Advice please

[Melpool2005]

I’ve had Hypo for five years now and started out on 50mg of Levo,, and over the years my medication has gone up and up .. as of yesterday I’m now on 200mg.. is this the maximum and what happens if it doesn’t work??

Thanks for any replies

[SeasideSusie Remembering]

Melpool2005

There is no set maximum dose, we need what we need to bring our FT4 and FT3 levels to wherever we need them to feel well.

What are your latest test results, can you please post them along with their reference ranges (ranges vary from lab to lab) so that we can get a picture of what is happening.

If you don't have your results, if you are in England your surgery may offer online access to them so you can check this out and register if it's available. If not then just ring and ask the receptionist (not the doctor) to arrange for you to have a print out of your results (don't accept verbal or hand written results) and say you'll pick it up at their convenience. In the UK we are legally entitled to our results without question or charge.

For a full picture we need to tet TSH, FT4 andFT3 although I doubt all will have been tested, so just post whatever you have.

We need optimal nutrient levels for thyroid hormone to work properly to testing key nutrients is important - Vit D, B12, folate and ferritin. See if these have been tested as well and post those results/ranges plus units of measurement for Vit D and B12. If they haven't been done ask if your surgery will do them, if not it would be a good idea to use one of our private labs, which many of us do.

Do you always take your Levo on an empty stomach, one hour before or two hours after food, with a glass of water only, no tea, coffee, milk, etc, and water only for an hour either side (otherwises absorption will be affected)? Do you take any other medication and supplements 2 hours away from Levo, some need 4 hours?

Do you do your test as always advised here:

* Blood draw no later than 9am. This is because TSH is highest early morning and lowers throughout the day. If looking for a diagnosis of hypothyroidism, an increase in dose of Levo or to avoid a reduction then we need the highest possible TSH

* Nothing to eat or drink except water before the blood draw. This is because eating can lower TSH and coffee can affect TSH.

* If taking thyroid hormone replacement, last dose of Levo should be 24 hours before blood draw, if taking NDT or T3 then last dose should be 8-12 hours before blood draw. Adjust timing the day before if necessary. This avoids measuring hormone levels at their peak after ingestion of hormone replacement. Take your thyroid meds after the blood draw. Taking your dose too close to the blood draw will give false high results, leaving any longer gap will give false low results.

* If you take Biotin or a B Complex containing Biotin (B7), leave this off for 7 days before any blood test. This is because if Biotin is used in the testing procedure it can give false results (most labs use biotin).

These are patient to patient tips which we don't discuss with phlebotomists or doctors.