is taking it's toll on me. Hoping this low dose of Levothyroxin .25 does what it needs to seamlessly. Anxiety building but keeping my "Adapt, Improvise and Overcome" mentality intact just now. Staying "Present" as much as possible.
new here but not new on HealthUnlocked - Thyroid UK
new here but not new on HealthUnlocked
Welcome to the forum
25mcg is only half the standard starter dose levothyroxine….but perhaps your doctor is being cautious in light of Afib etc
Bloods should be retested 6-8 weeks after each dose change or brand change in levothyroxine
The aim is to increase levothyroxine dose SLOWLY upwards, until TSH is always under 2
Always take levothyroxine on empty stomach and then nothing apart from water for at least an hour after
No other medications or supplements within 2 hours. Some like iron, magnesium, vitamin D, HRT not within 4 hours
Most important results are always Ft3 followed by Ft4
Always test thyroid as early as possible in morning before eating or drinking anything other than water and last dose levothyroxine 24 hours before test
Important to regularly retest vitamin D, folate, ferritin and B12. On levothyroxine we need optimal vitamin levels
How high was TSH
Were Ft4 and Ft3 tested, or thyroid antibodies
Please add results and ranges if you have them ….vitamin results too
TSH level is 4.8. From afib dr. I am already taking 50.mcg of Vit D and 400 Of Magnesium daily.
TSH 4.8 before starting on levothyroxine…….or after 6-8 weeks on 25mcg levothyroxine?
If before starting, then you need to retest after 6-8 weeks
Always test as early as possible in morning before eating or drinking anything other than water and last dose levothyroxine 24 hours before test
50mcg vitamin D is 2000iu daily
It might be high enough dose…..but it might not
Vitamin D should be tested twice year when supplementing
this year alone this diagnosed with asymptomatic brain tumor and now this hormone thyroid deficiency
Where is the brain tumour? If it's on your pituitary, it could be the cause of your hypothyroidism.
dealing with Afib for years
And your Afib could be caused by your low thyroid hormones.
Still exercising with weights and bicycling.
Be careful not to over-do it. If you find that it takes you longer and longer to recover from exercise, then you will know that you're over-exercising, and that that is making you more hypo. Escpecially on such a tiny dose of levo, which will probably be enough to stop your thyroid from making what little hormone it can, but not enough to replace it.
Make sure you get retested six weeks after starting levo. And, make sure to get an early appointment for the blood draw - before 9 am. And, leave a 24 hour gap between your last dose of levo and the blood draw.
Thanks for the input. If the AF is still present I am not feeling it much any longer since the Abalation. It is an anterial cranial Fossa - a walnut sitting between my eye sockets. On wait and watch right now with yearly MRI. Hoping to die with it and not from it! Even with afib and suffering multiple Pulmanary embolisms and now these at being over 65 the doctors all say biologically I appear to be in my 50's as I am still muscular from working out all these years. Poster boy for the old guys now!! That and keeping a younger girlfriend!! Laugh or cry 0- I would rather continue to laugh.. I have even outlived my Geriatric pride of 3 old cats I dearly loved.
TSH was 4.8. What is T3 - T4?
That TSH is saying that you're still hypo. A euthyroid (normal) TSH is around 1, never over 2, and you're hypo when it gets to 3. So, you need an increase in dose to 50 mcg.
T3 and T4 are the thyroid hormones. TSH is a pituitary hormone.
T4 is basically a storage hormone, and doesn't do much until it is converted to the active hormone, T3.
T3 is the active thyroid hormone needed by every single cell in your body to function correctly.
T3 is what causes symptoms when it is too high or too low.
So, your doctor should be testing your Free T4 and Free T3 every time he does a blood test. And not just the TSH.
TSH is produced by the pituitary when it senses that there is not enough thyroid hormone in the blood. Thyroid Stimulating Hormone, it stimulates the thyroid to make more hormone.
When the thyroid complies and raises the level of T4 and T3, the pituitary makes less hormone.
When the thyroid, for whatever reason, cannot comply, the TSH rises higher and higher.
Judging by the level of your TSH your T4 and T3 are going to be too low for good health. That is the definition of hypothyroidism. Hypothyroidism - and also hyperthyroidism - are not defined by the TSH level, despite what doctors think. It is the T4 and T3 levels that are the most important, and you cannot tell what they are just by looking at the TSH.
Your pituitary (hypophysis) is a pea-sized endocrine gland at the base of your brain, behind the bridge of your nose and directly below your hypothalamus. It sits in an indent in the sphenoid bone called the sella turcica. The pituitary gland is one of eight interrelated major endocrine glands:
my.clevelandclinic.org/heal....
So, I'm no expert, but judging by the position of your tumour, it could be pressing on your pituitary or your hypothalamus, and that would affect the output of TSH.
When TSH production is affected, the thyroid will not make enough thyroid hormone because it isn't being stimulated enough. So, the T4 and T3 could be much lower than the TSH is suggesting. And, they will keep getting lower as time goes on whilst TSH stays as it is, or drops even further. So, it is very important that your doctors tests them.
Wow, alot of digest there to get my head around. I looked again at my blood test and the T4 is 1.21 where norms are .82 - 1.77. SO that seems to within margin. No mention of T3. I have read the Cleveland clinic web jump you included and you could be right. Thus far I have been asymptomatic. I have messaged my doctor with questions for MRI upcoming. Thank you so much for so much info.
That T4 may be within the range, but that doesn't make it high enough to make you well. In fact, it's only 41.05%. Euthyroid would be around 50%, so it's too low. And if the FT4 is low, the FT3 will be even lower, as indicated by your high TSH.
I just started the Levothroxin 4 days ago. Dr says I should be feeling different in 2 weeks. Hope so.
Well, when he said 'different', you don't know if he meant better or worse! lol On such a low dose, it's doubtful you will feel much better. Doctors have very little understanding of thyroid. They have their pet theories, but as - for the most part - they have never experienced it for themselves, they are totally unrealistic in their expectations. I was told the same thing, but it took me a lot longer than two weeks to feel any benefit!
Be interested to see what your t4 T3 and tsh are. Afib often due to under medication and your dose is minimal.
Posted above, TSH was 4.8. T4 is 1.21.
So you’re under medicated. I’d be aiming to get my tsh under 1 and T3 and t4 high in ranges.
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