I asked about tinnitus earlier this week because me sleep was so disrupted I was having trouble focussing. I had already done my medicheck blood test was convinced that it would be invalidated because I was so clumsy that morning I dropped the sample. I also forgot to stick in the identiciation card and had to open up the pouch and reseal it.
However, I was delighted to receive the reults (and not have wasted my money) I was correct though. GP would only offer TSH test.
Results
Ferrtin 95ug/L ( range 13-150)
Folate Serum 6.64ug/L (range >3.89)
Vit B12 -Active 101.0 pmol/L (range37.5-188)
Vit D 47.5 nmol/L (range 50-200)
TSH 2.5 mU/L (range 0.27 - 4.2)
Free T3 3.43 pmol/L (range 3.1 -6.8)
Free Thyroxine 13.8 pmol/L (12 -22)
I am on 75mg levo. Test take 8 am 26ish hours after last dose.
Worried that my TSH is going up despite being back on 75mg levo.
I try to stick strictly to gluten free diet, 8 months now. (Not sure how strict it is since gluten is airbourne and I live with three other adults that cook from scratch, including baking.)
Stopped B12 two weeks prior, but had changed onto spray supplement. So pplease with the increase.
Vit D is an issue because I was taking 2000iu daily(with K2) after my evening meal. I have ordered a spray Vit D with k2. I think the drop indicates a gut issue.
Is there anything else I can do to stop feeling rough?
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66olives
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Remember to stop taking any supplements that contain biotin a week before all blood tests as biotin can falsely affect test results
We never recommend multivitamins on here, vast majority contain iodine not recommended for anyone on levothyroxine unless iodine has been tested and found to be deficient
Multivitamins are usually cheap poorly absorbed ingredients
Replacement therapy with levothyroxine should be initiated in all patients to achieve a TSH level of 0.5-2.0pmol/L.
NHS England Liothyronine guidelines July 2019 clearly state on page 13 that TSH should be between 0.4-1.5 when OPTIMALLY treated with just Levothyroxine
Note that it says test should be in morning BEFORE taking levothyroxine
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 eventually 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.
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Never delay seeking advice or dialling emergency services because of something that you have read on HealthUnlocked.
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