New to all of this

[kathy100]

Hi - I would appreciate some help here as I have just had some blood tests for hypothyroid among other things and the Dr who called me said initially that the blood tests did not indicate thyroid problems. I had previously had a blood test wherein the thyroid levels were higher but not a cause for concern. I explained how I felt and she called me back and said I should take 25mg of levothyroxine and have another blood test in 3 months. I have since aqcuired the test results and the vitamin levels are ok, vitamin d is borderline low, tsh is 5.83 miu/l and t4 is normal at 14.8 pmol/l There dont appear to be any other relevant results. The whole procedure has left me feeling unsure whether I should start on these levothyroxine tablets at this stage or do something else. My blood pressure is currently too high if thats connected in any way. Any help or advice would be much appreciated.

[greygoose]

Hi Kathy100, welcome to the forum.

I had previously had a blood test wherein the thyroid levels were higher but not a cause for concern.

Do you, by any chance, have the results of those thyroid tests? If you've had two consecutive tests, three or four months apart, with a TSH over-range like that, then you are hypo, no doubt about it.

A 'normal' (euthyroid) TSH is around 1, never over 2, and at 3 you are technically hypo. NHS doctors will not diagnose you at that point, but when the TSH is over five, the more enlightened ones will. The others like it to go over 10!

I cannot comment on your FT4 because you haven't put the range, but it looks like it could be low. Ranges vary from lab to lab so we always need to know what labs went with your results.

Forget the word 'normal'. It doesn't mean much in a thyroid context. Someone who has no thyroid problems is called euthyroid, and a euthyroid FT4 is around mid-range. But, when a doctor says 'normal', all s/he means is that it falls somewhere within the range. But, what is important is where it falls. Too low is too low, even if it is inside the range.

the vitamin levels are ok, vitamin d is borderline low

If I were you, I would not take your doctor's - or any doctor's - word for that. First of all, they have no training in nutrition, so they're just guessing. Secondly, we don't want 'ok' we want optimal. So, if I were you, I would post the results and ranges on here, and let those that really know about nutrients advise you what is good and what needs supplementing.

The whole procedure has left me feeling unsure whether I should start on these levothyroxine tablets at this stage

Yes, it can be confusing. But, with a TSH of over 5, you really are hypo and do need thyroid hormone replacement (levo). What worries me is the dose. A normal starter dose is 50 mcg, unless you are over 60. I see that you are 63, but even so, starting on such a low dose may possibly make you feel worse, rather than better. If that happens, please don't think that it means you shouldn't be taking them. It just means that the dose is too low for you. And, waiting 3 months for a restest is far too long on such a small dose. It should be 6 to 8 weeks. So, see if you can get retested sooner.

When you go for your retest, make sure that your blood draw is early in the morning - before 9 am - fast over night and leave a 24 hour gap between your last dose of levo and the blood draw.

[kathy100]

Thank you for taking the trouble to reply. I do not have those results but they did say that they were considerably higher than these. With regard to the T4 it is 14.8 pmo/l in a range of 10-20, vitamin d is 81 nmo/l in range of 76-250, eGFRcreat is 67 in range of 90-120mL/min but I have no idea what that means (apparantly thats not a problem) ferritin 168 ugl in range of 30-250, b12 362 ng/l 200-900 range, folate 6.5 ug/l 2-17 range. Hopefully that is all the information you need. I didnt realise the ranges were different. Best to all 😀

[shaws Administrator in reply to kathy100]

Alwaus request a print-out of your results and the ranges for your own records and post if you have any queries.

The aim is a TSH of 1 or lower with both Free T4 and Free T3 in the upper part of the ranges. Unfortunately few GPs seem to know this fact.

Also ranges can vary from lab to lab so that's why it is important to state the ranges too.

[SlowDragon Administrator]

TSH is over 5 and Ft4 near bottom of range

Have you had thyroid antibodies tested, folate, ferritin and B12?

As this is second test with TSH over 5 …you have “sub-clinical” hypothyroidism

Do you have hypothyroid symptoms?

If yes recommended to start on levothyroxine

gp-update.co.uk/Latest-Upda...

Approx how old are you

Standard starter dose of levothyroxine is 50mcg (unless over 65 or heart condition)

Bloods should be retested 6-8 weeks after each dose change or brand change in levothyroxine

Always test as early as possible in morning before eating or drinking anything other than water and last dose levothyroxine 24 hours before test

The aim of levothyroxine is to increase slowly upwards in 25mcg steps until TSH is ALWAYS under 2

Vitamin D

How low is vitamin D

Have you been prescribed vitamin D supplements