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150mcg may not be the correct amount of Levo for you. We need what we need. Dose by weight is just suggested as a starter dose, to be adjusted as necessary.
We can tell you if you are optimally medicated if you post your current test results, with reference ranges, and we can see if your dose needs adjusting:
TSH
FT4
FT3
Thyroid antibodies (will show if you have Hashi's)
And because low nutrient levels or deficiencies case symptoms similar to hypothyroidism you also need to test
Vit D
B12
Folate
Ferritin
These need to be at optimal levels for thyroid hormone to work properly.
Do you always get same brand levothyroxine at each prescription
If yes, which brand
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.
Previous post showed poor conversion
Improving low vitamin levels can help improve conversion…..and important to have optimal vitamin levels BEFORE considering adding T3 or NDT
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)
Low vitamin levels common as we get older too
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 and last dose levothyroxine 24 hours before test
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
To get a full picture of how you are, you need a full set of thyroid tests including tsh t4 and crucially T3. I like Medichecks and sometimes get the Advanced Thyroid set of tests - it is pricey especially when you add in £30 for the blood draw but it’s worth it to see what’s what and what you can improve or optimise. Take all tests first thing, 24 hours after last dose Levo and 7 days away from any vitamins containing biotin as that affects tests.
In addition to all the excellent advice you've already had - don't be taken in by the tyranny of "in range". Far too many GPs will stop treating you properly once you are "in range" but that isn't good enough (especially when all they've tested is TSH and, if you're lucky, free T4). You need all your results not only "in range"but "optimal"
For instance, the free T4 range might be 12 - 22. If your result is 12.5 you will feel horrible. If it's 19.5 you will feel much better, because we need our free T4 nice and high when on levo. But both are "in range" and so acceptable to a bored, lazy, uninterested GP x
You just might find the article below (and the full paper which you can access) interesting and/or useful.
The normal range: it is not normal and it is not a range
1. Martin Brunel Whyte
2. Philip Kelly
Abstract
The NHS ‘Choose Wisely’ campaign places greater emphasis on the clinician-patient dialogue. Patients are often in receipt of their laboratory data and want to know whether they are normal. But what is meant by normal? Comparator data, to a measured value, are colloquially known as the ‘normal range’. It is often assumed that a result outside this limit signals disease and a result within health. However, this range is correctly termed the ‘reference interval’. The clinical risk from a measured value is continuous, not binary. The reference interval provides a point of reference against which to interpret an individual’s results—rather than defining normality itself. This article discusses the theory of normality—and describes that it is relative and situational. The concept of normality being not an absolute state influenced the development of the reference interval. We conclude with suggestions to optimise the use and interpretation of the reference interval, thereby facilitating greater patient understanding.
When you say you need T4not only to be in range but optimal when on Levo, what about if you are not on Levo - is the bottom of the range adequate in order to feel OK?
No! If you are on T3 meds-only your free T4 will plummet but, if you are taking the right level of meds, this won't matter and free T3 will be high enough for you to feel well.
But not being on meds and having low in-range free T4 isn't good.
If you think you have an un-diagnosed thyroid issue:
In your case, I can see from your last post that your TSH is over-range and your free T4 is too low - so follow the great advice you got and hopefully your GP will DO something - good luck x
That's exactly the problem now. I asked for all my vitamins to be checked too but they said no not today. Gp only requested TSH T4
My recent TSH and T4 taken 24 hours after last dose (thanks for that tip Thyroid UK)
TSH 0.54 (range 0.30 -4.50)
T4 19.6 (range 10.0 -22.0)
I should feel better but i dont.
Im worse than ever.
Its down to diet now and being my own doctor.
Its obviously Hashimotos and I'll follow the advice for this from now on. Theres just so much out there its difficult finding the basis starting point.
Im having camera down next week so that may give me some answers too. Find out the state of my stomach. I think its all down to this awful condition.
Thanks for all the responses on here. So very very understanding.
Levothyroxine brand changes each time i collect even mixed brands for 100mcg and 25mcgIm sick of questioning this at pharmacy. Blame it on covid and cant get medications off the wagons gobbledegook! Yes really!
Im a nurse and we get them in hospital for patients!
I had this issue with my pharmacist who kept sending me different manufactures pills and telling me they are the same only to find out last manufacturer she sent actually had acacia in the inactive ingredients list (thanks to human beans searching skills) I would have never known. This stuff is poison and I felt like I was dying I couldn’t think straight, pulse would get super high and drop like a ton of bricks, body felt weak and blistering hives that have left permanent bruises on me… pure poison and should be banned.
I did get my issue fixed and sadly I had to turn into a 2 year old to make it happen.
If you go into Thyroid UK the charity who support this forum you will find a list of private companies who will process a full thyroid blood panel and even arrange for a nurse to do the venous blood draw for you. at your convenience.
This is where we all need to start off and it's essential that we have the antibodies, inflammation, and the TSH, T3 and T4 as well as ferritin, folate, B12 and vitamin D.
When with these results and ranges just start a new post with the results and ranges and you will be talked through anything that looks amiss.
Follow the instructions above on when, how and what to refrain from doing pre blood draw and this will be your next best step back to better health, you've waited long enough, now is your time to take back some control.
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